Treating and Preventing Constipation

Constipation occurs when your bowel movements (BM's) tend to be hard, dry, pebbly and require straining.  Sometimes, if the blockage is large enough, the only bowel contents that can make it around the blockage have to be liquidy.  This appearance of constipation plus diarrhea is called obstipation.  If this is the case, do not use medicines that treat diarrhea because they make the underlying constipation even worse!

Normally, your food is broken up by your stomach.  Nutrients are digested and absorbed by the small intestine.  The large bowel, or colon, serves to reabsorb water and important electrolytes such as sodium and potassium.  What's left by this point is mostly indigestible fibers from fruits and vegetables (also known as roughage or dietary fiber) and also bacteria from your bowels.  This fecal material is stored in the rectum which is at the very end of the colon.  When the rectum becomes full and stretched out, you feel the urge to go to the bathroom to have a BM.

If you do not eat enough roughage, then feces will stay in your rectum for longer than usual and become dehydrated.  This is how constipation is caused, and why the constipated BM's are dry, hard and pebbled looking.

Preventing constipation is mainly through eating enough fruits and vegetables to have normal, daily, formed BM's.  Eating more fruits and vegetables also helps to lower your risk of heart attack, stroke, diabetes, obesity and colon cancer.

On the other hand, folks who are long-standing "meat and potatoes" types can develop constipation to the point where their rectums no longer even feel fullness and they don't feel a need to go to the bathroom until they haven't had a BM for days. At this point they may even become dependent on fairly powerful laxatives or enemas to be able to have a BM at all.

Please note; it's the chronic constipation that results in a need for medications.  Laxatives and the like are not "addictive" in the strict sense.

At this point, over-the-counter (OTC) medications are available to help to establish a more normal and healthy pattern of BM's. There are a lot of them, so it helps to understand how they work so you can use them effectively.

First, add more fiber. Using Metamucil, Citrucel, flax seeds or bran every day can help to have more normal BM's.

Also, keep your BM's soft by using a daily stool softener such as DSS, or Colace.

It is also OK to use a plant-based mild stimulant (a cathartic) such as Senakot once or twice a day to be able to have daily soft BM's.

If you are using fiber, a stool softener and a cathartic once or twice every day and still have not had a BM in 2-3 days, then you should use a series of increasingly strong laxatives to help clear the blockage.  Try these one at a time a half day apart, to allow each one a chance to work:

1. Milk of Magnesia, 30 cc/1 fluid ounce
2. Magnesium Citrate
3. Dulcolax suppository