What Is Constipation?

Constipation occurs when bowel movements become difficult or less frequent. The normal length of time between bowel movements ranges widely from person to person. Some people have bowel movements three times a day; others, only one or two times a week. Going longer than three days without a bowel movement is too long. After three days, the stool or feces become harder and more difficult to pass.

You are considered constipated if you have two or more of the following for at least 3 months:

• Straining during a bowel movement more than 25% of the time.
• Hard stools more than 25% of the time.
• Incomplete evacuation more than 25% of the time.
• Two or fewer bowel movements in a week.

What Causes Constipation?

Constipation is usually caused by a disorder of bowel function rather than a structural problem. Common causes of constipation include:

• Inadequate water intake.
• Inadequate fiber in the diet.
• A disruption of regular diet or routine; traveling.
• Inadequate activity or exercise or immobility.
• Eating large amounts of dairy products.
• Stress.
• Resisting the urge to have a bowel movement, which is sometimes the result of pain from hemorrhoids.
• Overuse of laxatives (stool softeners) which, over time, weaken the bowel muscles.
• Hypothyroidism.
• Neurological conditions such as Parkinson's disease or multiple sclerosis.
• Antacid medicines containing calcium or aluminum.
• Medicines (especially strong pain medicines, such as narcotics,antidepressants, or iron pills).
• Depression.
• Eating disorders.
• Irritable bowel syndrome.
• Pregnancy.
• Colon cancer.

In some cases, lack of good nerve and muscle function in the bowel may also be a cause of constipation.

What Are the Symptoms of Constipation?

Symptoms of constipation can include:

• Infrequent bowel movements and/or difficulty having bowel movements.
• Swollen abdomen or abdominal pain.
• Pain.
• Vomiting.

How Is Constipation Diagnosed?

Most people do not need extensive testing to diagnose constipation. Only a small number of patients with constipation have a more serious medical problem. If you have constipation for more than two weeks, you should see a doctor so he or she can determine the source of your problem and treat it. If constipation is caused by colon cancer, early detection and treatment is very important.

Tests your doctor may perform to diagnose the cause of your constipation include:

• Blood tests if a hormonal imbalance is suspected.
• Barium studies to look for obstruction of the colon.
• Colonoscopy to look for obstruction of the colon.

The vast majority of patients with constipation do not have any obvious illness to explain their symptoms and suffer from one of two problems:

• Colonic inertia. A condition in which the colon contracts poorly and retains stool.
• Obstructed defecation. A condition in which the person excessively strains to expel stool from the rectum.

How Can I Prevent Constipation?

There are several things you can do to prevent constipation. Among them:

• Eat a well-balanced diet with plenty of fiber. Good sources of fiber are fruits, vegetables, legumes, and whole-grain bread and cereal (especially bran). Fiber and water help the colon pass stool.
• Drink 1 1/2 to 2 quarts of water and other fluids a day (unless fluid restricted for another medical condition). Liquids that contain caffeine, such as coffee and soft drinks, seem to have a dehydrating effect and may need to be avoided until your bowel habits return to normal. Some people may need to avoid milk, as dairy products may be constipating for them.
• Exercise regularly.
• Move your bowels when you feel the urge.

What Should I Do If I Am Constipated?

If you are constipated, try the following:

• Drink two to four extra glasses of water a day (unless fluid restricted).
• Try warm liquids, especially in the morning.
• Add fruits and vegetables to your diet.
• Eat prunes and/or bran cereal.
• If needed, use a very mild stool softener or laxative (such as Peri-colace or Milk of Magnesia). Do not use laxatives for more than two weeks without calling your doctor, as laxative overuse can aggravate your symptoms.

Warning About Constipation

Call your doctor if:

• Constipation is a new problem for you.
• You have blood in your stool.
• You are losing weight even though you are not dieting.
• You have severe pain with bowel movements.
• Your constipation has lasted more than two week

 Read on for some simple, recharging changes that can help you tackle all of the energy stealers in your life.

Energize Your Diet

Why is it that filling up on pasta or Chinese food for lunch leaves us snacky and sleepy an hour later? Or that falling short on fluids makes us forgetful and foggy? Fact is, eating habits play a powerful role in how well we function on every level. Below, six top fatigue-fighting nutrition strategies to chew on.

