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==Overview==
Constipation is usually easier to prevent than to treat. The relief of constipation with [[osmotic]] agents, i.e., [[lactulose]], [[polyethylene glycol]] (PEG), or [[magnesium]] salts, should also be immediately followed by prevention using increased [[fiber]] (fruits, vegetables, and grains) and a nightly decreasing dose of osmotic laxative. Effective measures for the primary prevention of constipation include [[fiber]] supplementation, appropriate fluid intake, toilet habits, and [[exercise]].


==Primary Prevention==
==Primary Prevention==
* Constipation is usually easier to prevent than to treat. The relief of constipation with osmotic agents, i.e. lactulose, [[polyethylene glycol]] (PEG), or magnesium salts, should immediately be followed with prevention using increased fiber (fruits, vegetables, and grains) and a nightly decreasing dose of osmotic laxative. With continuing narcotic use, for instance, nightly doses of osmotic agents can be given indefinitely (without harm) to cause a daily bowel movement.
* Constipation is usually easier to prevent than to treat. The relief of constipation with [[osmotic]] agents, i.e., [[lactulose]], [[polyethylene glycol]] (PEG), or [[magnesium]] salts, should also be immediately followed by prevention using increased [[fiber]] (fruits, vegetables, and grains) and a nightly decreasing dose of osmotic laxative.
* Recent controlled studies have questioned the role of physical exercise in the prevention and management of chronic constipation, while exercise is often recommended by published materials on the subject.
* Effective measures for the primary prevention of constipation include [[fiber]] supplementation, appropriate fluid intake, toilet habits, and [[exercise]].
* In various conditions (such as the use of [[codeine]] or [[morphine]]), combinations of hydrating (e.g. [[lactulose]] or [[Diol|glycols]]), bulk-forming (e.g. [[psyllium]]) and  stimulant agents may be necessary to prevent constipation.
 
* Eat lots of fiber.
=== Fiber supplementation ===
* Drink plenty of fluids each day (at least 8 glasses of water per day).
* Including enough [[Fiber|fibers]] in the daily diet is the most important primary prevention measure.
* Exercise regularly.
* The sufficient [[fiber]] intake for general [[gastrointestinal]] health is 30 g per day, while more is better.
* Go to the bathroom when you have the urge. Don't wait.
* [[Fiber]] content in different foods are as the following table:<ref name="urlTreatment for Constipation | NIDDK">{{cite web |url=https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/treatment |title=Treatment for Constipation &#124; NIDDK |format= |work= |accessdate=}}</ref>
{|
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Group
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Food
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Fiber contents
|-
| rowspan="5" style="background:#DCDCDC;" align="center" + |'''Beans, cereals, and breads'''
| style="background:#F5F5F5;" + |½ cup of beans (navy, pinto, kidney, etc.), cooked
| style="background:#F5F5F5;" align="center" + |6.2–9.6 g
|-
| style="background:#F5F5F5;" + |½ cup of shredded wheat, ready-to-eat cereal
| style="background:#F5F5F5;" align="center" + |2.7-3.8 g
|-
| style="background:#F5F5F5;" + |⅓ cup of 100% bran, ready-to-eat cereal
| style="background:#F5F5F5;" align="center" + |9.1 g
|-
| style="background:#F5F5F5;" + |1 small oat bran muffin
| style="background:#F5F5F5;" align="center" + |3.0 g
|-
| style="background:#F5F5F5;" + |1 whole-wheat English muffin 
| style="background:#F5F5F5;" align="center" + |4.4 g
|-
| rowspan="4" style="background:#DCDCDC;" align="center" + |'''Fruits'''
| style="background:#F5F5F5;" + |1 small apple, with skin
| style="background:#F5F5F5;" align="center" + |3.6 g
|-
| style="background:#F5F5F5;" + |1 medium pear, with skin
| style="background:#F5F5F5;" align="center" + |5.5 g
|-
| style="background:#F5F5F5;" + |½ cup of raspberries
| style="background:#F5F5F5;" align="center" + |4.0 g
|-
| style="background:#F5F5F5;" + |½ cup of stewed prunes
| style="background:#F5F5F5;" align="center" + |3.8 g
|-
| rowspan="7" style="background:#DCDCDC;" align="center" + |'''Vegetables'''
| style="background:#F5F5F5;" + |½ cup of winter squash, cooked
| style="background:#F5F5F5;" align="center" + |2.9 g
|-
| style="background:#F5F5F5;" + |1 medium sweet potato, baked in skin
| style="background:#F5F5F5;" align="center" + |3.8 g
|-
| style="background:#F5F5F5;" + |½ cup of green peas, cooked
| style="background:#F5F5F5;" align="center" + |3.5-4.4 g
|-
| style="background:#F5F5F5;" + |1 small potato, baked, with skin
| style="background:#F5F5F5;" align="center" + |3.0 g
|-
| style="background:#F5F5F5;" + |½ cup of mixed vegetables, cooked
| style="background:#F5F5F5;" align="center" + |4.0 g
|-
| style="background:#F5F5F5;" + |½ cup of broccoli, cooked
| style="background:#F5F5F5;" align="center" + |2.6-2.8 g
|-
| style="background:#F5F5F5;" + |½ cup of greens (spinach, collards, turnip greens), cooked
| style="background:#F5F5F5;" align="center" + |2.5-3.5 g
|}
 
