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GASTROINTESTINAL

Constipation in Adults

What is Constipation?

Constipation can mean different things to different people. It can mean that you aren't passing any stools for 1 or more days. It can also mean that you are passing very small and firm stools or that your stools have accumulated into a very large brick of poo that you are unable to pass (fecal impaction). Types 1-3 on the chart below are all forms of constipation.

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What Causes Constipation?

We get constipated when our stool takes too long to make it through the digestive system, which can happen for a variety of reasons.

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  • Not drinking enough water 

  • Stress or feeling anxious 

  • Holding our poop in too long 

  • Medications (opiate pain killers, antihistamines, weight loss medication and medications given during operations) 

  • Not enough exercise or movement 

  • Inadequate fiber in the diet 

  • Certain medical conditions (IBS, Celiac disease, hypothyroidism) 

  • A blockage in the intestines caused by scar tissue from previous operations 

  • Colon cancer 

Symptoms of Constipation

  • Pooping less than usual 

  • Small, hard stools 

  • Very large stools that are hard to pass 

  • Feeling bloated and uncomfortable 

  • Abdominal pain 

  • Incontinence of liquid stool (mostly in older adults or children) 

Prevention of Constipation

  • Drink plenty of water (if you are on a fluid restriction, speak to your doctor). Start with 4 x 8 ounce glasses of water a day and work your way up from there.  

  • Eat foods that contain fiber such as: fruits (especially prunes), vegetables, bran, whole grain cereals, breads and rice. 

  • If you don't get enough fiber in your diet, consider a fiber supplement like Metamucil 

  • Move your body! Exercise gets your intestines moving. A 30 minute walk per day can help prevent constipation. If you can't walk for 30 minutes, start with 5 or 10 minutes and work your way up. 

  • Use of a bench (Squatty Potty or other type of step) helps to eliminate straining and helps you to better empty your bowel.

Treatment of Constipation

Most constipation can be treated at home. It is important that you try some home remedies – many of the people seen in the emergency department for constipation have not tried anything at home before coming to the hospital. 

  • If you haven't already added fiber to your diet, it is time. Adding Metamucil can help to bulk up your stools which will stimulate your bowel to pass them. Make sure to drink plenty of water if you are taking a stool bulking agent. 

  • Drink some prune juice - it is a nice, natural remedy that works for many people. 

  • Warm compresses to your belly 30 minutes after meals followed by the ILU massage: 

*You can do this massage lying down instead of standing in the shower. 

Here are some other colonic massages you can try:

Still constipated? Maybe it is time for a laxative, but there are SO MANY TO CHOOSE FROM! You can speak to your pharmacist about which one is right for you. 

 

We recommend Restoralax (polyehtylene glycol – also sold under the name Lax-a-Day and available in generic brand options). It is a tasteless, odorless powder that can be mixed into just about any liquid. Start with 1 capful (17g) per day. If that isn't enough, use it twice daily until you have a bowel movement. If you have been constipated for a long time, you should use this until your stools are very soft but not watery. Some people need to use this daily to maintain regularity. 

When to See a Doctor

See a doctor if you are experiencing any of the following: 

  • You have tried all of these things and you are still constipated 

  • Rectal bleeding 

  • Not passing gas (farting) 

  • Moderate to severe abdominal pain 

  • There is a family history of colon cancer in a 1st degree relative (your parents, siblings or children) 

  • Weight loss that is unintentional and/or unexplained 

  • Vomiting stool or dark brown bits that look like coffee grinds

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Your doctor may want to send you for some imaging like an X-ray or CT scan of your belly. They may also prescribe you a different medication for your constipation and/or send you to a specialist for a colonoscopy (camera exam of your colon). 

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