Chronic Constipation
Q. I am chronically constipated no matter what foods I eat. When I’m under stress, it is even worse. Most remedies I try work for a short time only. Is this “irritable bowel syndrome”? Can you tell me more?
A. Irritable bowel is commonly found in women, frequently 30 or younger and often affluent. There are three variations: (1) alternating constipation and diarrhea (most common); (2) chronic abdominal pain with or without constipation; and (3) chronic diarrhea not accompanied by pain. It is a diagnosis of exclusion, meaning that all other possible explanations must be ruled out first.
Chronic constipation may occur for many different reasons. Often, a poor diet lacking in fiber and fluids is the culprit (a high-fiber diet without a large amount of liquids may actually worsen constipation!). Sometimes chronic constipation may be due to a particular problem with the bowel called Hirschsprung’s disease; in this case, constipation usually dates from childhood. Women who have had children may develop a rectocele, a “pouch” in which stool may collect, and weakness of the pelvic floor muscles may make it difficult to pass the stool.
You should discuss your problem with your doctor. You may need a referral to a gastroen terologist, a specialist in the intestinal tract. As a first step, concentrate on drinking at least 48-64 ounces of water or juices per day and increasing fiber; fiber supplements containing psyllium can also be helpful. Exercise also improves constipation in most people.
Tags: abdominal pain, constipation, thyroid