=== Fluid intake ===
* Fluid intake is the key factor to maintain the body [[hydration]] status and firm consistency of [[stools]].
* Caffeine, alcohol, and fizzy drinks should be limited, preferably avoided completely.<ref name="pmid14681719">{{cite journal |vauthors=Arnaud MJ |title=Mild dehydration: a risk factor of constipation? |journal=Eur J Clin Nutr |volume=57 Suppl 2 |issue= |pages=S88–95 |year=2003 |pmid=14681719 |doi=10.1038/sj.ejcn.1601907 |url=}}</ref>
 
=== Toilet habits ===
* Ignorance to [[Toilet training|toilet]] urge can lead to constipation.
* Never delay the [[defecation]] in case of urgency.<ref name="pmid19274784">{{cite journal |vauthors=Wald ER, Di Lorenzo C, Cipriani L, Colborn DK, Burgers R, Wald A |title=Bowel habits and toilet training in a diverse population of children |journal=J. Pediatr. Gastroenterol. Nutr. |volume=48 |issue=3 |pages=294–8 |year=2009 |pmid=19274784 |doi= |url=}}</ref>
 
=== Physical exercise ===
* It is postulated that 150 minutes of [[Physical exercise|physical exercises]] can prevent constipation.<ref name="pmid24587274">{{cite journal| author=Huang R, Ho SY, Lo WS, Lam TH| title=Physical activity and constipation in Hong Kong adolescents. | journal=PLoS One | year= 2014 | volume= 9 | issue= 2 | pages= e90193 | pmid=24587274 | doi=10.1371/journal.pone.0090193 | pmc=3938666 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24587274  }}</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:primary care]]
[[Category:Medicine]]
[[Category:Needs overview]]
[[Category:Up-To-Date]]
 
[[Category:Emergency medicine]]
{{WH}}
{{WS}}

Latest revision as of 21:08, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]

Overview

Constipation is usually easier to prevent than to treat. The relief of constipation with osmotic agents, i.e., lactulose, polyethylene glycol (PEG), or magnesium salts, should also be immediately followed by prevention using increased fiber (fruits, vegetables, and grains) and a nightly decreasing dose of osmotic laxative. Effective measures for the primary prevention of constipation include fiber supplementation, appropriate fluid intake, toilet habits, and exercise.

Primary Prevention

  • Constipation is usually easier to prevent than to treat. The relief of constipation with osmotic agents, i.e., lactulose, polyethylene glycol (PEG), or magnesium salts, should also be immediately followed by prevention using increased fiber (fruits, vegetables, and grains) and a nightly decreasing dose of osmotic laxative.
  • Effective measures for the primary prevention of constipation include fiber supplementation, appropriate fluid intake, toilet habits, and exercise.

Fiber supplementation

  • Including enough fibers in the daily diet is the most important primary prevention measure.
  • The sufficient fiber intake for general gastrointestinal health is 30 g per day, while more is better.
  • Fiber content in different foods are as the following table:[1]
Group Food Fiber contents
Beans, cereals, and breads ½ cup of beans (navy, pinto, kidney, etc.), cooked 6.2–9.6 g
½ cup of shredded wheat, ready-to-eat cereal 2.7-3.8 g
⅓ cup of 100% bran, ready-to-eat cereal 9.1 g
1 small oat bran muffin 3.0 g
1 whole-wheat English muffin  4.4 g
Fruits 1 small apple, with skin 3.6 g
1 medium pear, with skin 5.5 g
½ cup of raspberries 4.0 g
½ cup of stewed prunes 3.8 g
Vegetables ½ cup of winter squash, cooked 2.9 g
1 medium sweet potato, baked in skin 3.8 g
½ cup of green peas, cooked 3.5-4.4 g
1 small potato, baked, with skin 3.0 g
½ cup of mixed vegetables, cooked 4.0 g
½ cup of broccoli, cooked 2.6-2.8 g
½ cup of greens (spinach, collards, turnip greens), cooked 2.5-3.5 g

Fluid intake

  • Fluid intake is the key factor to maintain the body hydration status and firm consistency of stools.
  • Caffeine, alcohol, and fizzy drinks should be limited, preferably avoided completely.[2]

Toilet habits

  • Ignorance to toilet urge can lead to constipation.
  • Never delay the defecation in case of urgency.[3]

Physical exercise

References

  1. ↑ "Treatment for Constipation | NIDDK".
  2. ↑ Arnaud MJ (2003). "Mild dehydration: a risk factor of constipation?". Eur J Clin Nutr. 57 Suppl 2: S88–95. doi:10.1038/sj.ejcn.1601907. PMID 14681719.
  3. ↑ Wald ER, Di Lorenzo C, Cipriani L, Colborn DK, Burgers R, Wald A (2009). "Bowel habits and toilet training in a diverse population of children". J. Pediatr. Gastroenterol. Nutr. 48 (3): 294–8. PMID 19274784.
  4. ↑ Huang R, Ho SY, Lo WS, Lam TH (2014). "Physical activity and constipation in Hong Kong adolescents". PLoS One. 9 (2): e90193. doi:10.1371/journal.pone.0090193. PMC 3938666. PMID 24587274.

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