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Cynthia Poelker, MD, St. Luke's Hospital

Chronic constipation - A serious problem for many women

Most people aren't comfortable talking about it, but more people suffer from constipation than you may think. Almost everyone experiences it at some point in life, and about 15 percent of people in the U.S. suffer from the disease of chronic constipation. Two-thirds of sufferers are women.

A woman may be diagnosed with chronic constipation after having symptoms for at least three months. Symptoms include hard stools, straining during bowel movements and having less than three bowel movements a week.

It's not known exactly why more women suffer from constipation than men, but varying hormone levels, which influence the digestive system, is a probable contributing factor. Also, as many as 38 percent of women experience constipation during pregnancy, and some cases of constipation are most likely due to pelvic floor dysfunction after pregnancy.

Beyond causing discomfort and embarrassment, constipation can lead to even more serious complications. Hemorrhoids, or swollen and inflamed veins around the rectum and anus, are often the result of straining to have a bowel movement. Anal fissures, or tears in the lining of the anus, are another common complication.

If constipation becomes severe enough, it can lead to fecal impaction, when a mass of hard stool becomes too big to be removed with a normal bowel movement and requires serious medical intervention to remove it. Rectal prolapse (when tissue that lines the rectum falls down into or through the opening of the anus) and rectocele (a bulging of the rectum forward towards the vagina) are also potential consequences of constipation.

Prevention of constipation is very important for women, and lifestyle plays a primary role in colon health. Eating a diet rich in fiber is key. You should consume 30 to 35 grams of fiber every day. If you can't get enough fiber through your diet alone, you may want to consider a fiber supplement such as methylcellulose or psyllium. Be sure to gradually add fiber into your diet.

In addition to fiber, it is important to drink plenty of water. Daily exercise and responding promptly to bowel urges are also habits associated with lower rates of constipation.

Cynthia Poelker, MD, is a family physician on staff at St. Luke's Hospital. Dr. Poelker sees patients at Westglen Family Physicians in Ellisville. Call 636-230-5050 or visit her Meet the Doctor page.

This article was published in the St. Louis Post-Dispatch on September 24, 2009.

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