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Health Information The Hard Facts

Many adults — especially older adults — worry about their bowel movements, and many report constipation when they arent constipated at all. The big misconception leading to this anxiety: Healthy people have at least one bowel movement a day. The truth is, some people have bowel movements three times a day, some have them three times a week, says Carline Quander, MD, a gastroenterologist at Rush University Medical Center. In both cases, this could be perfectly normal.

So, what is constipation? Heres that answer, as well as some tips to help you prevent this common problem.

Its Constipation When...
Health care professionals consider you constipated if you have any two of the following symptoms for 12 (not necessarily consecutive) weeks in a 12-month period:

  • Fewer than three bowel movements per week
  • Straining during bowel movements
  • Lumpy or hard stools
  • Feeling of blockage in the anus or rectum
  • Feeling that everything isn't completely out
No one is immune to constipation, but by eating right and exercising you can help ward it off. The following tips for preventing constipation were provided by Susan Mikolaitis, RD, LDN, CNSD, a dietitian in Rushs Section of Gastroenterology and Nutrition.
  • Gradually introduce high-fiber foods into your everyday diet. Slowly increase your fiber servings by one serving every three to four days or you may experience increased gas. Remember to have the same number of servings of fiber every day; if you increase one day and decrease the next day, it will not be effective and may cause increased gas. See below for a list of foods that are rich in fiber.
  • Drink up. Drinking liquids can add fluid to the colon and bulk-up stools, which can make bowel movements softer and easier to pass. Contrary to popular belief, coffee counts as fluid, and an 8-ounce cup daily can help keep you regular.
  • Avoid foods with lots of added sugar. The 2005 Dietary Guidelines for Americans recommends no more than 8 teaspoons or, if youre reading food labels, 32 grams of added sugar to your diet daily. (Naturally occurring sugar from fruits, vegetables and milk are not considered added sugar.) Thats a lot less than you think. For example, a 12-ounce soda has 37.5 grams of added sugar, already higher than the recommended daily amount. Added sugars are also found in cakes, cookies, pies and other sweets.
  • Downsize the dairy. Most dairy products do not contain fiber. So limit low-fat milk, yogurt, and cheese consumption to a total of two servings a day. A serving is considered 8 ounces of low-fat milk, 6 ounces of low-fat yogurt with active cultures, or 1.5 ounces of low-fat cheese. To make sure you get the recommended daily amount of calcium, supplement your diet with nondairy foods that are rich in calciuim, such as soy milk, fortified cereals or orange juice, cooked soybeans, black or navy beans, almonds and spinach.
  • Avoid highly processed foods. White bread, white rice, white pasta, and other highly processed foods can increase constipation. Choose breads for which whole grain flour is the first ingredient on the label; they contain more nutrients and fiber than bread made from enriched or bleached flour. Likewise, whole wheat pasta, brown rice, amaranth, and quinoa are healthier alternatives to white pasta because they are higher in nutrients and fiber.
  • Limit the red meat, fish, and poultry. They are not a good source of fiber. If constipation is a problem for you, beef up on fiber-rich veggies and whole grains instead.
  • Exercise every day. Lack of exercise can cause food to move through the large intestine more slowly and increase the amount of water taken from the stool into the body. The less water you have in stools, the more likely youll get the hard, dry stools associated with constipation.
  • Break for the bathroom. If you ignore the urge to go, you may eventually stop feeling the urge, which can lead to not going. And the longer you hold it in, the more likely youll get constipated. So when you feel the need, go to the bathroom as soon as possible.
Keep in mind that constipation is a symptom, not a disease. In some instances, the cause can be something serious like cancer, polyps, or colitis (which is inflammation of the colon caused by problems such as poor blood supply), infection or an autoimmune reaction when the body mistakenly attacks healthy tissue as opposed to foreign invaders like viruses. More often, the problem is nothing severe.

If constipation is interfering with your daily routine, talk to your doctor before self-medicating. Many people rely too heavily on over-the-counter laxatives. The body can grow reliant on these medications, causing users to increase doses and fail to address the source of the problem. A conversation with your doctor could lead to a simpler, less habit-forming solution.

The Facts on Fiber
According to the American Dietetic Association, a person should eat between 20 and 35 grams of fiber daily. Exactly how much you need is based on the amount of calories your body requires to maintain a healthy weight. People who require fewer calories to maintain a healthy weight need closer to 20 grams of fiber a day, while the people who require more calories need closer to 35 grams per day.

The following is a list of some foods that provide an average of 2 to 3 grams of fiber per serving:
  • ¼ cup of beans or lentils
  • ½ cup of vegetables or fruits (eat the skin and seeds to get the full benefit)
  • 1 serving of whole-grain cereals and breads*
  • ½ cup oatmeal
  • ¼ cup nuts or seeds
  • 2 teaspoons of unprocessed bran, oat bran or rice bran added to yogurt with active cultures
*May contain more than 2 to 3 grams of fiber per serving.
More Information at Your Fingertips:
  • To learn more about constipation and other lower gastrointestinal problems, join experts at Rush for a free class on Tuesday, May 11. For more information or to register, call (888) 352-RUSH (7874).
  • Looking for a doctor? Call toll free: 888 352-RUSH (888 352-7874)
  • Follow Rush on Facebook and Twitter.

Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.

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