December is Constipation Awareness Month

The period between Thanksgiving and New Years is probably the time of year when our diets change the most through more opportunities for overeating, eating at irregular times and consuming a variety of holiday goodies. In addition, this hectic and stressful time of year, with shopping and parties added to our regular activities, undoubtedly leads to fewer of us getting the exercise we need. These factors are all set ups for changing bowel habits.

No doubt that many of us, including celebrities, will be undergoing various types of “cleanses” in January as part of our New Years’ resolutions.

How do you know if you’re constipated? Doctors and patients can and often do differ in what they mean by particular terms. Below are the so-called “Rome criteria” for constipation. You have to have two or more of these symptoms for at least three months:

  • Straining at defecation at least 25% of the time
  • Hard stools (see Bristol Stool Chart) at least 25% of the time
  • Incomplete emptying of the bowels at least 25% of the time
  • Two or fewer bowel movements per week

An important point to remember is that constipation affects almost everyone at one time or another. In most cases, following these simple steps will help prevent constipation:

  • Eat a variety of foods especially vegetables, fruits, and whole grains
  • Drink plenty of liquids
  • Exercise regularly
  • Visit the restroom as soon as you feel the urge to have a bowel movement
  • Fiber-containing tablets and powders available at the drug store may help
  • Consider using a diet journal to track your eating habits and patterns

One important point is that some medicines can cause constipation. Topping this list are prescription painkillers such as demerol.

Constipation is very prevalent in elderly patients as noted by Hippocrates who said, some 2,500 years ago, “the intestines tend to become sluggish with age.”

Constipation in children is common and rarely a sign of a serious health problem. However it can affect quality of life and cause emotional problems and family stress.

Links for health care professionals:

  • Systematic review: impact of constipation on quality of life in adults and children
  • The older person: management of constipation
  • Constipation in old age
  • Systematic review of randomised controlled trials: probiotics for functional constipation
  • Laxative abuse: epidemiology, diagnosis and management
  • Clinical Research Trials for constipation treatments
Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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