When it comes to personal bowel habits, there’s really no such thing as “normal.” For one person, having a bowel movement once every few days might be normal. Another person may typically have three to four bowel movements a day.
Within that range, however, many of us have periods when we go less often than usual, or have hard, pebble-like stools that cause discomfort. This occasional constipation is usually nothing worrisome.
If constipation persists or happens frequently, however, you may want to see your doctor to determine the cause. (See your doctor right away if you experience any “red flag” symptoms such as a change in bowel habits, including changes in stool characteristics, blood in your stool or unexplained weight loss.)
In most cases, fairly simple lifestyle changes or treatable medical conditions can reduce or eliminate bouts of constipation and make you much more comfortable throughout the day.
These changes can even help in more extreme cases. I recently saw a 64-year-old patient who had been admitted to the hospital multiple times with severe constipation — she was unable to move her bowels for weeks at a time. A colonoscopy did not reveal any blockage.
By utilizing a variety of medications and fiber supplements, as well as making lifestyle changes to reduce her anxiety, she is now able to have a daily bowel movement. It has dramatically improved her quality of life and overall health.
Lifestyle Causes of Constipation
Some everyday habits can have a significant impact on constipation, including:
- Not drinking enough fluids. If you’re not drinking enough fluids, your colon will absorb additional water from your stools, making them harder and more difficult to pass. You should drink six to eight servings of liquid a day. A good rule of thumb is to drink enough fluids throughout the day so that your urine is a light yellow or straw color.
- Eating too many processed, low-fiber foods. The colon has many nerve endings and muscle fibers that help pass stools by pushing against them. Green vegetables and other high-fiber foods help your colon do its job by making stools more “bulky” and easier to pass by stimulating more natural contractions of the colon.
- Not getting enough exercise. Like all aspects of good health, you need to be active in order to maintain good bowel function. Constipation is a significant problem for people who are bedridden due to poor health — don’t create the same problem for yourself by spending too much time on the couch.
- Too much stress. Stress is a problem in and of itself, but it also leads people to get trapped in bad exercise and eating habits. Exercise is an excellent stress reliever as are lifestyle changes such as focusing on better sleep and cutting back on caffeine.
In addition to the lifestyle changes above, occasional constipation can be treated with over-the-counter medications. We recommend osmotic laxatives over stimulatory laxatives. Osmotic laxatives, such as polyethylene glycol (PEG), draw water into the stool to make it softer.
Medical Causes of Constipation
If lifestyle changes do not improve your constipation, your doctor may consider possible medical causes, including:
- Thyroid problems. Low thyroid function can decrease the body’s ability to move waste along the GI tract. It’s one of the first things we test for in people suffering from chronic constipation, and it can be treated with medications aimed at improving low thyroid function.
- Certain medications. Constipation is a side effect of many types of medications, including opioids that are commonly prescribed to relieve pain. If your constipation seems to be related to a new prescription, work with your doctor to find alternatives or ways to counteract that medication’s constipating effects.
- Motility problems. Poor coordination of the pelvic and anal muscles sometimes contributes to or causes constipation. Sometimes, a simple intervention such as placing your feet on a footstool during a bowel movement can alleviate this condition. In severe cases, biofeedback therapy can be employed to help improve bowel function.
- Bowel blockages. Bowel blockages such as large colon polyps or colon cancer are fortunately not a very common cause of constipation, but something that needs to be considered. The best way to treat colon cancer is to prevent it by scheduling regular colonoscopy screenings.
The Importance of Colonoscopy
Colonoscopy is a painless procedure that can identify and remove benign polyps before they develop into colon cancer.
For men and women at normal risk for colon cancer, we recommend that you start screening at age 50. Those at higher risk because of a family history of colon cancer or colon polyps, or conditions such as inflammatory bowel disease, should begin at a younger age. Request a colonoscopy appointment with our online appointment request.
Community-based Cancer Prevention and Treatment
The Colon and Rectal Cancer Program at CentraState offers a full range of preventative, diagnostic and treatment services, including advanced robotic surgical technology. The program team is led by doctors and clinicians who specialize in diagnosing and treating colon and rectal cancer. For more information, call (855) 411-CANCER.
Dr. Kunal Gupta is board-certified in internal medicine and gastroenterology and earned a Master’s Degree in Business Administration. He serves as chief of gastroenterology at CentraState Medical Center. Dr. Gupta can be reached at Middlesex Monmouth Gastroenterology in Freehold by calling 866-CENTRA7.