Monday, August 15, 2011
Poop or Get Off the Pot! (AKA. Constipation Clarification)
Forgive the expression, but it's tough to think of a catchy title to talk about CONSTIPATION. That being said, constipation is a really common complaint- from toddlers to toddering elders. When I talk to patients about constipation, the first thing I do is to establish what is NORMAL for the patient. Often folks are surprised to hear that "normal" does not equal "daily" bowel movements. If you go once every few days and have no abdominal bloating or discomfort, then you are NOT constipated, that is simply YOUR "normal". Others have several bowel movements each day, and again, that is "normal" for them if there are no associated uncomfortable symptoms.
So what IS constipation? Constipation is "unsatisfactory defecation" with relatively infrequent and/or painful passage of stool. Typically this means less than three BM's per week, too much time straining (or hanging out reading) on the potty, or a sense that there is either bloating in your belly or that after you go, you feel like you still should poop more. Women suffer from constipation twice as much as men (likely in part from our hormonal swings that may affect the gut.)
Please don't ignore constipation, because there are many medical conditions that can slow the gut and cause constipation, such as diabetes, low thyroid hormones, pregnancy, metabolic disturbances (like low potassium levels), to name a few. Additionally, medications such as blood pressure pills (calcium channel blockers especially), antacids, antihistamines, antidepressants and pain pills also can slow the bowels.
The vast majority of the time, however, constipation is simply the result of a poor diet. Three things are needed to move your bowels: FIBER (goal 25g/day), MOVEMENT (walk, run, skip, bike- whatever works, just get up and move!) and HYDRATION (more water.) Caffeine is a gut stimulant, which is why people often poop right after their morning java, but too much caffeine dehydrates you and actually slows down the process. What's the goal? Whatever frequency is "normal" for YOU, and no abdominal discomfort. That being said, I rarely see a patient who truly averages 20g of fiber per day in their diet (not from supplements) who does not have "comfortable" daily BM's.
BOTTOM LINE: If you've had no change in your diet, medications or activity level, and you notice your bowel movements have become painful or less frequent, go and get checked out at your family doctor.