Constipation

Constipation is the most common gastrointestinal complaint in North America. Constipation may be defined as the passage of hard, dry stools fewer than two or three times each week (depending on age). Some people complain of pain, bloating, nausea, vomiting, straining, incomplete clearing of stools, and feeling sluggish or uncomfortable. Constipation is usually mild in severity, of temporary duration and of unknown cause. For most people, constipation may be prevented or relieved by ensuring adequate fluid intake, increasing consumption of fibrous foods, engaging in regular physical activity and practicing good bowel habits. Adults should drink six to eight 250 mL glasses of water and eat 25 to 35 grams of fiber each day as part of a well-balanced diet. Good sources of fiber are listed in Canada's website (www.hc-sc.gc.ca/hppb/nutrition/). Fruit juices including prune, apple and pear may also be helpful in countering constipation. Good bowel habits include trying to move the bowels at the same time each day, rather than waiting for, or disregarding the urge to defecate.

Constipation may persist in some individuals despite adhering to lifestyles measures. Constipation is a side effect of some common medicines, including non-prescription products such as antacids, certain pain relievers and iron. The condition also occurs more commonly in patients with diseases including Parkinson's disease, multiple sclerosis, diabetes, depression and irritable bowel syndrome. Your pharmacist is trained to assess and refer people with constipation, and may recommend use of a nonprescription laxative product.

There are several types of laxatives available and one may be best suited to your particular needs: ask your pharmacist for advice on selecting the right product. Laxatives may not be suitable for children, so always check with your pharmacist or doctor first. See your doctor if you are constipated and:

• haven't had a bowel movement for a week or more
• have bowel problems which are long standing or recurrent
• feel extremely uncomfortable or experience pain during defection
• experience rectal bleeding
• have a fever, vomit or have severe belly pain.

More information on constipation can be obtained at www.vh.org/adult/patient/internalmedicine/constipation/index.html