What is constipation?

Constipation

Constipation: Overview

Constipation means that you have a hard time passing stools (bowel movements). People pass stools from 3 times a day to once every 3 days. What is normal for you may be different. Constipation may occur with pain in the rectum and cramping. The pain may get worse when you try to pass stools. Sometimes there are small amounts of bright red blood on toilet paper or the surface of stools. This is because of enlarged veins near the rectum (hemorrhoids).

A few changes in your diet and lifestyle may help you avoid ongoing constipation. Your doctor may also prescribe medicine to help loosen your stool.

Some medicines can cause constipation. These include pain medicines and antidepressants. Tell your doctor about all the medicines you take. Your doctor may want to make a medicine change to ease your symptoms.

What are the types of laxatives?

There are four types of products for preventing or treating constipation.

Bulking agents.

Food such as bran or products such as Citrucel, Metamucil, Fibercon, or Perdiem ease constipation by absorbing more fluid in the intestines. This makes the stool bigger, which gives you the urge to pass the stool. Regular use of bulking agents is safe and often lets you have more stools.

Stool softeners.

Products such as Colace lubricate and soften the stool in the intestine, making it easier to pass. Stool softeners do not often cause problems but they don't work as well if you don't drink enough water during the day.

Osmotic laxatives.

Products such as Fleet Phospho-Soda, Milk of Magnesia, or Miralax and nonabsorbable sugars such as lactulose or sorbitol hold fluids in the intestine and draw fluids into the intestine from other tissue and blood vessels. This extra fluid in the intestines makes the stool softer and easier to pass. Drink plenty of water when you use this type of laxative.

Stimulant laxatives.

Products such as Correctol, Dulcolax, Ex-Lax, bisacodyl, or Senokot speed up how fast a stool moves through the intestines by irritating the lining of the intestines. Regular use of stimulant laxatives is not recommended. Stimulant laxatives change the tone and feeling in the large intestine and you can become dependent on using laxatives all the time to have a bowel movement.

Avoiding constipation to keep your bowels healthy

For healthy bowels, avoid constipation. You can try these steps.

  • Eat foods high in fiber.

    Include fruits, vegetables, beans, and whole grains in your diet each day.

  • Drink plenty of fluids.
  • Get some exercise every day.

    Try to do moderate activity that adds up to at least 2½ hours a week. Or try to do vigorous activity that adds up to at least 1¼ hours a week.

  • Take a fiber supplement.

    You can take a fiber supplement such as Citrucel or Metamucil, every day if needed. Read and follow all instructions on the label.

  • Schedule time each day for a bowel movement.

    Having a daily routine may help. Take your time and do not strain when you are having a bowel movement.

Caring for your child who has constipation

Here are some tips for caring for your child who is constipated.

  • Make sure your child drinks enough fluids.
  • Give your baby the right amount of extra fluid if you are using formula.
    • If you are switching from breast milk to formula or are only using formula, give your baby no more than 1 fl oz (30 mL) to 2 fl oz (60 mL) of water and no more than 2 times each day for the first 2 to 3 weeks. Be sure to give your baby the suggested amount of formula for feedings plus the extra water between feedings. Don't give extra water for longer than 3 weeks unless your doctor tells you to. Don't give plain water to a baby younger than 2 months.
  • If your child is older than 6 months, add fruit juices, such as apple, pear, or prune juice, to relieve the constipation. Don't give more than 4 fl oz (120mL) a day and don't give water for more than a week or two.
    • After age 6 months, give 0.5 Tbsp (7 mL) to 2 Tbsp (30 mL) of prune juice. Increase the amount slowly over time.
    • At age 9 months, add 1.5 Tbsp (22 mL) to 3 Tbsp (45 mL) of strained prunes each day.
  • If fruit juices don't help, add baby foods with a high fiber content twice a day.

    High-fiber baby foods include cooked dried beans or peas (legumes), apricots, prunes, peaches, pears, plums, and spinach.

  • For children age 12 months and older, add high-fiber foods.

    A diet with enough fiber (20 to 35 grams each day) helps the body form soft, bulky stool.

    • Give your child at least 1 cup of fruit a day. Choose whole fruit instead of fruit juice.
    • Give your child at least 1 cup of vegetables a day.
    • Include high-fiber foods, such as beans or whole grains, in your child's diet each day.
    • If your child gets constipated easily, limit foods that have little or no fiber, such as ice cream, cheese, meat, and processed foods.
  • Gently massage your child's belly.

    This may help relieve discomfort. You can also have your child lie on their back, legs flexed onto their belly. Then rotate your child's legs in a clockwise direction.

  • Try a bath or suppositories to relieve rectal pain.
    • Give your child a warm bath in the tub. This may help relax the muscles that normally keep stool inside the rectum (anal sphincter) so your child can pass the stool.
    • If your child is age 6 months or older and the warm bath doesn't work, use 1 glycerin suppository. It can lubricate the stool and make it easier to pass. Use a suppository only once or twice. If constipation isn't relieved or occurs again, talk with your doctor.
  • Don't give laxatives or enemas to children without first talking to your doctor.

    Children shouldn't need an enema or laxatives to have a bowel movement.

What is constipation in children?

Constipation occurs when stools become hard and are difficult to pass and your child is passing fewer stools. A child may cry because they are constipated. A crying episode usually occurs while the child is trying to pass a stool and normally will stop when the stool is passed.

Some parents are overly concerned about how often their child has a bowel movement because they have been taught that a healthy child has a bowel movement every day. This is not true. The frequency of bowel movements is not as important as whether the child can pass stools easily. If your child's stools are soft and pass easily, your child isn't constipated, even if your child doesn't have a bowel movement every day.

Constipation in children: When to call

Call your doctor now or seek immediate medical care if:

  • There is blood in your child's stool.
  • Your child has severe belly pain.
  • Your child is vomiting.

Watch closely for changes in your child's health, and be sure to contact your doctor if:

  • Your child's constipation gets worse.
  • Your child has mild to moderate belly pain.
  • Your baby younger than 3 months has constipation that lasts more than 1 day after you start home care.
  • Your child age 3 months to 11 years has constipation that goes on for a week after home care.
  • Your child has a fever.

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