Treating Constipation

Constipation occurs when bowel movements become less frequent and stools become difficult to pass. It happens most often due to changes in diet or routine, or due to inadequate intake of fiber. You should call your doctor if you have severe pain, blood in your stools, or constipation that lasts longer than three weeks.

Victoria Middleton

Victoria Middleton

RD
Registered Dietitian
New York City, NY
Yumna Khan

Yumna Khan

RD
Registered Dietitian
Burlington, ON
Margarita deGraaf

Margarita deGraaf

RD
Registered Dietitian
Burlington, ON

Dr. Daniel Ngui, BSc, (P.T.), MD, CFPC, FCFP, Family Physician, discusses diagnosing and treating constipation.

Quiz: Do You Understand Constipation?

Test your knowledge by answering the following questions:

Questions
True
False
1

Exercise can help treat constipation symptoms.

Explanation:
Exercise helps move digested food through the intestines, lowering the time it takes food to move through. This limits the amount of water the body absorbs from the stool.
2

Constipation is often defined as having fewer than five bowel movements a week.

Explanation:
Constipation is often defined as having fewer than three bowel movements a week.
3

Eating more fiber can be a good treatment for constipation.

Explanation:
Fiber helps treat constipation by making stool softer and bulkier, so it passes more easily through the intestines. Healthy sources of fiber include berries, beans, prunes, avocado, whole-grain cereals and breads.
4

Stress can cause constipation.

Explanation:
Your brain and gut are connected. Stress hormones can have an effect on the body, leading to constipation. Not only that, but when a person is stressed, he or she is more likely to eat an unhealthy diet and get less physical exercise. This can also cause or exacerbate constipation.
5

Laxatives are a long-term solution to constipation.

Explanation:
Laxatives should generally only be used in the short term to relieve constipation. When used for long periods of time, laxatives can lead to dehydration and electrolyte imbalance.
(Answer all questions to activate)

David Israel, BSc, MD, FRCPC, discusses constipation.

Fruits & Vegetables and lots of water

To help deal with all kinds of constipation stay hydrated

Diagnosing and Treating Constipation

Constipation is a big problem that patients just don’t want to talk about with their doctor.

It’s often embarrassing and they just don’t know how to bring it up. Based on some new studies on patient self-reporting, the prevalence of chronic constipation can be anywhere from 10-20 percent. Chronic constipation is a challenging problem because it affects one’s quality of life. It can cause emotions such as frustration, anxiety, embarrassment and stress. I think that chronic constipation definitely is important to speak about with your family doctor.

As patients and as doctors, we can often define the normal spectrum of normal bowel movements. Many times, we think normal is three spontaneous, complete bowel movements per week. But according to the American College of Gastroenterology, chronic constipation is defined as unsatisfactory defecation characterized by infrequent stools, difficult passage of stools, or both.

Patients often think about difficult bowel movements as being straining, having hard, lumpy bowel movements. Trying very hard or having a difficult time passing the bowel movement and also spending an exorbitant amount of time trying to have a bowel movement.

When you see your family doctor and talk about chronic constipation, it’s important that you don’t feel shy or embarrassed. It’s important that you bring up your history, as your family doctor will do their best to find out what’s going on.

When you see your family doctor, what they’ll do is talk to you about your history. What medical conditions you have, what medications you’re taking that can affect you. They are going to look for red flags or danger signs. The red flags can include weight loss, anemia, pain, problems with blood in the stool, or even new symptomatology that occurs in patients over 50 years of age.

These are all red flags that your family doctor will be listening to. During the visit, they’ll ask you about your family history of colon cancer or any inflammatory bowel diseases. During your visit, there may be a physical exam examining the abdomen or doing a rectal exam and they will offer you some tests. These tests will include blood tests to check for anemia, your thyroid, but also may include a referral for colonoscopy if there is a concern.

It’s important when you speak to your family doctor about treatment options for chronic constipation that they provide education about fluid and fibre. It has to be adequate combined with exercise to allow the body to deal with this naturally. Luckily, we have many over-the-counter products that can help with chronic constipation.

If there’s an adequate trial, and if you’ve tried your best as a patient and it’s not working, don’t be afraid to speak to your doctor because besides over-the-counters, there are prescription medications – prokinetic agents that can help you. It’s important you speak to your family doctor about treatment options for chronic constipation.

Presenter: Dr. Daniel Ngui, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor

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