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You don’t have to suffer from constipation

Tue., April 23, 2013

Constipation hits everybody at some point. The uncomfortable condition can be caused by many things, including a bad diet and dehydration. Dr. Vaibhav A. Parekh, director of Medstar Harbor Primary Care in Baltimore, talks about how to prevent and treat constipation, and how to tell if it’s a sign of more serious health problems.

Q. What are signs that you are constipated? What is a normal number of bowel movements?

A. Common signs of constipation include straining during a bowel movement, hard bowel movement and a sensation of incomplete emptying after a bowel movement. While there is no absolute normal number of bowel movements, fewer than three a week is one of the signs of constipation.

As simple as this might sound, unhealthy lifestyle choices are a frequent cause of constipation.

A diet lacking in adequate amounts of fruits and vegetables is a common, easily treatable and reversible cause of constipation. Five to seven servings of fruits and vegetables every day is considered to be an adequate amount. While this might sound like a lot, it’s not that difficult. Having a banana with breakfast, a nice salad serving with lettuce, tomatoes, cucumbers, peppers and berries for lunch, and an apple or orange after dinner would be one way to get enough fruits and vegetables in a day.

Lack of adequate water intake (2 to 3 liters every day) is another common cause of constipation. Sodas, juices, sweetened tea and flavored water are not substitutes and should not take the place of water. Caffeinated drinks act as diuretics and promote urination and fluid loss. This in turn can cause dehydration and lead to constipation

A sedentary lifestyle is another frequent culprit. A daily exercise regimen promotes a healthy bowel routine.

In addition, an erratic eating regimen often leads to an erratic bowel habit. Not having a set time for breakfast, lunch and dinner makes the bowel routine unpredictable and can lead to constipation.

Holding for too long when you need to have a bowel movement also leads to constipation. When you have the urge to go to the bathroom, just go.

Other causes of constipation include prescription drugs (especially narcotic painkillers, blood pressure medications, antidepressants and iron pills), diabetes, spinal cord injury, underactive thyroid, electrolyte disturbance (low potassium, calcium, magnesium), etc.

Q. How do you treat constipation?

A. Resorting to a healthy lifestyle is often a quick and easy fix to treating constipation. Eating plenty of fiber in the form of vegetables and fruits (not fruit juices), drinking adequate amounts of water and a regular exercise routine usually helps in regularizing bowel movements. In addition, having a set time for three meals a day helps to make bowel movements regular and predictable.

Despite making healthy lifestyle changes, if there is inadequate relief of constipation, try over-the-counter laxatives for a few weeks. These come in the form of oral medications and rectal suppositories. Different individuals react differently to these laxatives. Miralax and Colace are gentle to the colon, whereas magnesium citrate could result in diarrhea, at times severe.

These laxatives are very helpful in the treatment of short-term or occasional constipation.

Q. Is it safe to take laxatives?

A. Laxatives are safe to take if they are used for a short time (usually a few weeks), or to treat occasional constipation. Chronic use of laxatives can lead to electrolyte imbalance, loss of protein and salt overload.

In addition, chronic need to use laxatives may mask underlying medical problems, which over time could get worse.

For example, an individual may have hypothyroidism or be experiencing a side effect of prescription drugs resulting in constipation. Laxatives are not a good answer for these problems when treating the thyroid condition or changing medications would be a wiser approach.

Constipation could also be a sign of colon cancer in someone who also has decreased appetite, weight loss, black stools or blood in stools and perhaps a family history of colon cancer.

If the need for laxatives is for an extended period of time, it is important to keep your primary care physician in the loop.


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