Constipation, either acute or chronic, can be described as difficult, infrequent, or incomplete bowel movements. The stool tends to be small and/or hard. Bowel movements should, under normal circumstances, occur at least daily. Acute constipation generally results from a change in diet and/or lifestyle, significant stress, drug side effects, or some organic cause. Saline oral preparations and enemas, Epsom salts, or magnesium citrate preparations can be safely used if necessary.

Chronic constipation is usually due to diet, colon health problems, insufficient dietary fiber and roughage, a sedentary lifestyle, ignoring defecation urges, or frequent traveling. Chronic constipation is also associated with some disease conditions such as hypothyroidism, dehydration and nerve injury. Psychogenic constipation is described as an obsessive-compulsive fixation on frequency and quality of bowel movements.

Do not ignore the urge to defecate. Doing so can reduce the reflex and cause constipation to worsen. The delayed bowel movement becomes more difficult to pass and the unpleasant experience starts a negative feedback cycle. Chronic constipation is more common in women. The use of laxatives should be avoided unless the problem cannot be dealt with otherwise.

General rules for treating constipation
Before using laxatives, try first to remove any underlying cause. Make sure you are:

• Getting regular aerobic exercise
• Having or trying to have your movement at the same time each day
• Drinking enough water. Increase water consumption to 8 glasses per day
• Avoid refined foods which have had fiber taken out of them (white flour, white rice, peeled vegetables, etc.)
• Increase fiber (both water-soluble and non-water-soluble types) in the diet with more fruits and vegetables. If too difficult for now, try supplementing natural fibers like flax, psyllium, pectin, and guar gum. These possess a mild laxative action due to their ability to attract water and form a gelatinous mass.
• Consider the possibility of food allergies, especially milk, when you see diarrhea, alternating constipation and diarrhea, anal fissures, or other general allergy signs. A recent study found that 10 of the 86 patients allergic to milk showed "very delayed reactions" to a cow's milk challenge averaging over 13 days (range 4-26 days). These "very delayed" reactions included constipation, wheezing, and dermatitis.

Stimulant laxatives act on the large intestine by increasing peristalsis. The most common stimulant laxatives are derived from either cascara sagrada or senna. Both plants have long been used as laxatives and although extremely effective in promoting bowel movements, the use of stimulant laxatives should be avoided.

The US FDA has issued a final ruling that aloe and cascara sagrada will not be included in the final monograph for
over-the-counter (OTC) laxative drug products because they have not been shown to be generally safe and effective as stimulant laxatives. According to the ruling, aloe extract, aloe flower extract, cascara fluid extract aromatic, cascara sagrada extract, casanthranol, cascara sagrada bark and cascara sagrada fluid extract will no longer be allowed in OTC laxative drug products and are not GRAS (Generally Recognized As Safe) - February, 2002.

Check your transit time by consuming charcoal or beets. It should take from 18 to 24 hours to see evidence in the toilet (black or red). Longer times may result in bowel toxicity symptoms and increase the burden on your liver. If constipation does not improve using the above methods then professional help may be needed.

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