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:

Get moving.
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 medications, antihistamines (to a lesser degree), certain decongestants. and some antacids. Antacids that contain calcium or aluminum are binding and can cause constipation. When choosing an antacid, Schuster suggests you keep in mind that the names of most of those with aluminum start with the letter "a." Those that start with the letter "in" contain magnesium, which does not constipate. If you are unsure, check the label or ask your pharmacist.

Bulk up.
Many times, adding fiber or roughage to your diet is all that's needed to ensure regularity. Fiber, the indigestible parts of plant foods, adds mass to the stool and stimulates the colon to push things along.Fiber is found in fruits, vegetables, grains, and beans. Meats, chicken, fish, and fats come up empty-handed in the fiber category. The current recommendations for daily dietary fiber are 20 to 35 grams. "Most people eat between 10 and 15 grams," says Hermann. So there's plenty of room for improvement. Fiber supplements may be helpful, but most doctors and dietitians agree that it's preferable to get your fiber from food (see "Laxative Alert").

Add fiber slowly.
People assimilate high-fiber foods into their diet more easily if they do it gradually. "You need to add one high-fiber food at a time, start with small amounts, and wait a couple of days before adding something else so you don't throw your system into chaos," says Hermann. Sosin agrees and also stresses the need to "drink an adequate amount of fluids with the fiber."

Eat at least five servings of fruits and vegetables daily.
Select a variety of fruits and vegetables, recommends Hermann, some that are high in fiber and others that aren't so high. Potatoes (white and sweet). apples, berries, apricots, peaches, pears, oranges, prunes, corn, peas, carrots, tomatoes, broccoli, and cauliflower are all good choices.

Eat 6 to 11 servings of grain products daily.
That's in addition to the five servings of fruits and vegetables just mentioned. Grain products include cereals, breads, and starchy vegetables (such as corn, green peas, potatoes, and lima beans) "I tell people to start out the day with a high-fiber cereal because it's easy to do and it immediately knocks off a big chunk of the amount of fiber they should be getting during the day," says Hermann. Check the labels on cereal boxes; anything with more than five or six grams of fiber per serving qualifies as high fiber. If you don't like any so-called "high fiber" cereals, line up the boxes of cereal that you would be willing to eat and pick the one with the most fiber, suggests Hermann.
Read labels when choosing breads as well. "Just because a bread is brown doesn't mean it has a lot of fiber in it," says Hermann. Find a bread that has at least two grams of fiber per slice. Watch the portion size, too, when looking for high fiber foods. "Sometimes they will give you a very large size that's unrealistic for one serving," says Sosin.

Bring home the beans.
Dried beans and legumes-whether pinto, red, lima, navy, or garbanzo-are excellent sources of fiber. Many people don't like them because of the gassiness they may cause. Cooking beans properly can ease this problem considerably. Herman's technique for cooking less "explosive" dried beans: Soak the beans overnight, then dump the water out. Pour new water in, and cook the beans for about 30 minutes. Throw that water out, put in new water, and cook for another 30 minutes. Drain the water out, put new water in, and finish cooking.

Cut back on refined foods.
You can bump up your fiber intake by switching from refined foods to less-refined foods whenever possible. Switch from a highly processed cereal to a whole-grain cereal, move from heavily cooked vegetables to less-cooked vegetables, and choose whole-grain products over products made with white flour. A glass of orange juice, for instance, provides 0.1 grams of fiber, while eating an orange gives you 2.9 grams. And while a serving of potato chips has only 0.6 grams of fiber, a serving of popcorn supplies 2.5 grams. "As soon as you start juicing something or straining it or taking the pulp out, you're taking out the fiber," says Hermann.

Hello, Doctor?
Constipation can be a symptom of a more serious problem, such as an underactive thyroid, irritable bowel syndrome, or cancer, to name a few. See your doctor if you have any of these symptoms:
A major change in your bowel pattern
Constipation lasting for several weeks or longer
Blood in your stool
Severe pain during bowel movements
Unusual stomach distention
. Laxative Alert .
Laxatives seem like an easy solution for constipation woes, but they can cause many more problems than they solve. Indeed, these tablets, gums, powders, suppositories, and liquids can be habit forming and produce substantial side effects if used incorrectly
Laxatives work in many different ways, and "each one has its problems," says Marvin Schuster, M.D. Some lubricate, others soften the stools, some draw water into the bowel, and still others are bulk forming One real danger is that people can become dependent on them, needing ever-increasing amounts to do the job. Eventually, some types of laxatives can
damage the nerve cells of the colon until the person can't evacuate anymore. Some laxatives inhibit the absorption or effectiveness of drugs. Those with a mineral-oil base can prevent the absorption of vitamins A, D, K, and E. Still others can damage and inflame the lining of the intestine.
"I think laxatives ought to be avoided if at all possible and only used under a doctor's care," says Schuster In the long run, you'll be much better off to depend on exercise, adequate fluid intake, and a high-fiber diet to keep you regular.