• Have breakfast... even if you don't feel hungry. You'll be a lot perkier: Studies show that people who eat breakfast feel better both mentally and physically than those who skip their morning meal. British researchers at Cardiff University even found that spooning up a bowl of breakfast cereal every morning is associated with lower levels of the stress hormone cortisol.
• Eat every three to four hours. Having three smallish meals and two snacks throughout the day can keep your blood sugar and energy levels stable all day long, says Roberta Anding, R.D., a spokesperson for the American Dietetic Association (ADA). Note the word "smallish." Supersized meals demand more of your energy to digest, which can leave you feeling lethargic. At each mini-meal, get a mix of carbohydrates (which the body uses for energy), protein (which helps sustain energy if needed), and healthy fats like those found in fish, nuts, and olives -- these fats and protein contribute to meal satisfaction, so you don't go hunting for sweets an hour later and wind up with a short-lived sugar high and subsequent crash. A few meal ideas: a low-fat yogurt parfait with berries and a couple of tablespoons of whole-grain granola; salmon over mixed greens with whole-grain crackers; and beef tenderloin with a baked sweet potato and asparagus.
• Fill up on more fiber. Fiber has a time-releasing effect on carbs, so they enter your bloodstream at a slow and steady pace, giving your energy staying power, says Anding. When choosing your mini-meals (see above), include fiber-filled options that add up to the daily recommended 25 to 30 grams of fiber (the average person gets only between 10 and 15 grams). Some suggestions: a bowl of raisin bran (5 grams of fiber per cup); black beans and cheese wrapped in a multigrain tortilla (beans have 7.5 grams per 1/2 cup; one tortilla has 5 grams); air-popped popcorn (3.6 grams per 3 cups); an apple with the skin (3.3 grams); and whole-wheat spaghetti (6.3 grams per cup).
• Fuel your brain with omega-3s. Found in fatty fish (such as tuna and salmon), walnuts, and canola oil, these essential fatty acids play a role in keeping brain cells healthy and helping you feel mentally alert. Another potential bonus: Omega-3s encourage the body to store carbs as glycogen — the storage form of glucose (blood sugar) and the body's main source of stored fuel — rather than as fat.
• Stay hydrated. Water makes up the majority of your blood and other body fluids, and even mild dehydration can cause blood to thicken, forcing the heart to pump harder to carry blood to your cells and organs and resulting in fatigue. Also, ample fluids keep energy-fueling nutrients flowing throughout the body, says Nancy Clark, R.D., author of Nancy Clark's Sports Nutrition Guidebook. To gauge your hydration, Clark recommends monitoring how often you urinate. You should be going every two to four hours, and your urine should be clear or pale yellow in color. Tip: Besides drinking more, you can also consume foods that naturally contain water, such as yogurt, broccoli, carrots, and juicy fruits, like watermelons, oranges, and grapefruits.
• Watch caffeine intake after noon. Typically, consuming a moderate amount of caffeine — 200 to 300 mg, the amount found in two to three cups of coffee — can make you more energetic and alert in the hours following, says Anthony L. Komaroff, M.D., a professor of medicine at Harvard Medical School. But when caffeine is consumed in large quantities — or anytime in the afternoon or evening — the quality of your sleep that night can take a nosedive, leaving you with heavy eyelids the next day. One caution for those who are highly sensitive to caffeine: Although switching to a decaf latte in the afternoon sounds like the answer, researchers at the University of Florida found that out of 22 decaffeinated coffee beverages tested, all but one contained some caffeine.

• Energize Your Spirit

  • We're all familiar with physical exhaustion, but mental strain — sadness, boredom, worry, anger, and general stress (the biggie) — can take an even heavier toll on vitality, completely wearing you out. Life happens, and these difficult emotions will, too. But if you react wisely, your brain and body will rebound — along with your vim and vigor.
  • Splash some water on your face or take a shower when you're feeling burned-out. Some 55 percent of study participants reported using these types of "water therapy" to successfully increase their energy, according to findings in theJournal of Personality and Social Psychology. Apparently, a little H ₂ O refresher can instantly help take the edge off when you're feeling overwhelmed.
  • Suit up in a "power" outfit to beat the blahs. Fight the tendency to throw on sweats when you're feeling sluggish. Although it may seem counterintuitive to slip into the skirt you save for special occasions, it helps to look in the mirror and see an energizing image — not a deflating one that confirms and reinforces your internal state, says Alice D. Domar, Ph.D., founder and executive director of the Domar Center for Complementary Healthcare in Waltham, MA. Dressing for success will give you a big mental boost every time you catch sight of your reflection (or receive a compliment) throughout the day.
  • Vent your feelings. Keeping fear, anxiety, and stress pent up inside may seem like a grown-up way to deal with these emotions. But discussing negative feelings with another person can ease them far better than keeping them bottled up; by airing them, you reduce their ability to sap your stamina, says Komaroff, who is also the editor-in-chief of the Harvard Health Letter.
  • Turn on some tunes. Listening to music is one of the most effective ways to change a bad mood, decrease tension, and increase energy. Consider this: Runners in one study who listened to music while on the treadmill ran faster than those who jogged in silence — no matter how loud the volume or how fast the tempo, according to new findings in the journal Ergonomics. Other research suggests that music effectively distracts you from feeling fatigue. Try burning a CD of your favorite songs and playing it anytime you need a pick-me-up. (If you exercise, so much the better — but the music will move you either way.)
  • Let go of grudges. Nursing a grudge prompts your mind and body to react as if they're under chronic stress, increasing your heart rate and blood pressure and potentially resulting in an impaired immune system and exhaustion over time, according to a study in the journal Psychological Science. On the other hand, practicing empathy and forgiveness after you've been wronged makes you feel as if you're back in control, which keeps the body's stress responses in check. The next time you find yourself harboring ill feelings, repeat a stress-relieving mantra to yourself, such as, "Forgiveness makes me a happier and stronger person."
  • Take belly breaths. When we're under stress, we're prone to take "chest breaths" — short, shallow ones, says Domar. Chest breathing brings less air into the lungs and reduces the supply of energizing oxygen to the body and brain, leaving you physically and mentally drained. The goal is deep, diaphragmatic breathing — like that of a sleeping infant: When you breathe in, your belly should round and fill like a balloon; on an exhale, your belly should slowly deflate. Of course, remembering to practice deep breathing isn't the first thing on your mind when you're under the gun, so as a visual reminder, try posting a tranquil picture (such as a pool of water or your kids smiling) with the word "breathe" next to your computer, or anywhere you tend to feel on edge.
  • De-clutter a corner. Go through that teetering pile of papers or overflowing closet and clear it out. Clutter can make you feel out of control and overwhelmed, especially when you're already feeling stressed or down. Plus, simply accomplishing a goal, no matter how seemingly minor, can be energizing, says Domar.
  • Do some good. Acts of altruism can lend a little pep to your step. In fact, one study in the Journal of Health and Social Behavior found that volunteer work can boost your energy in six ways: It enhances happiness, life satisfaction, self-esteem, sense of control over life, physical health, and mood. Find short- and long-term volunteer opportunities at volunteermatch.o

