Constipation is likely something everyone has experience at some point. It is so common that we hear about it almost daily at Granville Primary Care, Butner-Creedmoor. It affects our youngest up to our most elderly patients— in fact, it is the most common gastrointestinal complaint in the United States. Often it occurs when somebody’s routine has changes with travel, when eating different foods, and with stressful situations. However, it can occur without a specific reason, too.
What is constipation? It is small, hard, and infrequent stool (bowel movements less than 3 times per week). Most constipation is caused by stress and a diet low in fiber and water. Rarely, it can be caused by diseases of the digestive track or medication side effects.
Fact #1 Constipation may be treated at home before seeing a doctor as long as there are no warning signs of a dangerous cause.
If you experience any warning signs, be sure to see your doctor right away. These warning signs include sudden big changes in bowel habits, severe pain, rectal bleeding in the toilet or on toilet paper, fevers, weight loss or feeling weak. Additionally, it is a good idea to see your doctor right away if you have any family history or concerns about digestive diseases.
Fact #2 Fiber is the top dietary deficiency in the United States!
It is no wonder constipation is so common. Did you know that most Americans do not get nearly enough dietary fiber? Most adults need at least 20-35 grams of fiber daily. Foods high in fiber include beans and lentils (about 10-15g per 1 cup), nuts (about 8g per 1/2 cup), fresh fruits (3-5g per fruit serving-- dried prunes have 12g per 1 cup), and vegetables (4-8g per 1 cup). Along with a low fiber diet, most people also do not drink nearly enough water. It is important for most adults to drink about 8 glasses of non-caffeinated and non- alcoholic beverages every day.
Fact #3 Constipation often responds to some simple remedies.
Try this two-step approach: First, eat foods that have a lot of fiber, and aim for 20-35 grams of fiber per day. Good fibrous foods are vegetables, high fiber cereals, beans, fruits (fresh or dry) and prune juice. You can also try over-the-counter fiber supplements with meals. Drink 8 glasses of non-caffeinated, non-alcoholic fluids. Try to have a bowel movement after a meal. If you feel the need to go to the bathroom, don't hold it. If that doesn’t work, try an over-the-counter laxative. Laxatives are medicines that help make bowel movements easier to pass.
Fact #4 There are four different types of laxatives.
No matter what laxative you choose, be sure to continue eating fiber and drinking fluids.
- Among the options for laxatives, one type includes bulk-forming laxatives. These include powders that you can mix with juice or water, such as psyllium seed (Metamucil™) and wheat dextrin (Benefiber™). Some are sold in biscuit or pill form, too. These products absorb water and increase soft stool in the colon.
- Second, there are agents that act like soap, softening stool and making it more slippery. These usually come in pill form, and the most common one is docusate sodium (Colace™).
- Third, there are osmotic laxatives, which are poorly absorbed substances that stay in the colon and absorb extra water. Examples of osmotic laxatives include magnesium or saline (magnesium citrate or Milk of Magnesia™), polyethylene glycol (Miralax™) and lactulose.
- Finally, there are stimulant laxatives such as bisacodyl, senna. These increase intestinal activity. Osmotic and stimulant laxatives come in both oral pills and powders, as well as rectal forms, like enemas or suppositories.
We recommend trying a single laxative from one of these four categories, and if that doesn’t work you may add one from a different category. Staying regular helps people feel good! Remember to watch for any warning signs, and see a doctor right away if you do. We at Granville Primary Care, Butner-Creedmoor are always glad to discuss constipation, as well as other digestive issues.
Dr. Liz Baltaro and Dr. Amy Nayo are primary care physicians expanding community access to quality pediatric and family medicine at Granville Primary Care, Butner-Creedmoor, located at 1614 NC Highway 56, Butner. To schedule your primary care appointment, please call 919-575-6103 or schedule online at ghshospital.org. You can schedule a primary care appointment with a provider as far as 12 months in advance through online scheduling.