Stomach/GI: Constipation
Constipation is a condition in which an individual has fewer than 3 bowel movements a week or has bowel movements that are hard and difficult to pass. Constipation is considered to be a common gastrointestinal compliant affecting approximately 42 million individuals in the United States. Constipation is very common during pregnancy, after childbirth, after surgery, and after taking certain medications. Most cases of constipation are easily managed with proper treatment, but some individuals suffer from chronic constipation, which can lead to other complications.

Signs and Symptoms
While the frequency and severity of constipation vary from individual to individual, common signs and symptoms include:
  • Stomachache or cramping that is resolved by a bowel movement
  • Straining during bowel movements
  • Fewer than usual bowel movements
  • Bloating or abdominal discomfort
  • Hard, compacted stools that are difficult to pass
Cause and Common Triggers
Some of the most common causes of constipation include:
  • Low-fiber diet
  • Inadequate water intake
  • Lack of physical activity
  • Nervous system disorder, such as scleroderma or lupus
  • Adverse effect of certain medications, such as narcotics, iron supplements, hypertension medications, and antacids
  • Excessive consumption of milk and other dairy products
  • Certain medical conditions, such as irritable bowel syndrome
  • Changes in routine, such as traveling
  • Problems with colon or rectum
  • Bowel obstruction
Testing and Diagnosis
If you experience persistent and chronic constipation, you should seek medical care from your doctor to determine the cause. Your doctor will probably conduct a physical exam and may order other tests, especially if you are suffering from chronic constipation.

Prevention and Management
Preventing constipation is easier than treating it. Lifestyle modifications for prevention and treatment include:
  • Eating more fruits, vegetables, and whole grains that are high in fiber
  • Drinking plenty of water and other liquids
  • Getting enough exercise
  • Not postponing trips to the bathroom
  • Using laxatives only if your doctor says you should and only for the recommended amount of time
  • Asking your doctor or pharmacist if medicines you take may be causing constipation

Treatment and Care
Treatment depends on the cause, severity, and duration of the constipation and may include 1 or more of the following:
  • Dietary changes including increasing fiber intake
  • The use of medications and/or supplements such as fiber supplements, stimulant laxatives, saline laxatives, osmotic laxatives, and/or stool softeners
  • Exercise and lifestyle modifications
  • Surgery
Homeopathic and Alternative Remedies
Some patients may find relief from constipation by making dietary changes and may elect to use alternative remedies such as:
  • Botanical products such as flaxseed and fenugreek
  • Herbal teas and extracts
  • Castor oil
  • Probiotics (to promote regularity)
It is important for patients to discuss the use of alternative remedies with their doctor or pharmacist to avoid drug interactions or contraindications and to ascertain the appropriateness of use.

A number of OTC products are available to prevent and relieve constipation. OTC products for treating and preventing constipation include:
  • Fiber Supplements
  • Laxatives
  • Probiotics
Patients should consult their pharmacist for a recommendation on an OTC product for preventing and treating constipation, guidance on its proper use, and information on potential drug interactions and contraindications.

Resources for Patients
Mayo Clinic
Medline Plus
Get Constipation Relief

Resources for Pharmacists
National Digestive Diseases Information Clearinghouse
American Gastroenterological Association
Fleet Laboratories Healthcare Professional Resources

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