Question: Doc! I feel fine but I am not regular in my bowel movements. My walking buddy tells me I should do something about it. Should I worry? — John, of Elida
You may have constipation.
Constipation is a common problem that makes it hard to have bowel movements. Your bowel movements might be too hard, too small or stool may be hard to get out. It may be happening fewer than three times a week. On the other hand, folks who are vegetarians may move the bowels once or twice a daily.
What causes constipation? Constipation can be caused by some side effect of some medicines, diet low in fiber or drinking not enough fluids. Severe constipation may be a sign of some diseases of the digestive system.
What can I do on my own to get rid of constipation?
Try to eat foods that have a lot of fiber or roughage. Good choices are fruits, vegetables, prune juice and high-fiber cereals. Half your plate may be filled with vegetables.
Try to drink plenty of water and other fluids. You may need 40 to 50 ounces of fluids a day.
Then there is a matter of training your bowels. Most people go when they feel the need to go to the bathroom. Do not hold it. Some other people train their bowels to move in the morning daily after they wake up. They may have a routine to drink one or two glasses of water or they may drink a cup of hot tea or coffee when they wake up to help them.
You may need more fiber to regulate your system. Generally, we need 20 to 35 grams of fiber a day. The amount of fiber must be increased gradually. Eating too much fiver may give a bloated feeling.
What is fiber?
Fiber is a substance found in some fruits, vegetables and grains. Most fiber passes through your body without being digested. But it can affect how you digest other foods, and it can also improve your bowel movements.
There are two kinds of fiber. One kind is called “soluble fiber” and is found in fruits, oats, barley, beans and peas. The other kind is called “insoluble fiber,” and is found in wheat, rye and other grains.
If you cannot get enough fiber from food, you can add wheat bran to the foods you do eat. Or you can take fiber supplements. These come in the form of powders, wafers or pills. They include psyllium seed, methylcellulose, polycarbophil and wheat dextrin.
Exercise also helps constipation by lowering the time it takes food to move through the large intestine. Hard, dry stools are harder to pass. Plus, aerobic exercise speeds up your breathing and heart rate. This helps to stimulate the natural squeezing or contractions of muscles in your intestines. Intestinal muscles that squeeze better will help move stools out quickly.
Yoga exercises also help. Ask your yoga instructor for yoga exercises for constipation. They are particularly good and to be recommended.
If drinking enough fluids and increasing more fiber does not help, your doctor may prescribe a prescription medicine.
Severe constipation may require surgery.
When should I see a doctor?
See your doctor or nurse if your symptoms are new or not normal for you, you do not have a bowel movement for a few days, the problem comes and goes, but lasts for longer than three weeks or you are in a lot of belly pain. Consult a doctor if you may have other symptoms that worry you. For example, bleeding, weakness, weight loss or fever. Make sure you see a doctor if other people in your family have had colorectal cancer or inflammatory bowel disease.
Prolonged constipation can lead to several health complications such as swollen abdomen, hemorrhoids, anal fissures, rectal prolapse.
I hope you can “regulate” yourself. Lifestyle changes may help constipation.
Suman Kumar Mishr MD, Fellow of American College of Endocrinology. Cridersville, Ohio