Abdominal Problems
Constipation
Constipation occurs when stools
are difficult to pass. Some people are overly concerned with frequency because
they have been taught that a healthy person has a bowel movement every day.
This is not true. Most people pass stools anywhere from 3 times a day to 3
times a week. If your stools are soft and pass easily, you are not constipated.
Constipation may occur with cramping
and pain in the rectum caused by straining to pass hard, dry stools. There
may be some bloating and nausea. There may also be small amounts of bright
red blood on the stools caused by slight tearing as the stools are pushed
through the anus. The bleeding should stop when the constipation is relieved.
If a stool becomes lodged in the
rectum (impacted), mucus and fluid may leak out around the stool, which sometimes
leads to leakage of fecal material (fecal incontinence). You may experience
this as constipation alternating with diarrhea.
Lack of fibre and inadequate water
in the diet are common causes of constipation. Other causes include inactivity,
delaying bowel movements, medications, pain caused by
a tear (fissure) in the lining of
the rectum, and laxative overuse. Irritable bowel syndrome (See
Irritable Bowel Syndrome) may also cause constipation.
Toilet training may contribute
to constipation in young children. Children who are involved in play or other
activities and ignore the urge to pass stools may become constipated. Children
and adults who are reluctant to use toilets away from home may become constipated.
Eat plenty of high-fibre foods such as fruits, vegetables,
and whole grains. You can also add fibre to your diet in the following
ways (also See
Fibre):
Eat a bowl of bran cereal with
10 g of bran per serving.
Add 30 ml (2 tbsp) of wheat bran to cereal or soup.
Try a product, such as Prodiem
or Metamucil, that contains a bulk-forming agent. Start with
15 ml (1 tbsp) or less and drink extra water to avoid bloating.
Avoid foods that are high in fat and sugar.
Drink
1.4 to 1.9 L (1.5 to 2 qt)
of water and other fluids every day. Drink extra fluids in the morning.
Exercise more. A walking program is a good start. See
Fitness.
Set aside relaxed times for having bowel movements. Urges
usually occur sometime after meals. Establishing a daily routine (after
breakfast, for example) may help.
Go when you feel the urge. Your bowels send signals when
a stool needs to pass. If you ignore the
signal, the urge will go away and the stool will eventually become dry
and difficult to pass.
Follow the diet outlined in Prevention to help relieve
and prevent constipation.
If necessary, use a stool softener or a very mild laxative
such as milk of magnesia. Do not use mineral oil or any other laxative
for more than 2 weeks without consulting your doctor.
If an infant or child up to age 10
is having rectal pain because he
or she is unable to have a bowel movement, put the child in a warm bath
with 56 g (2 oz) of baking soda in the tub. This may help relax the
muscles that normally keep stool inside the rectum, allowing the child
to pass the stool.
If your child is 6 months old or older and the warm bath
does not work, use 1 or 2 glycerin suppositories to make the stool easier
to pass. Use glycerin suppositories only once or twice. If constipation
is not relieved or develops again, discuss the problem with your doctor.
Do not give laxatives or enemas to a child without talking
to your child's doctor first.
If rectal bleeding is heavy (more than a few bright red
streaks) or
if the blood is reddish brown or black.
If rectal bleeding lasts longer than 2 to 3 days after
constipation has improved, or if bleeding occurs more than once.
If you have sharp or severe abdominal pain.
If you have rectal pain that either continues after you
pass a stool or keeps you from passing stools at all.
If constipation and major changes in bowel movements
continue after 1 week of Home Treatment, and there is no clear reason
for such changes.
If you experience stool leakage (fecal incontinence).
If your stools have become consistently more narrow (may
be no wider than a pencil).
If you are unable to have bowel movements without using
laxatives.
If constipation is causing an infant or child to be in
pain.
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