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Abdominal Problems

Constipation

Prevention - Home Treatment - When to Call a Health Professional

Constipation occurs when stools are difficult to pass. Some people are overly concerned with frequency because they have been taught that a healthy person has a bowel movement every day. This is not true. Most people pass stools anywhere from 3 times a day to 3 times a week. If your stools are soft and pass easily, you are not constipated.

Constipation may occur with cramping and pain in the rectum caused by straining to pass hard, dry stools. There may be some bloating and nausea. There may also be small amounts of bright red blood on the stools caused by slight tearing as the stools are pushed through the anus. The bleeding should stop when the constipation is relieved.

If a stool becomes lodged in the rectum (impacted), mucus and fluid may leak out around the stool, which sometimes leads to leakage of fecal material (fecal incontinence). You may experience this as constipation alternating with diarrhea.

Lack of fibre and inadequate water in the diet are common causes of constipation. Other causes include inactivity, delaying bowel movements, medications, pain caused by

a tear (fissure) in the lining of the rectum, and laxative overuse. Irritable bowel syndrome (See Irritable Bowel Syndrome) may also cause constipation.

Toilet training may contribute to constipation in young children. Children who are involved in play or other activities and ignore the urge to pass stools may become constipated. Children and adults who are reluctant to use toilets away from home may become constipated.

Prevention

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  • Eat plenty of high-fibre foods such as fruits, vegetables, and whole grains. You can also add fibre to your diet in the following ways (also See Fibre):

    • Eat a bowl of bran cereal with 10 g of bran per serving.

    • Add 30 ml (2 tbsp) of wheat bran to cereal or soup.

    • Try a product, such as Prodiem or Metamucil, that contains a bulk-forming agent. Start with 15 ml (1 tbsp) or less and drink extra water to avoid bloating.

  • Avoid foods that are high in fat and sugar.

  • Drink 1.4 to 1.9 L (1.5 to 2 qt) of water and other fluids every day. Drink extra fluids in the morning.

  • Exercise more. A walking program is a good start. See Fitness.

  • Set aside relaxed times for having bowel movements. Urges usually occur sometime after meals. Establishing a daily routine (after breakfast, for example) may help.

  • Go when you feel the urge. Your bowels send signals when a stool needs to pass. If you ignore the signal, the urge will go away and the stool will eventually become dry and difficult to pass.

Home Treatment

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  • Follow the diet outlined in Prevention to help relieve and prevent constipation.

  • If necessary, use a stool softener or a very mild laxative such as milk of magnesia. Do not use mineral oil or any other laxative for more than 2 weeks without consulting your doctor.

  • If an infant or child up to age 10 is having rectal pain because he or she is unable to have a bowel movement, put the child in a warm bath with 56 g (2 oz) of baking soda in the tub. This may help relax the muscles that normally keep stool inside the rectum, allowing the child to pass the stool.

  • If your child is 6 months old or older and the warm bath does not work, use 1 or 2 glycerin suppositories to make the stool easier to pass. Use glycerin suppositories only once or twice. If constipation is not relieved or develops again, discuss the problem with your doctor.

  • Do not give laxatives or enemas to a child without talking to your child's doctor first.

When to Call a Health Professional

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  • If rectal bleeding is heavy (more than a few bright red streaks) or if the blood is reddish brown or black.

  • If rectal bleeding lasts longer than 2 to 3 days after constipation has improved, or if bleeding occurs more than once.

  • If you have sharp or severe abdominal pain.

  • If you have rectal pain that either continues after you pass a stool or keeps you from passing stools at all.

  • If constipation and major changes in bowel movements continue after 1 week of Home Treatment, and there is no clear reason for such changes.

  • If you experience stool leakage (fecal incontinence).

  • If your stools have become consistently more narrow (may be no wider than a pencil).

  • If you are unable to have bowel movements without using laxatives.

  • If constipation is causing an infant or child to be in pain.

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