Constipation Overview

Constipation causes difficulty in expelling out stool via normal muscle contractions. Stool composition depends on fiber and fluids.

What is Constipation?

At one time or the other, everyone suffers from constipation. Some people pass stool two times a day, while others may pass stool every other day. Some people pass firm stool, while others pass stool that is not so firm. The frequency of passing stool and the firmness do not determine if one is constipated. A person knows when he is constipated by feeling sluggish, and bloated. The stool is dry and hard, the person has difficulty even pain in expelling the stool.

How does constipation take place?

After the food has been digested, the portion that is not digested (fiber), and water pass to the colon. The colon absorbs the water, forming the stool. Muscle contraction, helps colon to expel the stool to the rectum. If the colon absorbs too much water, the stool is hard and dry, and the muscle contractions may not enable the colon to move stool towards the rectum. This is called constipation.

What is the role of fiber and fluids?

The insoluble fiber in our diet adds to the bulk of the stool. The soluble fiber along with fluids, make the stool softer. Lack of fiber and sufficient fluids in the diet, makes the stool harder and compact and difficult to expel.
The plant foods such as grains, vegetables, fruits, and nuts contain fiber. The meats, dairy products, and fats have no fiber.
Daily dietary intake for adults should be 25 to 30 grams. For children over age 2, dietary fiber intake should be 5 grams plus the age of the child. 25% of the fiber should be soluble fiber. The fluid intake for adults should be about ½ gallon per day.
Inadequate dietary fiber can cause hemorrhoids, diverticulosis, and colorectal cancer. Dietary fiber helps fight heart disease, colon cancer, diabetes, and obesity.

Who gets constipation?

1. Poor Diet
Low fiber, low fluid intake, and high fat are main cause of constipation. This is most evident in case of children when they start to take regular milk and little fiber. Once the diet is changed to low fat milk and given some fiber, they recover nicely.
The soluble fiber itself is not of much use, unless accompanied with sufficient fluids. One need to take about ½ gallon of water every day.
2. Physical Activity
We don't really understand the mechanism, but we do know that lack of physical activity does attribute to constipation.
3. Poor bowl movement habits
Ignoring the urge to have a bowl movement can cause constipation. Ignoring for long periods, makes the colon to absorb more water making the stool harder. Frequent ignoring of the urge, actually stops the urge to be felt.
4. Pregnancy, Menopause and menstruation
The hormonal changes, can cause constipation.
5. Aging
With age, our metabolism slows down including the physical activity level.
6. Over-the-counter Medicines
Common culprits are: Antacids containing aluminum hydroxide, Iron supplements, laxatives abuse, enema abuse, pain killers and cough medicines with codeine.
7. Prescription medicines and Medical Conditions
Many medicines and medical conditions can cause constipation. They are beyond the scope of this website.

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