Sooner or later almost everyone suffers from an episode of constipation. It is difficult to give one definition of constipation, because regular bowel habits are different for every person: "normal" bowel habits can be anywhere from three bowel movements per day to three per week. It isn't necessary to have one bowel movement a day.

Many things - from diseases to some medications - can cause constipation; however, the most common causes of constipation are related to lifestyle, including:

• Low fibre in the diet
• Not drinking enough fluids
• Lack of physical activity
• Ignoring the urge for a bowel movement
• Overuse of laxatives

Preventing Constipation

There are many steps that can be taken to help prevent - and treat - constipation.

1. Know Your Medications. It is important to understand the medications you are taking because some prescription and non-prescription medications can cause constipation. If you are unsure whether one of your medications may cause constipation, ask your doctor or pharmacist.
2. Eat High Fibre Foods. Fibre creates "bulk" in our system and helps the bowels push out waste. Foods that are high in fibre include: fruits and vegetables nuts and seeds, legumes (dried peas, beans, lentils), whole grain breads and cereals, bran (wheat - not oat), and dried fruits (prunes, raisins, apricots, dates).
3. Drink Fluids. Another way to help prevent constipation is to drink plenty of fluids (unless you are fluid restricted by your doctor). Drinking at least 8 glasses of fluid a day can help relieve constipation. Some good suggestions are water, juice and milk but remember that beverages with caffeine don't count!).
4. Regular Exercise. People who are inactive either by choice or because of disease or illness, often have more trouble with constipation. A good rule is to move around a bit: try not to sit in one spot for more than 30 minutes at a time. For those who are able, a short walk every day can help get your bowels moving.
5. Don't ignore the urge to have a bowel movement. Putting off bowel movements can cause constipation and make existing constipation worse. The best advice is to listen to your body when it tells you to 'go'.

Treating Constipation

If you have taken the above non-medications steps to help prevent and/or treat constipation without success, there are some non-prescription medications that can help relieve constipation.

1. Fibre supplements can ease constipation the same way real fibre does. These products usually work within about 24 hours and are effective for occasional constipation as well as for people who suffer from chronic constipation. It is important to drink lots of fluids (a minimum of three glasses of water or juice a day, but you should always try to drink more) while on fibre supplements. Examples of fibre supplements are Medicine Centre Fibre Laxative and Metamucil.
2. Stool softeners are also a good way to treat occasional and chronic constipation. Stool softners are non-stimulating, which means bowels cannot become dependent on them. They can be used regularly by people with a chronic problem or by those who are on medications that cause constipation. Examples of stool softeners are Medicine Centre Docusate Sodium, Colace, and Surfak.
3. Laxatives are one of the most common treatments for constipation. They directly stimulate bowels to help push out waste material. Laxatives tend to work quickly (6 to 8 hours) and are only appropriate for occasional treatment of constipation. If stimulant laxatives are used regularly for a long period of time, there is a risk that your bowels can become dependent on them and you can lose your normal bowel function. A few examples of stimulant laxatives are: Ex-lax, Senokot, Dulcolax, Correctol, and Nature's Remedy.
4. Alternatives to stimulant laxatives that can work quickly are magnesium hydroxide (e.g. Milk of Magnesium) and lactulose. These two are good choices and can be used safetly in almost any individual. Note: people with congestive heart failure and people with kidney problems should stay away from these products.
5. Suppositories used rectally are another option and can provide quick relief (15 minutes to 3 hours). There are stimulating suppositories (e.g. Dulcolax) as well as gentle acting suppositories (e.g., glycerin suppositories).

When To See A Doctor

It is important to see your doctor if any of the following is true:

• Constipation lasts for several weeks or longer
• A major change in your bowel pattern
• Blood in your stool
• Severe pain during bowel movements
• Unusual stomach distention

There are many choices when faced with constipation. Lifestyle changes are recommended, but there are times when medication is necessary. Choosing the right therapy depends on many factors, including the cause of constipation, whether it is an occasional or regular problem, and if any medications are being taken.

Compiled by Carlene Kusch
Chemainus Pharmacy, Chemainus, B.C.
Edited by Megan Stiles
Last Reviewed: September 2001