Relief From
Constipation

Recognizing Symptoms
Relieving Discomfort

It's happened to most of us at one time or another. That tight, bloated feeling, signaling a bout of constipation. Although constipation may not seriously impact your daily routine, it can make you feel quite uncomfortable. In this booklet, we provide you with important information about constipation: what it is, what causes it, and what you can do to keep your digestive system functioning smoothly.

Fortunately, in most cases constipation can be easily treated. One of the most important things you can do to keep yourself "regular" is to eat a high-fiber diet. Read on to discover why diet is so important.

Symptoms
When many people think about "regularity," they think that it means a bowel movement a day. But this is not necessarily true. There is tremendous variability in bowel function among healthy people. It may be normal for some people to have a bowel movement several times during the day, while others have three or four bowel movements a week.

If that's the case, how do you know when you are constipated? Symptoms such as the following usually point point to a problem:

• Infrequent (fewer than two a week) bowel movements.
• Hard, dry stools that are difficult and painful to pass.
• The sensation of a full rectum, even after you have had a bowel movement.

Causes
Why do people get constipated? Many factors may lead to constipation. Often you can correct the problem by making some simple changes in your lifestyle. Constipation usually is associated with one or more of the following:

• Inadequate fiber in the diet
• Lack of exercise
• Stress and anxiety
• Pregnancy
• Ignoring the urge to defecate
• Pain from hemorrhoids or fissures
• A side effect from medication

Sometimes constipation may be a sign of a more serious condition. If you have noticed a recent change in your bowel habits, or if the condition persists even when you have changed your diet, consult your physician immediately.

Constipation and Your Digestive System
To better understand why you suffer from constipation, let's take a quick tour of your digestive system. Like a long, winding pipe, the digestive system carries food throughout your body, sending nutrients to the bloodstream and waste products through the small and large intestines. Here's how it works:

• The digestive process begins in your mouth. Your teeth break up the food into small pieces and your saliva mixes with the food, allowing it to pass through the esophagus into the stomach. Using muscular contractions, the esophagus sends food from the mouth to the stomach.
• Like a giant processing center, the stomach churns the food into smaller pieces, preparing it to travel on to the lower part of the digestive tract.
• After leaving the stomach, the food passes into the small intestine, where the food's nutrients are further broken down and absorbed into the bloodstream. By the time food passes through all 21 feet of the small intestine and reaches the colon, only water and waste products remain.
• Now the colon begins the process of removing waste from the body. First, it absorbs excess water from the waste. Then the colon moves the waste to the rectum. Under normal conditions, the colon is amazingly efficient. For every 10 quarts of water entering the colon, approximately 9.9 quarts are reabsorbed before reaching the rectum.
• When the colon's natural contractions or rhythms are disturbed--due to stress, medication, pregnancy, illness, resisting the urge to defecate, lack of exercise, or inadequate fiber intake--the waste materials move too slowly and too much water is absorbed. This results in hard, dry stools that are difficult to pass.

Prevention
The good news is that there are some simple things you can do to prevent constipation. For healthy bowel habits, consider the following:

• Eat regular meals. Chew food thoroughly and slowly.
• Drink plenty of fluids, including water, milk, fruit and vegetable juices, and soups.
• Exercise daily.
• Establish regular toilet habits. If you feel the urge to have a bowel movement, respond immediately. Delaying now may mean straining later.
• Eat a diet that includes high-fiber food such as fruit and vegetables, whole-grain breads and cereals, and beans.

Treatment
Generally, constipation is a condition that can be corrected. However, there are times when it may point to a more serious problem. You should see your doctor if the following occurs:

• Recent, unexplained onset of constipation.
• Constipation persists despite appropriate increase in exercise, changes in the diet and other efforts to resume normal bowel movements.
• Constipation occurs alternately with diarrhea.
• Blood in the stool or intense abdominal pain.

Your doctor will want to know if you have a history of constipation or any other digestive problems. He or she will ask about bowel habits, diet, and stress. Blood and stool studies may be done, and the rectum and the lower part of the colon may be examined. This is done by using a proctoscope, a viewing device with a light at then end. Additional tests may include a barium x-ray or colonoscopic exam.

To encourage better bowel movements, your doctor may suggest some initial lifestyle changes, such as improving your diet and increasing exercise. If these changes do not help relieve your constipation, your doctor may suggest one of the following types of laxatives:

• A fiber laxative
• A stool softener
• A chemical laxative

Laxatives should be used only as directed. Different laxatives work in various ways; let your doctor choose the best one for you.

Sticking To a High-Fiber Diet
One way you can correct constipation is by improving your diet. You do this by including high-fiber foods in your meals. This means that you consume more whole grain breads, fruits and vegetables. What exactly is fiber? Fiber is the part of a plant that cannot be digested. Fiber itself adds bulk to keep other foods moving along the digestive tract, and it holds water which, in turn, softens the stool for easy elimination.

Fiber comes in two different forms: soluble and insoluble. While they work differently, both are needed for proper bowel function. All fiber sources contain both kinds of fiber in varying amounts.

How can you get enough fiber in your diet? The secret is to eat a well-balanced diet that includes a variety of high-fiber foods.

You don't have to totally rearrange your diet to accommodate more fiber. One way to start is to substitute high-fiber foods for low-fiber ones. Switch your bakery habits from white bread and rolls to whole-grain breads. Try brown instead of white rice. Eat "whole grain" cereal. And most easily of all, add fruits and vegetables to your diet.

Your general rule of thumb should be at least one serving of whole grain in every meal. Try this sample menu:

Breakfast -- Cereal and/or toast. Make sure the first name on your cereals and breads is Whole Grain. Add banana slices to cereal.

Lunch -- Sandwich on whole-grain bread. Carrot sticks. Snack -- Apple or raisins. Skip the candy bar, or at least cut back.

Snack -- Apple or raisins Skip the candy bar, or at least cut back.

Dinner -- Broiled chicken and steamed broccoli. Wheat rolls. Salad.

Try to increase your intake of vegetables and fruit. You should be getting three servings of each every day. Try a sliced banana on your cereal, substitute carrot sticks for chips as a lunch side, and crunch on a salad for dinner. Wherever possible, eat the peels (you're off the hook with bananas and oranges).

There are possible downsides to increasing fiber. Some high-fiber foods, like beans, can produce excessive gas or bloating. Take in too much fiber too soon and you could suffer from bloating or abdominal cramps.

Remember, whenever you change your diet, for whatever reason, do it gradually. Let your body adjust. And check in with your doctor if you experience any discomfort.

A Fiber Solution: METAMUCIL®
If your physician has recommended increasing your fiber intake in order to treat constipation, he or she may suggest the convenience and effectiveness of Metamucil.

What does METAMUCIL add?
METAMUCIL contains psyllium, a 100%-natural fiber that helps you restore regularity, increase your fiber intake, and maintain regularity when recommended by your physician.

How much fiber can METAMUCIL add?
At 3.4 grams per dose, taken up to three times per day, you can add as much as 10.2 grams of psyllium fiber. That's about half of the minimum amount of fiber recommended for your daily consumption. And it's one of the most concentrated sources of soluble fiber. In fact, METAMUCIL's fiber contains more than eight times the amount of soluble fiber found in oat bran, gram for gram.

When can I take METAMUCIL?
You can take METAMUCIL in the morning, at noon or in the evening, with or without food with at least 8 ounces of liquid (one to three times a day). Laxatives, including bulk fibers, may affect how well other medicines work. If you are taking a prescription medicine by mouth, take this product at least 2 hours before or 2 hours after the prescribed medicine.

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