Many people feel that regularity is the key to good health. Is this true or is it a myth? Grandmothers around the world have promoted daily bowel movements for generations, but there is no evidence that a trip to the bathroom each morning is necessary. People vary in the frequency that suits them best. Some do well on a schedule of no more than three times a week. Others feel good on a schedule as frequent as a few times a day.
Constipation is defined as unsatisfactory defecation155, but doctors and patients don’t always agree on what is most important. Physicians may prefer objective measures like the number of days between bowel movements. But people may be as concerned about consistency as frequency. They complain about the effort of passing hard “golf balls” or “bricks.”
Sometimes physicians dismiss constipation as a minor complaint. While it is not usually life threatening, constipation can be serious. Almost 100,000 people are hospitalized each year for constipation-related problems. Many more suffer considerable distress and reduced quality of life as a result of this common condition.
Fluids and fiber are the cornerstones of constipation prevention. Those who are constipated are often urged to drink more water. Adequate fluid (at least 6 glasses of water a day) is essential, but unless someone is actually dehydrated, drinking extra water does not solve the problem of hard stools. Together with fiber, though, the fluids may help. The first step, of course, is to make sure that the diet contains at least 25 grams of fiber a day. That may take some doing, but it can be accomplished with 5 to 10 servings of vegetables and fruits a day, along with whole grains rather than refined bread, pasta, crackers, and the like. For some people, though, even that may not be enough to conquer constipation completely.
If constipation arises suddenly or if it starts to interfere with everyday activities, it makes sense to check in with your doctor. There are some conditions, such as an underactive thyroid gland or Parkinson’s disease, that can lead to constipation. In those cases the underlying disease needs to be treated.
Warning signs that should trigger a doctor’s visit include blood in the stool or bleeding from the rectum; dark, tarry stool; weight loss of 10 pounds or more; a family history of colon cancer; or a positive Hemoccult test, a way of identifying invisible blood in the stool.156 Be sure to tell the doctor about any of these issues, so the proper work-up can be done.
People taking medications or even supplements should also check with their doctor to see whether one of these might be responsible. A surprising number of prescription drugs can trigger constipation as a side effect. Because of the impact that constipation can have on their sense of well-being, patients sometimes become upset if doctors don’t warn them that a prescribed medication may interfere with bowel function. Narcotics are among the most notorious offenders, but there are many others. Sometimes, switching to a different medicine can ease the problem. The physician should always be involved in such a decision, because some of these drugs may be essential treatment for a serious condition such as cancer or AIDS.
Constipation accompanied by pain, nausea, vomiting, or fever should not be ignored. It deserves medical attention. Even without such symptoms, persistent constipation should also be brought to a physician’s attention. Uncomplicated constipation may respond to home treatment.

  • Begin with diet. Make sure you get six to eight 8-ounce glasses of water or other fluids daily. Concentrate on increasing fiber, and make sure you get 25 to 35 grams daily.
  • Ask your doctor to check whether a medical condition or medication may be causing your constipation.
  • Eat fruit. Apples, dried apricots, and (in moderation) dried plums, aka prunes, are a wonderful way to establish regularity when needed.
  • Sprinkle ground flaxseed on your food, or take a solution of simmered flaxseed in juice.
  • Chew sugarless gum or enjoy sugar-free candy for its laxative effect.
  • Take psyllium as directed, with an 8-ounce glass of water.
  • Docusate may soften stools and ease straining.
  • Milk of magnesia may give relatively quick relief, but should not be overused. It’s off-limits for anyone with kidney trouble.
  • Prescription drugs such as MiraLax are intended for short-term use of less than 2 weeks.

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  1. DV

    After many years of colonoscopies and metamucil which only seemed to make things worse an elderly physician from Hungary told me that he always recommended warm prune juice – and that did the trick for me – I do not take it every day – wish I had known this sooner as my constipation led to diverticulitis. Also when in hospital a GI Doctor recommended Mirolax- no flat – put in anything – and slow acting too.

  2. C.F.

    Dried Apricots work for me, sometimes I don’t even get through 4 of them before running to the bathroom… Also a handful of chocolate chips with a hot cup of coffee is very powerful. 1 mug of HOT Prune Juice is another great remedy. In all my 35 years, these tricks are what helps me.

  3. c. eng

    So my doc prescribed Metamucil every day plus 8 glasses of water for my irregularity. Is Metamucil in any way harmful ?
    PEOPLE’S PHARMACY RESPONSE: Aside from the remote possibility of allergy, we’re not aware of harm if it is used according to dosage instructions.

  4. jhg

    Dear pharmacy,
    A few days ago you printed a recipe for a power pudding that may help with chronic constipation. I am very interested in this pudding, however, there were no portion sizes mentioned. How much wheat bran, applesauce and prune juice? Please respond as I am in serious need.
    Thank you,

  5. GM

    My doctor recommended magnesium tablets for leg cramps. She said they would also help with constipation. I take 2 or 3 250 mg tablets every night and have all the benefits of bran with no gas.

  6. vicky

    I eat 8 prunes every day to keep regular is that okay? My other problem is I have to get up twice in the night to urinate which is very annoying. Is there something I can take to overcome this?

  7. B

    Grandma always suggested prunes. She was right about that.

  8. S

    I bought some psyllium seeds at the health food store. One home remedy that I read says to grind them up, mix 2 parts psyllium with 1 part flax seed and one part oat bran, add water and have as a little mash every night. Don’t know how much to take at a time, whether this mixture should be refrigerated, and whether this can be taken on a regular basis or this is a once-in-a while-remedy.

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