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Constipation

Constipation is a symptom, not a disease. and can be cured with a simple enema. It is frequently caused by a disturbance of bacteria and Flora of the large intestine.

The normal functions of the colon are to:

* Remove water and nutrients from the liquid waste material that passes from the small intestine into the colon.
* It serves as a storage area for waste material.
* Help move and expel feces from the body.

Constipation may occur because:

* Too much water is removed by the colon, causing dry or hard stools,
* Stool moves too slowly through the colon
* The patient is unable to expel feces.

Normal bowel habits among healthy people vary greatly from three times a day to three times a week. In some individuals, constipation may refer to infrequent bowel movements (less than 3 per week). While troublesome, constipation is usually not too serious. Constipation should be treated and corrected to reduce abdominal discomfort and other related symptoms and to prevent the development of complications. Untreated chronic constipation may lead to or aggravate more serious problems such as hemorrhoids or fecal impacting (partial blockage due to hard stool).

Measures to Treat Constipation:

The goal of treatment is to reestablish normal bowel habits without the use of laxatives. The treatment measures listed below should explain in more detail.

* Eat a diet high in roughage (fiber).
* Eat regular meals; it is especially important to have breakfast.
* Taking bulking agent with meals and follow with a full glass of water. Begin with:

     o 1-2 tablespoons  bran 3 times a day or
             o 1-2 heaping teaspoons Metamucil 3 times a day

* Never take harsh (stimulant) laxatives except as directed.
* Establish regular daily bowel habits; DO NOT ignore the urge to have a bowel movement.
* Allow 15 minutes after breakfast to sit on the toilet – do not strain.
* If there has been no bowel movement after 48 hours, take 1 or 2 tablespoons Milk of Magnesia at bedtime. but a warm water enema would be better for you and is faster.
* If no bowel movement occurs after 3 days, use a glycerin suppository and take a high enema
* Exercise daily.
* Whenever possible, avoid medications that contribute to constipation. DO NOT stop taking any prescribed medications unless approved to do so by your physician.

Proper Diet:

The first treatment for constipation is to eat a high fiber diet to provide natural bulk in your daily food intake. Dietary fiber, often called roughage, is a portion of food that passes through the intestine and colon almost unchanged. Undigested fiber holds water to keep the stool soft and adds bulk which helps move stool to the rectum. Most Americans eat very little roughage and this is often a major factor in the cause of constipation. An increase in dietary fiber generally results in a softer and bulkier stool which can be passed more easily. Ask to see a dietitian for complete instructions. Be sure to drink at least 3 glasses of water a day more is better !! 1 glass= 8 fluid ounces.

Bulk Agents:

Bulk agents are very useful in addition to dietary fiber to restore and maintain regularity. These include bran and psyllium.

Bran:

Unprocessed bran, known as “millers bran,” can be purchased at a health food store as an inexpensive source of fiber. Bran is the outer coating or shell on grain which is removed during processing white flour. It has very little taste. Wheat, oats, and brown rice are common sources of bran. One tablespoon of raw bran contains approximately 2 grams of dietary fiber. This may be used to supplement the fiber content of your diet.

Start with one or two tablespoons of bran in a glass of juice or water and gradually increase to three times a day with meals. If you prefer, it may be sprinkled on cereals or included in bran muffins, hamburgers, etc. Start slowly to allow your digestive system a chance to get used to increased fiber. Gradually increase the amount as necessary to achieve desired results. Bran tablets are also available – one tablet equals approximately 2 grams dietary fiber. Drink a full 8-oz glass of water with the tablets. You will find both fine bran and coarse bran available. Purchase the coarse bran because it holds water better.

With an increase in dietary fiber or the addition of bran to your diet, you may notice a temporary increase in bloating, fullness, abdominal cramps and gas. DO NOT STOP USING THE BRAN! Symptoms will lessen as bowel habits improve and usually disappear within 2-3 weeks. If discomfort is significant, it may be necessary to temporarily reduce your amount of fiber intake, then again gradually increase it as your body usually adjusts to the additional fiber. Do not give up if success is not achieved immediately.

Bran will not have any effect on stool already in the colon. It must mix with food in order to absorb water and increase stool volume. Depending on how long you have had constipation, improvement may take a few days to several months. Sometimes it is helpful to empty the bowel with a laxative before starting the high fiber and bran diet.

Commercial Bulk Agents:

Commercial bulk products provide natural or synthetic fiber which softens the stool, increases the bulk and makes the stool easier to pass.

Phylum is a natural dietary fiber made from ground husks of psyllium. seed, which has the ability to hold water and form bulk. psyllium. holds water better than bran, so smaller amounts are needed to be effective. Metamucil, Effer-Syllium, Perdieum Fiber and Fiberall powder or wafers are brands of psyllium.

Synthetic or man-made bulk forming products such as Citrucel or Fiberall Chewable Tablets are similar to psyllium. They work the same way and may cause less gas. Many pharmacies sell generic brands of bulk agents which are less costly.

Begin by taking 1 or 2 rounded teaspoonfuls of powder 2 or 3 times a day with meals. These agents are very safe and if you are not getting desired results, you should increase the daily dose. Mix rapidly with water or juice and drink immediately; followed by drinking a large glass of fluid. If preferred, fiber wafers may be used. The wafers should also be eaten with 8 ounces of your favorite beverage and, for best results, followed by another glass of liquid. Start with 2 wafers a day and increase to 2 wafers 3 times a day. Again, it may be a few days to several months before the desired effects are seen. Some of the recommended bulk agents are listed below – note the difference in dosage.

Each dose listed is equal to approximately 3.4 grams of psyllium. and may be taken 1-3 times a day.

Type Dosage
Powder
Citrucel, orange flavor 1 level tablespoon
Citrucel, sugar free 1 heaping tablespoon
Fiberall Powder 1 rounded teaspoon
Metamucil, sugar free 1 rounded teaspoon
Metamucil, regular flavor 1 rounded teaspoon
Metamucil, orange/strawberry 1 rounded tablespoon
Granules
Perdiem Fiber Granules 1 rounded teaspoon
Serutan Toasted Granules (chewable) 2 level teaspoons
Wafers
Fiberall Wafers 1 wafer
Metamucil Fiber Wafers 2 wafers
Tablets
Fiberall Chewable Tablets 1 tablet
Fiber Con 2 tablets
Powders
Metamucil, ALL 1 heaping tablespoon
Citrucel, ALL 1 heaping tablespoon

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