Constipation need not ruin active lifestyle
While I fully expect to be the "butt" of many comments for this column, I feel compelled to address this topic at the request of several patients.
Geriatric physical therapists commonly encounter patients who suffer from constipation that limits their participation in rehabilitation. Pradoxically, research demonstrates that exercise and activity actually help relieve constipation.
The National Digestive Diseases Information Clearinghouse reports that 3.1 million people in the United States suffer from constipation. This problem leads to nearly 400,000 hospitalizations, 1.4 million visits to emergency rooms, 1 million prescriptions and 121 deaths each year.
Constipation is defined by the Ohio University College of Osteopathic Medicine as three or fewer bowel movements per week. It is estimated that more than 27 percent of the elderly are affected.
Severe constipation can necessitate immediate medical attention in some cases due to intestinal obstruction.
In addition to infrequent bowel movements, symptoms may include feeling unwell, weight loss, loss of appetite, abdominal distention, pain and vomiting.
Risk factors for constipation include age, immobility, inadequate fluid and fiber consumption, recent surgery, and medications such as antihistamines, antidepressants, psychotropic drugs, opioids, calcium channel blockers and antacids.
-âExercise and mobility: Physical activity is one of the most important factors in preventing constipation. A minimum of 30 minutes of physical activity, five days per week, helps significantly. However, if age and poor health limit activity, then frequent, short bursts of mobility and exercise are recommended. It is critical for such people to work on transfers from chair or bed to standing upright to maintain strength and mobility.
-âDiet rich in fiber: Fruits, vegetables and bran are essential.
-âSupplements: With a physician's approval, supplements such as Metamucil or Citrucel can be helpful. Stool softeners, suppositories or enemas may also be worth discussing with your doctor.
Healthy people must continue to keep active. Get into good exercise habits at a young age and continue throughout your life. Maintaining a consistent schedule of eating and exercise is also helpful.
Here are some simple suggestions for healthy people beginning an exercise program for prevention of constipation:
-âGet your physician's approval.
-âConsult with a physical therapist to set up a program for your needs.
-âAerobic exercise: Buy good running sneakers, not walking shoes; plan to exercise three to five times per week for 30-35 minutes; walk for aerobic fitness; begin with 5-10 minutes and add 1-2 minutes each session; walk in a mall if it's too hot or too cold outside.
-âWeight training: Use light dumbbells, sandbag weights and resistance bands; begin with five to 10 repetitions and add one or two reps each session; alternate weight-training days with walking days.
Depending on your general health and ambulatory status, endurance exercises may be appropriate for you. Consider one or two of the following as a good starting point:
-âWalk inside the house: Start at 1-2 minutes nonstop every hour or two. Add 1-2 minutes every week.
-âStatic marching: Hold onto a countertop or back of a chair and march in place for 30 seconds. Rest 1-2 minutes and repeat. Do five cycles. Add 5-10 seconds every week.
-âClimb the stairs: If you can do so safely, use the steps for exercise once or twice per day. Gradually add one or two reps per day.
-âWalk a mall or use a treadmill: If you are able to leave the house and can tolerate more extensive endurance exercises, get out and walk a mall or use a treadmill.
-âRecumbent bike: If balance is a problem but you can tolerate more extensive endurance exercise, use a recumbent bike (a bike with a backrest).
PAUL J. MACKAREY, P.T., D.H.Sc., O.C.S., is a doctor in health sciences specializing in orthopedic and sports physical therapy. He is in private practice and is an associate professor of clinical medicine at Commonwealth Medical College. His column appears every week. Email: firstname.lastname@example.org.