Constipation is the most common gastrointestinal complaint in the U.S. People who experience constipation have infrequent bowel movements, pass hard stools, or strain during bowel movements. The normal frequency for bowel movements varies widely. In general, you're probably experiencing constipation if you pass fewer than three stools a week and those stools are hard and dry. Fortunately, most cases of elimination are dependent on a balanced diet and exercise.
- Inadequate fluid intake or dehydration
- Diets low in fiber
- Changes in lifestyle or routinge, e.g., travel, especially to areas where bathrooms are not available when needed
- Laxative abuse
- Inattention to bowel habits or ignoring the urge to have a bowel movement
- Lack of physical activity.
- Use of certain drugs such as iron, calcium, antacids with aluminum or calciu,, antidepressants or cough suppressants.
For young adults, constipation is not usually an organic problem but a functional one that results from inactivity and a diet low in fiber. It is sometimes made worse by regular laxative use.
In general, most physicians agree that bowel movements occurring anywhere from 3 times a week to 3 times a day are within normal range and not anything to worry about. It is thought that comfortable patterns of elimination are dependent on a balanced diet and exercise.
- If constipation is a new problem
- If you also have abdominal pain
- If your stools are black (the use of "Pepto-Bismol" or iron may cause black stools)
- If you see blood in your stool (bright red blood in small amounts is often seen with the passage of hard stools). This may be caused by damage to the tissue around the rectum or by bleeding from a hemorrhoid, and is not serious in nature.
- If you need to use laxatives regularly
If you are a Brown student and you are concerned about constipation, you can make a confidential appointment at Health Services by calling 401.863-3953. Health Services provides a range of services including general health care, inpatient services and emergency medical care. You can request a medical provider by gender or by name. We are located at 13 Brown Street on the corner of Brown and Charlesfield Streets.
- Increase your activity. Get 30 minutes of exercise each day.
- Establish a convenient, uninterrupted time for a bowel movement each day. Bowel activity and mobility is greatest about 15 to 20 minutes after breakfast, so this may be the best time. If the urge to have a bowel movement is ignored, the stool becomes increasingly dry and hard and constipation is almost inevitable or becomes worse. Straining is not recommended because it can cause a tightening of muscles that should actually be relaxed during a comfortable bowel movement.
- Drink 8 glasses of liquid a day, especially water.
- Gradually increase the fiber in your diet. The American Dietetic Association recommends eating 20 to 35 grams of fiber a day. The fiber acts like a large sponge in the bowel because it holds water and keeps waste moving. For breakfast each day you should eat bran cereal and fruit. Raw vegetables and fruit, grains, beans, and cereals all contain important of fiber. Remember - you have to drink liquids for fiber to work.
- If dietary and exercise efforts fail, a non-digestible fiber powder such as Metamucil (psyllium) may help. It acts to increase the bulk in your stool but must be taken with plenty of fluids to prevent any problem with blockage in the bowel. The usual dose is 1 heaping teaspoon in an 8oz. glass of water or juice. Psyllium can be taken long term without adverse effects.
It takes patience and a change in diet and lifestyle to solve constipation - there is no quick and easy answer. It may take 4 to 6 weeks to re-establish normal bowel function, especially if laxatives have been used on a regular basis. Increase the fiber in your diet gradually because your stomach and intestines need time to get used to this change. Be aware that increases in fiber may cause gas and bloating temporarily.
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Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.