Constipation

What is it?

Constipation is difficulty in passing stools or the incomplete or infrequent passage of hard stools.

Who is affected?

Constipation is the most common gastrointestinal complaint in the United States.

According to the results from the 1991 National Health Information Survey, more than 4 million people complain of constipation most or all of the time. Those reporting constipation most often are women, children, adults ages 65 and over, and pregnant women.

There are approximately two million doctor visits each year for constipation complaints and Americans spend $725 million on laxatives each year¹.

What are the symptoms?

Being "regular" varies from person to person. It could mean anywhere from three bowel movements a day to three a week. Common symptoms include:

Decreased frequency of elimination

A hard-formed stool
Straining to pass a stool
A feeling of abdominal or rectal fullness or pressure
Less common symptoms include abdominal pain, reduced appetite, back pain and headache

How can I prevent and treat constipation?

While there are many causes of constipation, lifestyle changes can be a simple and effective treatment option:

Increase dietary fiber intake to 25-35 grams per day. Ensuring sufficient fiber intake might help prevent hemorrhoids and diverticular disease.
Drink eight glasses of caffeine-free beverages a day.
Get regular exercise.
Other common causes of constipation include medications, irritable bowel syndrome, changes in one's life or routine (pregnancy, older age, and travel), abuse of laxatives, or ignoring the urge to have a bowel movement.

OTC medications can be used to relieve constipation:

Laxatives or fiber supplements are available in liquid, tablet or powder form. A doctor should help you determine if you need a laxative and which form is best for you.

Bulk-forming laxatives (fiber supplements) are usually considered the safest, but can interfere with the absorption of some medicines. They absorb water in the intestine and make the stool softer.
Stimulants cause rhythmic muscle contractions in the intestines. Choose products that do not contain phenolphthalein. The FDA has proposed a ban on all OTC products containing phenolphthalein due to studies suggesting that it might also increase a person's risk for cancer.
Stool softeners provide moisture to the stool and prevent dehydration.
Lubricants grease the stool, which enables it to move more easily through the intestine.
Saline laxatives draw water into the colon for easier passage of stool.

The following are examples of OTC medications that can be used to treat constipation:

Symptom relief	Helpful medications	Active ingredients* to look for in generic and name brand OTC products
Encourage bowel movements to relieve constipation	Bulk Forming	Calcium Polycarbophil Example: Fibercon® Partially Hydrolyzed Guar Gum Methylcellulose Psyllium
	Saline Laxatives	Magnesium Hydroxide Example: Phillips Milk of Magnesia®
	Lubricant	Mineral Oil
	Stimulants	Bisacodyl Example: Fleet® Sennosides Example: Senokot®
For use on a short-term basis to relieve constipation in people who should avoid straining during bowel movements because of heart conditions, hemorrhoids, or other health problems. They soften stools, which make them easier to pass.	Stool Softeners	Docusate Sodium Example: Colace®

* Active ingredients: ingredients in a medication that produce a therapeutic response

Sources:

¹ National Digestive Disease Clearinghouse at www.niddk.mb.gov

Note: This information is intended to provide readers with health information. The information provided is not a substitute for consultation with a healthcare provider. Brand names included on this Web page are provided for examples only. Their inclusion does not mean that they are endorsed by Blue Cross and Blue Shield of North Carolina.