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Constipation
Constipation is a symptom,
not a disease. It is defined as having fewer bowel movements than
usual, with a long or hard passing of stools.
Older people are
more likely than younger people to have constipation. But experts
agree that older people often worry too much about having a
bowel movement every day. There is no right number of daily
or weekly bowel movements. “Regularity” may mean bowel movements
twice a day for some people or just twice a week for others.
Questions to
Ask
Some doctors suggest asking these questions to decide if you
are really constipated.
- Do you often have
fewer than three bowel movements each week?
- Do you often have
a hard time passing stools?
- Is there pain?
- Are there other
problems such as bleeding?
If the answers are yes,
you probably do have a problem. Otherwise, you probably do not.
What Causes Constipation?
Doctors do not always know what causes this problem. Eating
a poor diet, drinking too little, or misusing laxatives can
be causes. Some medicines can lead to constipation. These include
some antidepressants, antacids containing aluminum or calcium,
antihistamines, diuretics, and antiparkinsonism drugs.
The role of diet.
People may become constipation if they start eating fewer vegetables,
fruits, and whole grains. These foods are all high in fiber,
and, according to some studies, high fiber diets can help prevent
constipation. Eating more high fat meats, dairy products, and
eggs can be another cause of constipation. So can eating more
rich desserts and other sweets high in refined sugars.
People who live
alone may lose interest in cooking and eating. As a result they
start using a lot of convenience foods. These tend to be low
in fiber, so they may help cause constipation. In addition,
bad teeth may cause older people to choose soft, processed foods
that contain little, if any, fiber.
People sometimes
do not drink enough fluids, especially if they are not eating
regular meals. Water and other liquids add bulk to stools, making
bowel movements easier.
Misuse of laxatives
and enemas. Many people think of laxatives as the cure for
constipation. But heavy use of laxatives is usually not necessary
and often can be habit forming. The body begins to rely on the
laxatives to bring on bowel movements and, over time, forgets
how to work on its own. For the same reason, if you use enemas
often you may lose normal bowel function. Another side effect
of heavy laxative use is diarrhea.
Overuse of mineral
oil-a popular laxative-may reduce the body’s ability to use
vitamins (A, D, E, and K). Mineral oil may also interact with
drugs that prevent blood clots (anticoagulants), causing undesired
side effects.
Other causes
of constipation. Lack of exercise or lengthy bedrest, such
as after an accident or illness, may cause constipation. For
people who stay in bed and who suffer from chronic constipation,
medications may be the best solution. But simply being more
active, when possible, is best.
If people ignore
the natural urge to have a bowel movement, they may become constipated.
Some people prefer to have their bowel movements only at home,
but holding a bowel movement can cause ill effects if the delay
is too long.
In some people,
constipation may be caused by abnormalities or a blockage of
the intestines. These disorders may affect the muscles or nerves
responsible for normal bowel movements. A doctor can perform
a series of tests to see if a problem like this is the cause
of constipation. If so, the problem can often be treated.
Treatment
If you become constipated, first see the doctor to rule out
a more serious problem. If the results show that there is no
disease or blockage, and if your doctor approves, try these
remedies:
- Eat more fresh
fruits and vegetables, either cooked or raw, and more whole
grain cereals and breads. Dried fruit such as apricots, prunes,
and figs are especially high in fiber.
- Drink plenty
of liquids (1 to 2 quarts daily), unless you have heart, blood
vessel, or kidney problems. But be aware that some people
become constipated from drinking large amounts of milk.
- Some doctors
recommend adding small amounts of unprocessed bran (“miller’s
bran”) to baked goods, cereals, and fruit. Some people suffer
from bloating and gas for several weeks after adding bran
to their diets. Make diet changes slowly, to allow the digestive
system to adapt. Remember, if your diet is well balanced and
contains a variety of foods high in natural fiber, it may
not be necessary to add bran to other foods.
- Stay active.
Do not expect to
have a bowel movement every day or even every other day. “Regularity”
differs from person to person. If your bowel movements are usually
painless and occur regularly (whether two times a day or three
times a week), then you are probably not constipated.
Resources
More information about constipation is available from the National
Digestive Diseases Information Clearinghouse, Box NDDIC, Bethesda,
MD 20892, (301) 654-3810.
For more information
about health and aging, call or write:
The National
Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225
1-800-222-4225 (TTY)
National Institute
on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes of Health
1994
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