What is constipation?

Constipation is a common digestive problem that makes it difficult for you to have a bowel movement. Your bowel movements may be infrequent. Your stools may be very hard, making them so difficult to pass that you have to strain. Or you may feel like you still need to have a bowel movement even after you've had one.

How often should I have a bowel movement?

Not everyone has bowel movements once a day. It's not true that you must have a daily bowel movement to be considered "regular." A normal range is anywhere between 3 times a day to 3 times a week. You may be getting constipated if you start having bowel movements much less often than you usually do.

How do I know if my child is constipated?

Your child may be constipated if one or more of the following are true:

• He or she has fewer than 3 bowel movements a week.
• The stools are hard, dry and unusually large.
• The stools are difficult to pass.

For some children, it is normal to pass stools as far apart as every few days. Whether your child is constipated or not depends on how often he or she normally passes stools and how easy this is to do. If stools are soft and easy to pass, less frequent stools are not a problem. If they are hard and difficult to pass, your child is likely constipated. If your child is having trouble with constipation for more than 2 weeks, it is called chronic constipation.

What causes constipation?

As the food you eat passes through your digestive tract, your body takes nutrients and water from the food. This process creates a stool, which is moved through your intestines with muscle contractions (squeezing motions).

A number of things can cause the stools to move more slowly through your intestines, leading to constipation. You can affect the process if you don't go to the bathroom when you have the urge to have a bowel movement, drink enough fluids, get enough exercise or eat enough fiber, and if you take certain medicines or regularly use laxatives. Constipation is also common in pregnant women.

What causes constipation in children?

Constipation in children is caused by many of the same things that cause adults to have it. For example, it is likely to happen when your child doesn't drink enough water, milk or other fluids, or if your child doesn't eat a healthy diet that includes enough fiber. Fiber is found in foods such as cereals, grains, fruits and vegetables. If your child eats a diet high in fat and refined sugars (candy and desserts), he or she is probably not getting enough fiber, which may result in constipation.

Constipation may also begin when you switch your baby from breast milk or baby formula to whole cow's milk, and when you switch from baby food to solid food. Sometimes constipation happens after your child has been sick or has taken certain medicines. You should not be concerned if your child becomes constipated for a short period of time. Constipation is common in children and usually goes away on its own.

Young children who have chronic constipation often ignore the urge to have a bowel movement. Your child may not want to interrupt play, or may be afraid or embarrassed to ask a teacher or use a public restroom. When a child avoids bowel movements, stool builds up in the lower bowel. The stool becomes larger and harder. Passage of the stool can be painful and makes children want to avoid having a bowel movement even more.

How can the doctor tell if my child has constipation?

Your doctor will ask you about the pattern of your child's bowel movements. You can help your doctor by keeping a day-by-day list of your child's bowel movements. You should include:

• When your child sat on the toilet
• How long your child sat on the toilet
• What your child's stool looked like
• If your child has any soiling in his or her underwear

It also is important to note unusual changes in your child's stools or behavior. Some things to watch for include:

• Stools that are large in diameter
• Stools that are very hard
• Small amounts of bright red blood on the toilet tissue after your child has a bowel movement
• Stomach pain and bloating
• Loss of appetite
• Crying or screaming during bowel movements
• Avoiding the toilet or resisting toilet training

Your doctor will examine your child. The physical exam may include an exam of your child's rectum. The doctor may order an X-ray of your child's abdomen.

How is constipation treated?

Eating enough fiber and drinking enough fluids are key to treating constipation. They help your stools move through your intestines by increasing the bulk of your stools and making your stools softer. Increasing how often you exercise will also help.

Talk to your family doctor if:

• Constipation is new and unusual for you
• You have constipation for 3 weeks or more despite at-home treatment (such as diet changes)
• You have abdominal pain
• You notice any blood in your stools
• You lose weight without reason

How do I get more fiber?

It is suggested that men 50 years of age and younger consume at least 38 grams of fiber per day, while women 50 years of age and younger should consume at least 25 grams per day. To add fiber to your diet, eat at least 2 cups of fruits and 2 1/2 cups of vegetables per day. Also try eating cereals that contain bran or adding bran as a topping on your fruit or cereal.

If you are adding fiber to your diet, start slowly and gradually increase the amount. This will help reduce gas and bloating. Make sure to drink plenty of water, also.

• Is constipation dangerous?
• Can constipation be a sign of another health condition?
• I've been using laxatives regularly for a long time. How can reduce their use?
• How can I tell if my baby is constipated?
• Besides high-fiber foods, what else can I do to increase my fiber intake?
• What lifestyle changes can I make to treat and prevent constipation?