It’s Important
ReSources
INCREASING FIBRE IN THE DIET
WHERE TO FIND MORE INFORMATION
Following are some hints on how to increase the fibre
in your diet:
Medline Plus
www.nlm.nih.gov/medlineplus/constipation.html
Digestion & Gastrointestinal Care
• Eat 5-10 servings of fruits and vegetables each day
• Replace white bread with whole-grain breads and
cereals, eat more foods like pasta or rice and
non-buttered popcorn
• Add 1/4 cup of wheat bran or ground flax seed to foods
such as cooked cereal or applesauce or meat loaf
• Eat cooked beans each week
National Digestive Diseases Information
Clearinghouse
www.digestive.niddk.nih.gov/ddiseases/pubs/constipation
Mayo Clinic
www.mayoclinic.com/health/constipation/DS00063
Note: If you suddenly start including a lot of fibre in
your diet, you will likely notice bloating, cramping,
or gas. You should start slowly and add more fibre
to your diet every few days. Remember to drink more
fluids when you increase the amount of fibre you eat
(six to eight 250 mL glasses per day!).
CONSTIPATION IN CHILDREN
Medications for infants
• The use of enemas is not recommended; impaction
can be treated with glycerin suppositories on the
recommendation of a health professional
• Lactulose or sorbitol can be used as osmotic
laxatives on a doctor’s recommendation
Medications for children one year and older
• Milk of magnesia, mineral oil, lactulose, and sorbitol
are considered safe and effective as recommended
by a health professional (see below)
• Young children are at increased risk of aspiration
pneumonia with the use of mineral oil
A health professional should be involved in your
decision to treat your child for constipation. Your PROfile
Pharmacist will be happy to discuss your child’s situation
with you and recommend an appropriate course of action.
The information found in this PROfile health brochure is of
a general nature only. It is not intended to replace the advice
of your pharmacist, physician, or other healthcare provider.
If you have questions relating to your specific health
concerns, please contact your personal healthcare provider.
Your PROfile Pharmacist
has many resources for
education about constipation and
is always available to discuss
your health concerns!
EXCLUSIVELY AT
Constipation
962886 Revised 2009
Most children who are constipated usually don’t need
special treatment. Like adults, each seem to have their
own ‘normal’ schedule, and the best treatment involves
alteration of diet. Warning signs that may indicate a
more serious condition include vomiting, weight loss,
poor weight gain, fever, abdominal bloating, or poor
appetite. Constipation can also be a sign of dehydration
and poor feeding in younger infants and newborns, and
so a pediatrician must carefully evaluate problems in
this age group.
CloserLook
WHAT IS ‘CONSTIPATION’?
We are all different, and that applies to how many
times a week it is normal for each of us to have a
bowel movement. Anywhere from three times a day
to three times per week is considered normal. If you
begin to have bowel movements much less often
than is usual for you, you may be getting constipated.
Other symptoms include straining, discomfort, or
a sense of incomplete evacuation during a bowel
movement, and hard, lumpy stools.
Treatment
HOW CAN I PREVENT CONSTIPATION?
• Eat a balanced diet high
in fibre (fruits, vegetables,
bran) - beans, peas,
raspberries, and broccoli
are examples of foods
that are high in fibre
• Drink at least six to eight
250 mL glasses of water
daily
WHAT CAUSES CONSTIPATION?
• Exercise regularly
There are many causes of constipation, some of
which are listed below:
• Leave time to try and have
a bowel movement at the
same time each day
• Diet high in animal fats and refined sugar without
sufficient amounts of fibre (e.g. fruits, vegetables,
whole grains)
• Use the washroom when
you have the urge
• Medications such as narcotic pain relievers,
antispasmodic medications, antidepressants,
iron supplements
• Do not rely on laxatives
unnecessarily to have
bowel movements
• Lack of exercise
• Emotional factors such as depression
• Certain health conditions (e.g. irritable bowel
syndrome, stroke, Parkinson’s disease)
• Poor bowel habits such as neglecting the urge
to have a bowel movement
• Pregnancy
WHEN SHOULD I SEE A DOCTOR ABOUT
CONSTIPATION?
You need to visit your doctor if you are constipated and:
• You have not had a bowel movement for seven days,
or
• You are extremely uncomfortable because you are
constipated, or
• You have pain in your rectum (back passage) or
rectal bleeding, or
• You have a fever, your stomach hurts, you feel like
throwing up, or you have unexplained weight loss, or
• Your bowel movements are thin as a
pencil, or
• You have a problem with your bowels
that lasts longer than two weeks or
keeps coming back, or
• It is extremely painful to have a
bowel movement
The need to treat constipation with medication is
often dependent upon the cause of the constipation.
A health professional should be consulted if anything
other than a bulk-forming laxative is used for treatment
of constipation, especially if you are pregnant. If
constipation is chronic (does not go away), you should
follow the steps under ‘How can I prevent constipation?’
and increase the amount of fibre in your diet (see other
side of brochure), or take a fibre supplement.
Bulk forming laxatives include psyllium, sterculia
gum, polycarbophil, methylcellulose, and bran. These
laxatives are suitable for long-term use and usually
take from one to three days to work. Drink plenty of
fluids with these products, or they make constipation
worse.
Saline laxatives (e.g. milk of magnesia, magnesium
citrate) act like a sponge to draw water into the colon
for easier passage of stool. They usually work within
a few hours.
Osmotic laxatives (e.g. lactulose) also draw fluid
into the intestine. They usually take about one to two
days to work. This type of laxative may be used on
an ongoing basis under a doctor’s supervision and
under certain conditions.
Stool softeners (e.g. docusate sodium, docusate
calcium) prevent stools from being dry and hard and
allow for easier bowel movement.
Stimulant laxatives (e.g. senna, cascara, bisacodyl,
castor oil) cause irritation of the bowel to stimulate
movement. Suppositories act within 5-30 minutes
while tablets work in about 6-12 hours. Castor oil
usually works within 2-6 hours.
If fecal impaction (accumulation of
hardened feces in the rectum) is
suspected, a doctor should be
consulted. A lubricant and/or enema
(e.g. mineral oil or phosphate enema)
is often used in these circumstances.