Constipation

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1. What is Constipation?

Constipation is difficulty emptying your rectum.  It is often described as having less than 3 bowel movements (BM) per week

2. How Common is Constipation?

Constipation affects 30% of people older than 65

3. What Causes Constipation?

Constipation is often caused by multiple factors:

  •  Aging can affect the muscles and nerves in  the bowel
  • Weakness of the Pelvic Muscles
  • Inactivity and Poor Physical Fitness
  • Dietary factors including lack of fluids and dietary fibre.
  • Chronic  laxative use – can make the colon sluggish and dependent.
  • Medications
  • Neurological Disorders such as MS and Parkinson’s Disease
  • Disorders of the colon
    • Irritable Bowel Syndrome
    • An Obstructing Lesion such as a tumour

4. What Can I do for Constipation?

  • Increase your activity level- try walking for 20-45 minutes every day
  • Strengthen  your pelvic floor muscles with Kegel Exercises if you have problems controlling your bowels
  • Increase fluids to a minimum of 2 litres per day
  • Increase dietary fiber by eating bran and whole grain cereals and breads. this is particular important if your stools are of small volume and loose
  •  Add Psyllium to your diet. You must add 1 teaspoon to 8 oz. of water to avoid large dry hard stools. Never use Psyllium if you have had fecal impaction
  • Add natural fruit laxatives like prunes and prune juice. You can make your own “Fruit Lax Spread”See your doctor in case any of your medications are causing constipation.
    • Ingredients1/2cup of dates1 ¼ cups of prune nectar½ cup of figs¾ cup of raisins½ cup of prunes

      Simmer dates in prune juice until soft. Add the rest for the ingredients and blend to a smooth paste.

      Add 1-2 tablespoon of fruitlax to toast or crackers.

  • Laxatives – use with caution. They can damage the colon leading to dependency and worsening constipationSuppositories and enemas may be helpful
    • Stool softeners such as Docusate sodium . these tend to be mild
    • Stimulant laxatives such as Senna and Bisocodyl  -these can cause loss of potassium and protein and lead to dependence
    • Osmotic Laxatives such as PEG and Lactulose increase the fluid content of stools, softening them and improving transit time through the colon and bowel movements

5. What can my Doctor do for Constipation?

  • Your doctor can exam you to ensure that there is no obstruction in the rectum, weakness in the anal sphincter or other illness causing constipation
  • Your doctor can review your medications in case there are any causing or exacerbating constipations. They may be able to stop these medications, substitute  with a less constipating alternative drug or lower the dose
  • Rarely, your doctor may need to do X-rays or special tests to rule out severe constipation or an obstructing colonic lesion

6. Where can I find Other Information about Constipation?

The National Institute on Aging

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

The Canadian Digestive Health Foundation

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