Irregularity is one of those things that no one likes to talk about. It's personal and, well, a little embarrassing. But if you're one of the millions of people who's ever been constipated, you know it can put a real damper on your day.
The first thing to realize when you're talking about constipation is that "regularity" is a relative term. Everyone has his or her own natural rhythm. Ask four people to define regularity, and you're likely to get at least four different answers. Normal bowel habits can span anywhere from three bowel movements a day to three a week, according to Marvin Schuster, M.D., professor of medicine with a joint appointment in psychiatry at Johns Hopkins University School of Medicine and chief of the Division of Digestive Diseases at Francis Scott Key Medical Center, both in Baltimore.
"One of the most common forms of constipation is imaginary or misconceived constipation," says Schuster. It's based on the idea that if you don't have the "magical" one bowel movement a day, then something's wrong. Constipation has a lot to do with a person's comfort level, says Peter Banks, M.D., director of Clinical Gastroenterology Service at Brigham and Women's Hospital and lecturer on medicine at Harvard Medical School, both in Boston. People who are constipated often strain a lot in the bathroom, produce unusually hard stools, and feel gassy and bloated.
Schuster calls it "constipation" if you have fewer than three bowel movements a week or if you experience a marked change in your normal bowel patterns. A sudden change in bowel habits merits a visit to your doctor to rule out any more serious underlying problems (see "Hello, Doctor?"). But for the occasional about of constipation, here are some tips to put you back on track:
Exercise seems not only to boost your fitness but to promote regularity as well. "The thinking is that lack of activity puts the bowels to rest," says Banks. That may partially explain why older people, who may be more sedentary, and those who are bedridden are prone to becoming constipated. "We encourage people to get up and be more active," says Banks. So gear up and get moving. You don't have to run a marathon; a simple walking workout doesn't take much time and can be very beneficial. When it comes to regularity, even a little exercise is better than none at all.
Raise your glass.
Drinking an adequate amount of liquids may help to alleviate constipation or prevent it from happening in the first place. The reason for this is simple. "If you dehydrate yourself or drink too little fluid, that will dry out your stool as well and make it hard to pass," says Schuster.
On the other hand, some people have the misconception that if you drink far more than you need, you can treat constipation. Schuster disagrees, saying the excess fluid will just get urinated out.
To achieve a balanced intake of liquids, a good rule of thumb is to drink eight cups of fluid a day, says Mindy Hermann, R.D., a registered dietitian and spokesperson for the American Dietetic Association. (This rule of thumb doesn't apply, however, if you have a kidney or liver problem or any other medical condition that may require restricting your intake of fluid.) Drink even more when it's hot or when you're exercising. Hermann suggests that athletes weigh themselves before and after a workout. Any weight lost during the activity reflects water loss. To replace it, they should drink two cups of liquid for every lost pound of body weight.
For those who are constipated, all liquids are not created equal. Avoid drinking a lot of coffee or other caffeinated drinks, urges Elyse Sosin, R.D., a registered dietitian and the supervisor of clinical nutrition at Mount Sinai Medical Center in New York. Caffeine acts as a diuretic, taking fluid out of your body when you want to retain it. She suggests sticking with water, seltzer, juice, or milk instead.
Don't fight the urge.
Often, because people are busy or have erratic schedules or because they don't want to use public bathrooms, they suppress the urge to have a bowel movement. "If they do this over a period of time, it can block the urge so it doesn't come," explains Schuster. If at all possible, heed the call when you feel it.
Take advantage of an inborn reflex.
As babies, we're all born with a reflex to defecate a short time after we're fed, says Schuster. With socialization, we learn to control our bladders and bowels and we inhibit this reflex. Schuster suggests that you try to revive this reflex by choosing one mealtime a day and trying to have a movement after it. "Very often, people can program the colon to respond to that meal." Schuster does point out that this works better with younger people than with the elderly.
Know your medications.
A number of prescription and over-the-counter medications can cause constipation. If you are currently taking any medication, you might want to ask your doctor or pharmacist whether it could be causing your constipation. Among the drugs that can cause constipation are calcium-channel blockers taken for high blood pressure, beta-blockers, some antidepressants, narcotics and other pain