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A Conversation about Constipation

Let's chat about constipation.

That invitation alone ought to provide a certain relief to some of the estimated 4 million Americans who suffer from recurrent constipation. After all, for such a common problem, it's not one we discuss much. As they say, misery loves company....

I got to thinking about constipation while writing this week's "Eat, Drink and Be Healthy" column about probiotics, the edible "friendly bacteria" that are touted as fix-alls for everything from the immune system to the digestive tract. While probiotics may in fact help keep some people more regular by populating their intestines with "good" bacteria, more research is needed before any strain of probiotic can be confidently recommended as a standard medical treatment for constipation.

Constipation -- which is technically defined as having a bowel movement less frequently than once in three days -- can be chronic or temporary. Beyond that, constipation's in the eye of the beholder: If you're accustomed to going three times a day and you're suddenly reduced to one, that may be your version of constipation.

Sometimes constipation's related to stress; some people (like me!) get that way when our schedule is disrupted, as when we travel. While some diseases, hormonal imbalances such as those a woman experiences during pregnancy, and medications can cause chronic constipation, quite often it's a result of poor diet and lack of exercise.

But improving your diet -- by adding more whole grains, legumes, vegetables and fruits -- can be hard, particularly for older people for whom shopping and cooking are challenging. Exercising requires resolve, too. That's in part why so many people turn to laxatives to relieve constipation: According to the the NIH, Americans spend more than $725 million a year on over-the-counter laxatives.

Nearly everyone gets constipated once in a while. But if you find yourself getting that way more often than usual, you should see a physician to make sure illness or a medication's not to blame. If neither appears to be the culprit, it might behoove you to gradually introduce more fiber into your diet. You could also try eating yogurt, making sure the variety you choose contains live cultures. (Here's more on choosing a probiotic product.) Just go easy at first, as introducing these foods too abruptly could cause uncomfortable bloating, gas and even diarrhea.

Do you suffer from chronic (or occasional) constipation? What do you do to correct it?
Please cast your vote in this week's "poll" (which we know isn't scientific, right?) and elaborate in the Comments section below.

Results of last week's poll: More than 500 people weighed in to say how many different diets they'd tried. 32 percent had tried fewer than 5; 27 percent had tried between 5 and 10, followed closely by the 26 percent who had tried more than 10 diets. 12 percent of you said you'd tried none at all.

Coming next Tuesday: This weekend I'm going to try my hand at making home-made yogurt. I'll document the process in photos and post them here next week!

By Jennifer LaRue Huget  |  March 24, 2009; 7:00 AM ET
Categories:  Alternative and Complementary Medicine , Chronic Conditions , Family Health , General Health , Nutrition and Fitness  
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I missed the earlier article on dieting but my comment would have been the same then as it is now for constipation. A heart-healthy vegan diet (i.e. plant-based; basically no meat, no dairy) has not only made it easy for my family to lose weight but regularity is not a problem even with travel and stress. It also makes for spending less money on groceries...but a little more time in the kitchen.

Posted by: dotboy10 | March 24, 2009 7:52 AM | Report abuse

25 g of fiber daily goes a long way towards preventing this problem.

Posted by: RedBird27 | March 24, 2009 7:55 AM | Report abuse

I have been eating 3/4 cup of wheat bran on my cereal for 33 years, I have NO constipation and my colonoscopy results at age 50 were pronounced "Clean as a whistle!"

Posted by: hsk0526 | March 24, 2009 10:11 AM | Report abuse

I exercise aerobically at least 30 minutes daily--long time runner. I have a healthy and varied diet. Most of the time, I have no problem with constipation EXCEPT when I take iron or calcium (even medications that are coated or include calcium). During four pregnancies I was unable to take iron supplements and in my post menapausal years I have been unable to supplement with calcium and have suffered some bone loss. The trade off is just too great. If I become constipated, my hemmorhoid acts up. Does anyone have an answer? I'd like to fortify my bones and blood but can't tolerate the effects of constipation that would result.

Posted by: jpionkow | March 24, 2009 11:34 AM | Report abuse

For the record, diet and exercise aren't always the cure all. I get 20-25 grams of fiber a day and run 30-35 minutes a day 5 days a week and on a good week, I have three bowel movements. I eat everything you're supposed to: leafy greens, fiber-rich cereal (my cereal alone contains 13g in one cup!), strawberries, blueberries, fiber-rich yogurt, drink coffee and even with the exercising I still suffer- have suffered all my life. My mom made me drink pruce juice at a young age- nothing has ever helped. I know that I could go to the doctor and get medication, but I've just learned to live with problem.

Posted by: efort1 | March 24, 2009 4:27 PM | Report abuse

Isn't staying hydrated a major player in remaining regular?

Posted by: jbsuisse | March 24, 2009 5:29 PM | Report abuse

4 prunes a day will work for most people, and they are loaded with beneficial nutrients. Or try PlumSmart, a refreshing delicous fruity fresh plum juice, 8 oz a day. Found right next to Prune Juice in the grocery store. Or the old stand-by, Prune Juice, drink 6 - 8 oz daily. All natural ways to go!

Posted by: prune | March 24, 2009 6:48 PM | Report abuse

I've dealt with Irritable Bowel Syndrome on and off for most of my life, and have periods of constipation that alternate with episodes of diarrhea. Fun. From my perspective, constipation is more about having hard, dry stools than the frequency of going. I don't obsess about whether I go once, twice, or three times a day, or once, twice, or three times a week. But I hate it when I need to go and I have trouble (and discomfort!) passing the stool because it's so hard.

When worse comes to worst, a dose of a stool softener can help. And once in a while, maybe twice a year, I have to resort to a laxative. But mostly I try to eat well and stay well-hydrated.

There's a real danger in taking laxatives frequently, as many people with binge/purge eating disorders have found. Your colon eventually becomes atonic and normal peristalsis stops, which can cause big problems.

Posted by: sally1860 | March 24, 2009 7:17 PM | Report abuse

I've tried it all for constipation - prunes, laxatives, fiber, etc. I find nothing replaces a balanced diet (low sugar and starch) and regular exercise. There are some probiotics that can help with constipation. Supplements and foods containing Bifidobacteria target the colon and lower GI tract that can be helpful in alleviating constipation. I've tried Nutri Health's Flora Source, which contains 5 Bifidobacteria strains.

Posted by: AnnaM2 | March 25, 2009 11:28 AM | Report abuse

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