    Energize Your Spirit

    • We're all familiar with physical exhaustion, but mental strain — sadness, boredom, worry, anger, and general stress (the biggie) — can take an even heavier toll on vitality, completely wearing you out. Life happens, and these difficult emotions will, too. But if you react wisely, your brain and body will rebound — along with your vim and vigor.
    • Splash some water on your face or take a shower when you're feeling burned-out. Some 55 percent of study participants reported using these types of "water therapy" to successfully increase their energy, according to findings in theJournal of Personality and Social Psychology. Apparently, a little H ₂ O refresher can instantly help take the edge off when you're feeling overwhelmed.
    • Suit up in a "power" outfit to beat the blahs. Fight the tendency to throw on sweats when you're feeling sluggish. Although it may seem counterintuitive to slip into the skirt you save for special occasions, it helps to look in the mirror and see an energizing image — not a deflating one that confirms and reinforces your internal state, says Alice D. Domar, Ph.D., founder and executive director of the Domar Center for Complementary Healthcare in Waltham, MA. Dressing for success will give you a big mental boost every time you catch sight of your reflection (or receive a compliment) throughout the day.
    • Vent your feelings. Keeping fear, anxiety, and stress pent up inside may seem like a grown-up way to deal with these emotions. But discussing negative feelings with another person can ease them far better than keeping them bottled up; by airing them, you reduce their ability to sap your stamina, says Komaroff, who is also the editor-in-chief of the Harvard Health Letter.
    • Turn on some tunes. Listening to music is one of the most effective ways to change a bad mood, decrease tension, and increase energy. Consider this: Runners in one study who listened to music while on the treadmill ran faster than those who jogged in silence — no matter how loud the volume or how fast the tempo, according to new findings in the journal Ergonomics. Other research suggests that music effectively distracts you from feeling fatigue. Try burning a CD of your favorite songs and playing it anytime you need a pick-me-up. (If you exercise, so much the better — but the music will move you either way.)
    • Let go of grudges. Nursing a grudge prompts your mind and body to react as if they're under chronic stress, increasing your heart rate and blood pressure and potentially resulting in an impaired immune system and exhaustion over time, according to a study in the journal Psychological Science. On the other hand, practicing empathy and forgiveness after you've been wronged makes you feel as if you're back in control, which keeps the body's stress responses in check. The next time you find yourself harboring ill feelings, repeat a stress-relieving mantra to yourself, such as, "Forgiveness makes me a happier and stronger person."
    • Take belly breaths. When we're under stress, we're prone to take "chest breaths" — short, shallow ones, says Domar. Chest breathing brings less air into the lungs and reduces the supply of energizing oxygen to the body and brain, leaving you physically and mentally drained. The goal is deep, diaphragmatic breathing — like that of a sleeping infant: When you breathe in, your belly should round and fill like a balloon; on an exhale, your belly should slowly deflate. Of course, remembering to practice deep breathing isn't the first thing on your mind when you're under the gun, so as a visual reminder, try posting a tranquil picture (such as a pool of water or your kids smiling) with the word "breathe" next to your computer, or anywhere you tend to feel on edge.
    • De-clutter a corner. Go through that teetering pile of papers or overflowing closet and clear it out. Clutter can make you feel out of control and overwhelmed, especially when you're already feeling stressed or down. Plus, simply accomplishing a goal, no matter how seemingly minor, can be energizing, says Domar.
    • Do some good. Acts of altruism can lend a little pep to your step. In fact, one study in the Journal of Health and Social Behavior found that volunteer work can boost your energy in six ways: It enhances happiness, life satisfaction, self-esteem, sense of control over life, physical health, and mood. Find short- and long-term volunteer opportunities at volunteermatch.org and charityguide.org.

