Constipation

About 25% of the population suffers from occasional or chronic constipation. Relief from constipation starts with a good lifestyle to improve intestinal function. Learn more about how to treat this uncomfortable health problem.

What is constipation?

Constipation isn’t a disease but rather a symptom that is characterized by the following signs:

• Infrequent stools. The normal frequency of bowel movements varies greatly from person to person, ranging from 2 to 3 times a day, up to 3 times a week.
• Straining to have a bowel movement.
• Hard stools that can only be expelled with straining or manual extraction.
• A feeling that not everything came out.
• Bloating.

Constipation can be occasional (e.g., when you go on vacation or start  taking a medication) or chronic (when the problem persists for at least 3 months).

This health problem affects people over the age of 65 in particular. This is generally because people at this age tend to  decrease their fluid intake, take medication, decrease their physical activity, and change their eating habits.

Young children who are going through potty training and school-aged children can also become constipated if they don't drink enough fluids or if they ignore the urge to have a bowel movement.

Also, 30% of pregnant women suffer from constipation, especially in their 3rd trimester. This happens when the uterus presses on the colon, which makes it hard for stool to pass. Pregnant women may take vitamin supplements that contain calcium and iron, which can also cause constipation.

Constipation causes

Many factors can cause constipation:

• A low intake of dietary fibre.
• Insufficient fluid intake.
• Not enough exercise or lying down for too long.
• Ignoring the urge to have a bowel movement.
• A decrease in the strength and speed of intestinal contractions. This is often related to age.
• Hemorrhoids or anal fissures.
• Certain diseases or conditions: thyroid disorders, anxiety, depression, cancer, diabetes, multiple sclerosis, Parkinson's disease, eating disorders.
• Certain medications (e.g., calcium or iron supplements, morphine, chemotherapy drugs). Ask your pharmacist if the medications you’re taking can cause constipation.

How to relieve constipation?

Adopting a healthy lifestyle usually prevents constipation and helps you avoid the discomfort of this condition.

• Eat a diet rich in fibre (25 g to 30 g per day). The foods below are considered foods for constipation, as they contain a lot of fibre:
  • Fruits and vegetables. Canada's Food Guide recommends that adults eat 7 to 10 servings per day. Always  eat the skin (if edible).
  • Whole grains (e.g., whole wheat bread and pasta, brown rice, oatmeal). Canada's Food Guide recommends that adults eat 6 to 8 servings per day. Wheat bran or oat bran cereals are also a good choice.
  • Legumes.
  • Nuts  (such as almonds) and seeds.
  • Prunes, apples and pears. These fruits contain sorbitol, a sugar that’s a natural laxative.
• Drink plenty of fluids (especially water) every day (6 to 8  glasses, or 1.5 to 2 litres).
• Exercise regularly.
• Have a bowel movement as soon as you feel the urge, and take your time. Try to have regular bowel movements, meaning at the same time each day. In the morning shortly after breakfast is often a good time.
• Eat at regular hours.

Eat at regular hours.If these habits aren't enough to relieve your constipation, you can try a fibre supplement or a mild laxative. Your pharmacist can tell you about different over-the-counter (OTC) products.

How to use laxatives?

Usually, you can easily manage constipation by changing your eating habits and using OTC laxatives. In rare cases, your doctor may also prescribe medication.

Several classes of OTC laxatives can provide constipation relief. They also come in various forms, such as tablets, oral liquids, suppositories or enemas.

The best laxative for you will depend on many criteria: your age, symptoms, health condition, the medications you’re taking, how fast the treatment should work, and how long you intend to use it.

Before using laxative medications, you should always consult your pharmacist, who can help you choose the best product for your situation.

When to consult a doctor?

You should see a doctor if:

• You have significant abdominal pain, bloody or black stools, fever, nausea, or vomiting with your constipation.
• You have rapid and unexplained weight loss.
• You have used laxatives for several days without relief.
• You haven’t had a bowel movement in 7 days.
• You have recently had abdominal surgery.
• You have a family history of intestinal cancer.
• You wake up at night with constipation symptoms or the urge to have a bowel movement.

Constipation is a common health problem. If you have any questions about it, don’t hesitate to talk to your pharmacist, who can give you confidential advice.