Q: I am a healthy person, but I have a problem with
having proper bowel movements even though I eat a healthy diet. What can
Dr. Donnica: I am assuming you mean you have trouble with constipation,
which is a very common challenge for women. In constipation, bowel movements
either occur less often than expected, or the stool is hard, dry, and difficult
to pass. Normal frequency for bowel movements varies considerably, but ranges
from 3 times per day to 3 times per week. Constipation is usually related to
diet, lifestyle, or medications. While you may have a healthy diet, it may be
low in fiber. You need about 25 to 30 grams of fiber daily to be "regular."
Most Americans get less than half that amount. Foods high in fiber that promote
bowel regularity include most fruits and veggies, although bananas may be binding.
Raisins and prunes on the other hand, can really help.
Usually when discussing constipation we focus on what you eat, but what you
drink-and how much-may be even more important. Be sure to drink an adequate
amount of water or other beverages such as fruit juice (6 to 8 glasses per day).
Exercise is important to most aspects of our health, and bowel regularity is
no exception; this is the reason a vigorous daily walk is called a "constitutional."
Poor toilet habits can also contribute to constipation, such as ignoring the
urge to defecate because of travel, convenience, or competing demands (a big
problem for moms with small children, for example). Go when you gotta go!
Constipation may also occur as
a side effect of many different prescription and nonprescription medications,
including iron supplements and vitamins that contain iron; calcium supplements;
antacids that contain aluminum; antidepressants and tranquilizers; narcotic
pain killers; general anesthesia; diuretics; and certain prescription drugs
used to treat hypertension (especially verapamil), seizure disorders, or Parkinson's
disease. Overuse of laxatives can also be a problem. Your body comes to rely
on these medicines, eventually causing constipation rather than relieving it.
Less often, constipation may be a symptom of some underlying illness
or condition that either affects the digestive tract alone or involves larger
portions of the body. Examples of this include irritable bowel syndrome, intestinal
obstruction, diverticulitis, colorectal cancer, hypothyroidism, hypercalcemia,
systemic sclerosis, multiple sclerosis, Parkinson's disease and spinal cord
Constipation is a very common problem that affects at least 80 percent
of people at some time in their lives. Currently in the United States, treatment
for constipation accounts for over 2.5 million visits to doctors' offices each
year, with at least $800 million spent annually for laxatives. Although adults
of all ages may suffer from constipation, the risk for this problem increases
dramatically after age 65 in both men and women.
Symptoms of constipation include:
- Fewer than three bowel movements per week
- Small, hard, dry stools that are difficult or painful to pass
- The need to strain excessively to have a bowel movement
- A feeling that your rectum is not empty after a bowel movement
- Frequent use of enemas, laxatives or suppositories
If you have constipation together with rectal bleeding, abdominal
pain or abdominal distention, tell your doctor immediately. He or she may wish
to see you for further evaluation, including a brief physical exam and digital
Created: 8/15/2002  - Donnica Moore, M.D.