Constipation. It’s one of those icky topics most of us are too squeamish to talk about so we suffer in bloated, uncomfortable silence. When we do finally get frustrated enough to see a doctor, the solution to the problem is usually simple and has been under our control all along.
“For many, it’s too embarrassing to discuss and so they may not bring it up with their doctor until it reaches the point where it’s extremely uncomfortable,” said Dr. Eric Esrailian, co-chief of the Vatche and Tamar Manoukian Division of Digestive Diseases at the University of California, Los Angeles. “They may not even discuss it with family and friends.”
Constipation turns out to be one of the top reasons people show up in the gastroenterologist’s office, according to Dr. James Reynolds, director of the program in neurogastroenterology and motility at the Perelman School of Medicine at the University of Pennsylvania.
You should know the average person’s body wants to have one big bowel movement a day, and preferably in the morning, Reynolds said.
When things get irregular, people often don’t realize their symptoms point to constipation. “They’ll say, ‘I’m not constipated, I go to the bathroom,’” Esrailian says. “But if you have to strain and you’re uncomfortable with each bowel movement, you may have underlying constipation.”
Many end up with chronic constipation because of misconceptions about how the bowels are supposed to work, Reynolds added “frequency doesn’t correlate with how well your system is working. Some constipated people will have multiple bowel movements a day or even conditions that they perceive as diarrhea.”
If you’re passing material that looks like rabbit pellets, then you’re constipated, no matter how many times it happens in a day, Reynolds said. The bloating that’s making you crazy is just what happens when there’s a backup of waste material in the colon, Reynolds says. That backup is also responsible for the loss of appetite.
“I tell my patients that your colon is like a savings account,” Reynolds explains. “So if you’re supposed to pass 300 milliliters a day, but you’re retaining 100 — in a week or two, you’ve got 1½ quarts of excess stool in your colon.”
It all comes down to priorities. What will get you on the right track is the right diet, exercise and the will to make time for it.
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Lifestyle changes to banish constipation are fairly simple:
1. Leave enough time in the morning to take care of your bathroom needs.
Do this even if this means getting up a little earlier, Reynolds suggested.
2. Don't make abrupt changes in your diet.
"The lower gastrointestinal tract enjoys being bored," said Dr. James Dewar, an assistant professor of family medicine at the University of Pittsburgh School of Medicine. "That's why we can become constipated when we go on vacations and live on a different schedule and are trying different foods. We wonder why things are not working and why we feel bloated. Get into a routine and stick with it and things will return to normal."
3. Drink plenty of fluids.
Dewar doesn't suggest a specific amount for everybody. "It should be enough that you are going to the bathroom every two to three hours and passing a decent volume of urine that is the color of a pale lemonade — that's a sign that you are well hydrated," he said.
4. Include plenty of fiber in your diet.
Reynolds suggested fruits and foods that contain oats. Indulge in probiotics. Whether you get it from a pill or from an active culture yogurt, it will make your digestive system happy, Reynolds said.
A side benefit from fixing your constipation: you’re far less likely to develop hemorrhoids.