Constipation

Keywords: treatment for constipation, treatment of constipation, constipation treatment, dyschezia, stool impaction, fecal impaction

 

Funny Bone: Constipation Poem

I’m still sitting here alone
At the feasting’s aftermath
Trying to empty myself
But can only pass gas

This darn solid impaction
Would still refuse to budge
And though I push, and push
In the bowl, there’s still no fudge!

Valsalva maneuvers, Ha!
You have really failed me now
This load that’s inside of me
Feels like the load of a cow’s

I can feel it all upstairs
But my sphincter won’t dispose it
This will surely be my ticket
Straight to diverticulosis

And hemorrhoids! No please…
Don’t mention that one!
Bless me with a family of those
And gone are my days of fun

Alright. Now I can feel it coming
After pushing for thirty minutes
Get ready.  Get Ready!  Fire!
And out comes one single pellet!

Super Mom, forgot the importance of fiber…

Constipation (dyschezia): having a decreased frequency of bowel movements, resulting in retention of stool in the abdomen.  And yes, you can be constipated while still having bowel movements.  This is a common question patients ask me.  This is possible because although you are voiding,  you may not be voiding as much as you need to so it backs up. This results in abdominal pain, mostly on the left abdomen, but can be all over the abdomen.  You also may have abdominal distension, and difficulty to void.


Red Flags for Constipation

If you’re having any of these symptoms, go immediately to see your doctor or the Urgent Care for evaluation for a more serious medical problem and receive proper treatment.

  • constipation with severe abdominal pain or distension
  • constipation with a fever, body aches, chills, night sweats
  • constipation with rectal pain or rectal bleeding
  • constipation with inability to pass gas as well
  • constipation with nausea and vomiting
  • constipation with weight loss

 

Self Treatment for Constipation

If you do not have any of the above red flags and simply haven’t had a bowel movement as often as usual, then you may try to self-treat first before seeking medical advice.

Drink Plenty of Water: More often than not, my patients with constipation are slightly dehydrated.  This is usually confirmed with a urine test that shows a very concentrated urine.  Then when asked, they readily admit that they know they don’t drink enough water.  How can you tell when you’re dehydrated?  You might be dizzy when you get up, you might feel thirsty, your urine is dark, or you haven’t been able to urinate at all.

The classic recommendation is to drink  eight glasses (8 oz. each) of water a day, although we’re questioning whether there is scientific data to support that recommendation.  Pure water is better than any other beverages, some of which can dehydrate you even more.  If you have been vomiting or having diarrhea, you may drink diluted Gatorade instead to replenish your electrolytes.  Dilute it down to 1/3 to 1/2 with water.  Drink until your urine is a very light yellow.  Every time you notice your urine is darker than a slight yellow, drink more water.  This alone may do the trick for your constipation because just by adding water to the dried stools in your intestines, you slush it up so it can move on out!

Add Juices with Osmotic Pressure: The classic one we recommend as family practitioners is prune juice.  That’s because it is concentrated enough to actually draw fluids from your intestines through osmotic pressure to add fluid to your stools to help soften them up to move them.  The aweful thing about prune juice is the taste.  Not a lot of people like them, so I sometimes recommend concentrated apple juice or orange juice instead.

Add Fiber to your meals: You should always aim to get more fibers in your meals to prevent constipation.  However, once you are constipated already, you may have to add it as a supplement.

 

Medications at the Pharmacy for Constipation

If the above steps have not helped you, you may need to turn to your friendly pharmacist for help with this one.  The top 3 brands recommended by pharmacists are listed below, according to Pharmacy Time’s OTC Guide.  Always follow directions on the bottles.

Fiber Bulker/Laxatives: It’s too late you add fibers to your diet now, you’ll need to boost it up with some supplemental fibers to jump start the machine.  The top 3 products recommended are Metamucil, Benefiber, and Citrucel.  I prefer the powder form that you mix into your drinks instead of the pills.  That way, you also get the fluids down at the same time.

Oral Laxatives: If the fibers don’t work, go on to these guys.  These are non fiber laxatives, designed to help you purge your system.  They may cause cramping and abdominal pain.  The top 3 brands are MiraLAX, Phillip’s Milk of Magnesia, and Fleet Oral Laxatives.

Laxative Stimulants: These guys are even stronger.  They actually stimulate your instestines to contract and push things along, therefore, they may cause more abdominal cramps.  Top 3 brands are Senokot (senna), and Dulcolax (docusate) or Peri-Colace (also docusate).

Enemas: Enemas are a last resort.  They may work if your stool is impacted just above the rectal vault, but may not be as effective if the impaction is higher up.  If you’re desparate, go ahead and try a Fleet Enema.

Most cases of constipation can be successfully treated at home following the above guidelines in a step wise fashion, each step adding something stronger.  Once your constipation has resolved, you should work on changing your habits to prevent future constipation by:

  • eating more fibers with your meals
  • drinking plenty of water.  The classic recommendation is 8 glasses of water 8 oz. each per day, but that may seem too much for some.  I usually recommend to drink until your urine is a slight yellow.
  • excercise regularly to help move the bowels as well.

However, if you’ve reached the end of the list above and you don’t feel any relief with your constipation, then it’s time to pay your doctor a visit.

 

When Should You See Your Doctor for Constipation?

  • When you’ve exhausted the above list and are still not having regular bowel movements
  • When pain and distension in the abdomen becomes severe
  • When you start getting nausea or vomiting
  • When you start getting fevers, chills, body aches, or sweats

 

What Can Your Doctor Do for Your Constipation?

  • Examine you and give you a definitive diagnosis and treatment plan.
  • Do blood tests to make sure your liver, kidneys, gallbladder, and pancreas are not involved
  • Do abdominal x-rays to see the extent of the constipation and see if there are signs of other serious medical conditions
  • Determine if it is safe for you to try even stronger laxatives, and prescribe them if necessary
  • If necessary, order a CT scan of your abdomen to rule out other conditions
  • If necessary, send you to a gastroenterologist to further evaluate and treat you

Danh H. Nguyen, M.D.
Patient’s Self Treatment Guide
“Written For Today’s Self-Empowered Patients”
Last Updated 05/23/2011

© www.selftreatmentguide.com

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