Constipation

Constipation is a condition that causes you to have difficulty passing stools. Normally, people have anywhere from two or three bowel movements a week to two or three a day. Constipation can occur at any age, but it is more frequent in infancy and old age.

Signs and Symptoms

What Causes It?

Most cases of constipation are caused by changes in diet or physical activity, including not drinking enough fluids. Psychological factors, particularly depression, may cause constipation. Chronic abuse of laxatives can also lead to chronic constipation. Certain drugs can cause it, as can physical abnormalities in the bowel or intestinal tract.

What to Expect at Your Provider's Office

Your health care provider will perform a physical exam and may feel your abdomen or give you a rectal examination. Tests may include blood and stool evaluations, or more specialized tests such as a barium enema (where a contrast dye is given in an enema—the dye outlines the intestines on x-ray).

Treatment Options

Chronic constipation can usually be prevented with a combination of dietary changes, extra fluid intake, exercise, and, when necessary, short-term use of a laxative. Your health care provider may talk with you about proper bowel habits (consistent, unhurried elimination practices). He or she may have you use a laxative or stool softener over the short term or suggest a bulk-forming agent, such as psyllium, bran, or methylcellulose. You can purchase these bulk-forming agents over the counter.

Drug Therapies

With more than 700 commercial laxative products available, the choice is often individual preference. People with any bowel obstruction, abdominal inflammation, or kidney or heart failure should not take the following laxatives:

Complementary and Alternative Therapies

Lifestyle and dietary changes along with nutritional support can contribute to the long-term resolution of constipation. Certain herbs may help promote bowel activity. Use laxative herbs with caution because they may become less effective with habitual use.

Nutrition

Herbs

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups a day. Tinctures may be used singly or in combination as noted.

A combination of herbs to aid digestion and relieve constipation includes the following in equal parts as a tea or tincture: licorice root (Glycyrrhiza glabra), cascara sagrada (Rhamnus purshiana), dandelion root (Taraxacum officinale), yellowdock (Rumex crispus), fennel seed (Foeniculum vulgare), and ginger (Zingiber officinale). Steep tea for 20 minutes. Drink 1 cup, three times a day, before meals. You may take 15 to 20 drops of a tincture, three times a day, before meals. For long-term use (more than two weeks), eliminate cascara and substitute burdock (Arctium lappa). Do not take licorice if you have high blood pressure.

Homeopathy

Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of constipation based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

Physical Medicine

Castor oil packs to the abdomen may be useful in resolving constipation. Apply oil directly to skin, cover with a clean, soft cloth (for example, flannel) and plastic wrap. Place a heat source (hot water bottle or heating pad) over the pack and let sit for 30 to 60 minutes. For best results, use for three consecutive days in one week.

Contrast hydrotherapy may help to stimulate digestion. Apply hot and cold towels to the abdomen. Alternate three minutes hot with one minute cold. Repeat three times to complete one set. Do two to three sets a day.

Acupuncture

The studies investigating acupuncture treatment for constipation have been small and have produced both positive and negative results. In one study of 17 children, acupuncture successfully treated constipation.

Although acupuncturists do treat constipation, they generally believe that constipation is a symptom of a different underlying gastrointestinal condition. Acupuncturists treat people with constipation based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of gastrointestinal conditions, a qi deficiency is usually detected in the colon and lung meridians.

Chiropractic

Although no well-designed trials have evaluated chiropractic treatment for constipation, some chiropractors suggest that manipulation (particularly in the lower spine) helps relieve constipation in certain individuals.

Massage

Therapeutic massage can help reduce stress and relieve constipation due to spasm and nervous tension.

Following Up

If you have chronic constipation, you may need to work regularly with your provider. Left untreated, it can cause serious health problems.

Special Considerations

Constipation is common in pregnancy and is usually relieved by changing your diet and drinking more water. If you are pregnant, do not take herbs that are stimulating to the digestive tract since they can induce contractions. Do not use laxative herbs in pregnancy without a provider's supervision.

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