    • Get a Restorative Rest

      When you have a lot to do (um...always), usually the first thing to get squeezed off your agenda is sleep. But miss out on shut-eye and your energy, positivity, productivity, and memory are sure to suffer. And nearly a quarter of American adults aren't getting enough rest, which has led to an epidemic of daytime sleepiness, according to a poll by the National Sleep Foundation. The key to bucking this trend is to brush up on sleep hygiene. Try these steps for starters.

      • Cut back on TV and computer time after 8 p.m. If you're already a night owl (you go to bed late and sleep in on weekends), the bright light emitted from television and computer screens can make falling asleep at a decent hour even harder. The reason: Light suppresses the production of melatonin, a hormone secreted at sunset that tells the brain that it's nighttime, explains John Herman, Ph.D., director of the training program in sleep medicine at the University of Texas Southwestern Medical School at Dallas. And when melatonin levels are low, your brain is fooled into thinking that it's still daytime — and remains raring to go. Whenever possible, wait until the next morning to tune in and/or log on. If you must use light-emitting technology at night, try to turn it off an hour or two before hitting the sack.
      • Hide your alarm clock. Watching the clock to see how long it's taking you to drift off or how much time you have left before your alarm goes off can result in a poor night's sleep, says Kelly A. Carden, M.D., medical director of the Sleep Health Center Affiliated with Hallmark Health at Medford in Medford, MA. This hypervigilance keeps the brain awake and alert and prevents you from slipping into deep, restorative sleep. The easy fix: Set your alarm clock, then either face the numbers away from you or put it on the floor, in a drawer, or across the room.
      • Give your pet his own separate sleeping space. At night, pets snore, jiggle their tags, move around a lot, and even hog the covers and bed space. It's no wonder that 53 percent of pet owners who sleep with their pets in the bedroom have some type of disrupted sleep every night, according to a study from the Mayo Clinic Sleep Disorders Center in Rochester, MN. Consider relocating your furry friend's sleeping quarters to another area, even if it's just his own bed in your bedroom.
      • Lower the thermostat. For a good night's sleep, make sure your room is comfortably cool — enough so that you need a light blanket. This ensures that your environment is in sync with your body's internal temperature, which naturally drops during the night, according to the National Sleep Foundation. Studies suggest the ideal sleeping temperature is between 54 and 75 degrees; anything cooler or warmer may cause you to wake up.
      • Skip the nightcap. Alcohol depresses the nervous system — the system of cells, tissues, nerves, and organs that controls the body's responses to internal and external stimuli. So while sipping a glass of wine before bed may help you nod off, the sedative effects wear off as your body metabolizes the alcohol, which may cause you to wake up in the middle of the night and have trouble falling back to sleep. Alcohol has also been shown to interfere with the body's natural 24-hour biorhythms, causing blood pressure to rise and heart rate to race at night when it's normally calm and relaxed. You don't have to give up that evening cocktail entirely to achieve sound sleep — just try to avoid alcohol within two to three hours of bedtime.
      • Get your exercise. While scientists don't yet understand why, aerobic exercise has been proved to help you fall asleep faster at bedtime, spend more hours in deep sleep, and wake up less often throughout the night, says Komaroff. At the same time, vigorous exercise can act like a stimulant (which is a great daytime energizer), so schedule your workouts in the morning or afternoon, when you need a boost the most.
      • Follow the 15-minute rule. If you can't fall asleep, or if you wake up and can't get back to sleep within about 15 minutes, get out of bed and do something relaxing that will help clear your head, such as reading, meditating, or knitting (but not watching TV or surfing the Web). Then, once you feel sleepy again, go back to bed. If you stay put and fret about being awake, you'll only make yourself more anxious — and less likely to catch the z's you need.
      • Write down your worries. During the day, jot down any stressors that are weighing on you, says Carden. Then, do some mental problem-solving before your head hits the pillow — or, if you're falling short on solutions, tuck your list away and resolve to brainstorm ideas during your morning shower or commute to work. Just knowing you've established a plan for tackling your to-do's will make you feel like you've made some progress, allowing you to relax, drift off — and wake up the next morning ready to take on the day