- Trouble passing bowel movements (BMs): straining, hard stools, or rectal pressure
- BMs are not regular
- Normal bowel movement (BM) frequency varies from 3 times a day to 3 times a week.
- Trouble or pain passing a BM or infrequent BMs may mean a person has constipation.
- Passage of a large BM is not constipation. The amount of food a person eats determines the BM size. The more a person eats, the larger the BM.
- The passage of small, dry, rabbit-pellet-like stools is not constipation. This is from a lack of fluids.
- Healthy living and eating habits can help prevent and treat constipation.
- Not enough fiber in diet: This makes BMs hard and more difficult to pass. Fiber will help hold more water in the stools. Good sources of fiber are fresh fruits and vegetables, beans, and bran. A person can also take fiber supplements (like Metamucil).
- Not enough liquids: This causes stools to be dry and harder to pass. Adults should drink 6-8 glasses of water a day.
- Lack of exercise: This decreases bowel function. Exercise helps keeps the bowels regular. People who have to stay in bed are more likely to be constipated. They may get fecal impaction.
- Holding in BMs: Some people ignore their body's signals for having a BM. This can lead to problems with constipation.
- Recent travel: Travel can cause constipation. It gets in the way of normal diet and BM cycle.
- Eat a high fiber diet. Drink plenty of liquids.
- Exercise regularly (even a daily 15 minute walk!).
- Get into a rhythm. Try to have a bowel movement (BM) at the same time each day. Don't ignore the body's signals to have a BM.
- Avoid enemas and laxatives.
When to call your doctor
Call Your Doctor Now (night or day) If
- You feel weak or very sick
- Vomiting bile (green color)
- Vomiting and stomach looks more swollen than normal
- Severe rectal pain that does not go away after a Sitz bath or suppository
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think you need to be seen
- Stomach pain comes and goes and have a fever
- Stomach is more swollen than normal
- Last bowel movement (BM) was more than 3 days ago
- Leaking stool
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Weight loss greater than 10 pounds (5 kg) and not dieting
- Minor bleeding from rectum happens often
- Cannot have a BM without using a laxative, suppository, or enema
- Taking new prescription drugs
- Constipation happens often (less than 3 BMs per week or straining more than 25% of the time)
Self Care at Home If
- Mild constipation
CARE ADVICE FOR MILD CONSTIPATION
- What You Should Know:
- Trouble passing a BM or infrequent BMs are signs of constipation.
- Healthy living habits can help you with your mild constipation.
- You can treat mild constipation at home.
- Here is some care advice that should help.
- High Fiber Diet: This will help soften your BMs. The fiber works by holding more water in your stools.
- Try to eat fresh fruit and vegetables. These include peas, prunes, citrus, apples, beans, and corn.
- Eat more foods made from whole grains. These include bran flakes, bran muffins, graham crackers, oatmeal, brown rice, and whole wheat bread. Popcorn is also a source of fiber.
- Liquids: Liquid intake is needed to keep your BMs soft.
- Drink 6-8 glasses of water a day. Be aware that certain medical conditions require fluid restriction.
- Prune juice is a natural laxative.
- Avoid alcohol.
- Get Into a Rhythm:
- Try to have a BM at the same time each day. The best time is about 30-60 minutes after breakfast or other meal.
- Don't ignore your body's signals to have a BM.
- Bulk Laxatives:
- Metamucil (psyllium fiber): One teaspoon (5 cc) in a glass of water 2 times a day.
- Bulk-forming agents work like fiber to help soften the stools. They also help to keep your intestines working well. Long-term use of this type of laxative is most often safe.
- Side effects: You may have mild gas or a bloating feeling.
- Read all package instructions.
- Osmotic Laxatives:
- Miralax (polyethylene glycol 3350): This is an "osmotic" agent. It causes water to stay in the stool. You can use this laxative to treat occasional constipation. Do not use it for more than 2 weeks without talking to your doctor. Miralax will help you have a BM in 1-3 days. It may cause you to have diarrhea. If you are pregnant, talk to your doctor before using this drug. Miralax is sold in the United States.
- Milk of Magnesia (magnesium hydroxide): This is a mild and safe laxative. You can use Milk of Magnesia for short-term treatment of constipation. (Research suggests that Miralax may be more effective.) You should take 2 tablespoons (30 ml). Do not use it if you have kidney disease.
- Read all package instructions.
- Sitz Bath for Rectal Pain:
- Take a 20 minute bath in warm water (2 oz. baking soda per tub). This is also called a Sitz bath.
- A Sitz Bath may help you have a BM.
- If the Sitz bath does not work, try 1 or 2 glycerin rectal suppositories. You can get these over-the-counter.
- Enemas: Should be used rarely and only after other measures have not worked.
- Call Your Doctor If:
- Constipation lasts more than 2 weeks after using Care Advice
- You get worse
Author: David A. Thompson, M.D.
Last reviewed: 9/1/2012
Last revised: 6/11/2013 11:50:10 AM