Are you experiencing bowel movements that are hard and dry, less frequent than
usual, and difficult or painful to pass? If you answered "yes" to
any of these, you may be experiencing constipation.
Occasional constipation affects almost everyone, especially adults, and females
in particular. About 25% of men and 35% of women over the age of 65 experience
constipation. Pregnancy, childbirth, and surgery can also contribute to constipation.
On the other hand, not everything that seems like constipation is. You may
think you're constipated if you don't have a bowel movement every day, or if
your stool is firm. But these by themselves don't necessarily equal constipation.
"Normal," in terms of bowel movement frequency, depends on your age,
physiology, diet, social and cultural influences, and other individual factors.
There is no right or wrong number of bowel movements that you should have per
day or per week. For example, while the normal frequency of bowel movements
in Western society may range from 1 to 3 per day to 1 to 3 per week, in countries
where a high-fibre diet predominates, normal bowel movements may occur as often
as several times a day.
How does constipation happen? Water is absorbed from the food you eat
as it moves through the colon (large intestine). What's left is a waste product,
which doctors refer to as stool. As the muscles in the colon contract,
the stool is pushed down towards the rectum. But when the muscles of the colon
are sluggish, the colon absorbs too much water, and the stool becomes hard and
dry, which makes it difficult to pass. This results in painful and difficult
What commonly causes constipation? Constipation can be caused by:
- a low-fibre diet
- not drinking enough fluids
- lack of exercise
- ignoring the urge to have a bowel movement
- a change in routine, such as travel
- a life change, such as pregnancy
- older age
- chronic illness
- recovering from surgery
- taking certain medications.
There are several kinds of medications that can cause constipation. For example,
95% of people who take medications such as pain medications (narcotics or opioids)
to control pain, either after surgery or for other reasons, experience constipation.
Other constipation-causing medications include:
- antacids that contain aluminum
- antispasmodic drugs
- antidepressant drugs
- iron supplements
- anticonvulsants for epilepsy
- antiparkinsonism drugs
- calcium channel blockers
However, if you have tried different treatments and lifestyle modifications
unsuccessfully, the constipation has not gone away, and it's been going on for
a period of 12 months or more, you may be suffering from chronic constipation.
Also known as idiopathic, or "of unknown origin," chronic constipation
may be associated with inadequate fluid and fibre intake, rectal disease such
as hemorrhoids or fissures, irritable bowel disease, intestinal problems such
as problems with nerves and muscles in the colon, or hormonal control. Seniors
are particularly prone to chronic constipation because of age-related decreases
in bowel function, diets low in fibre, lack of physical activity, and use of
medications that promote constipation.