Do you know anyone who’s suffering from chronic constipation?
I do (no it’s not me). Someone close to me has been dealing with this condition for over 30 years. This article is for her, and anyone out there who knows someone with chronic constipation.
In a case published in the Canadian Medical Association Journal, Himanish Panda and Dr. Andrews described the story of a patient with chronic constipation. She wasn’t named, but I guess we can call her Caroline.
Caroline’s 40, with a history of difficulty passing stool over the last several years. She describes her stool as “hard and pellet-like”.
For years, Caroline was having difficulties going to the bathroom. Last year, she was going to the bathroom only every 3 or 4 days.
What can she do?
1. Make sure it is constipation
This may sound obvious, but it’s actually very important. In some cases, difficulty passing stool can be part of a more serious problem such as irritable bowel syndrome (IBS) or worse, bowel cancer. I wouldn’t want to imagine a missed diagnosis for one of those.
So, the first thing to do is to check for “alarm features”:
- Progressive weight loss
- Blood in the stool (may look more black than red)
- Presence of a lump in the abdomen or near the anus
- Anemia, particularly in men and postmenopausal women
For Caroline, she didn’t have any of these alarm features, so her doctor prescribed something simple to relieve her symptoms.
2. Try dietary fibre
If none of the alarm features are there, you can talk to your doctor about taking fibre supplements while drinking more water every day. It’s the simplest and least expensive thing to try, and gets to the cause of chronic constipation for most people.
What to do:
- Changes in diet (e.g., more vegetables), or psyllium fibre: 6-12 g a day
- Try it for 2 weeks and see how it goes
Caroline took psyllium fibre for two weeks, but it made her feel more bloated than before. So her doctor gave her something else.
3. Try a non-prescription laxative
There are many non-prescription laxatives out there. The generic name we want to look for is polyethylene glycol 3350 (PEG 3350). You may also know this as Lax-a-day or Restoralax.
Caroline took PEG 3350 at 17 g a day, and this worked for her.
- When dealing with chronic constipation, there’s basically two things to keep in mind.
- Can this be more serious than just constipation?
- If not, that’s good news! Try adding fibre into your diet or talk to your doctor about over the counter laxatives.
- If you are not sure about you or a loved one has constipation or something more serious, ask your doctor, nurse, or pharmacist.
Source case report: Panda H and Andrews CN. CMAJ 2016;188(4):277-8. A paid subscription may be required.
Photo adapted from original by Skitterphoto, used under license.