James A. Surrell, M.D.

By JAMES A. SURRELL, M.D.

Since constipation and diarrhea are two very common medical conditions that we all may experience from time to time, let me again review these two common bowel patterns.

So, what is a “normal” bowel pattern? A normal bowel pattern is generally defined as having up to three bowel movements per day or having three bowel movements per week. Of course, this will be strongly related to the amount of the fiber and fluids in your personal diet.

Also be aware that if you have a significant change in your personal bowel habits, it is very important to see your health care provider without delay, to determine the cause of this bowel pattern change. Further, always be aware that any over-the-counter or prescription medications may cause either constipation or diarrhea in certain individuals.

Our digestive system is made up of the stomach, where food and drink enters the system, the small intestine, where nutrients are absorbed, and the colon and rectum, through which the waste material passes. The colon is also the organ that absorbs liquids to maintain a proper fluid supply in our body.

Simply stated, constipation is waste material moving too slowly through the colon and the rectum. Diarrhea is when our food and drink is passing rapidly through our digestive system leading to frequent liquid bowel movements.

Be aware that dietary fiber is an important part of a healthy diet and can help us to avoid both constipation and diarrhea, as noted here.

CONSTIPATION — This is most commonly caused by not drinking enough water and other fluids, and by not eating enough dietary fiber. If a person does not drink enough fluid, the colon absorbs as much fluid as it can get out of the food that enters the colon. This is done to prevent dehydration. The waste material in the colon now becomes thickened, and moves more slowly through the colon. This results in hard stools that become difficult to pass out of the rectum.

In addition to not consuming enough fluids, certain prescription and over-the-counter medications may also cause constipation.

DIARRHEA — This is the opposite of constipation and represents an abnormally rapid passage of food and drink through the digestive system. Diarrhea may be caused by infection, inflammation, medications or stressful life events. It is important to note whether or not a person is having diarrhea episodes at night during their normal sleep time. If there is no diarrhea interrupting one’s sleep, it is very unlikely that there is a bowel infection or bowel inflammation (such as colitis), as the cause of the diarrhea.

In certain individuals, antibiotics and some other medications may also cause diarrhea. Stress may also cause diarrhea, as is most commonly seen in people with irritable bowel syndrome.

Both constipation and diarrhea may be effectively treated by increasing the amount of dietary fiber in one’s diet. Fiber acts like a “sponge” in your colon.

With constipation, fiber absorbs water and fluid and keeps fluid in the colon, making the stools pass more easily through the colon and out the rectum. With diarrhea, the fiber absorbs the excess fluid rapidly passing through the colon, makes the stools more formed, and this slows down the passage of stool. Therefore, a basic treatment for both chronic constipation and diarrhea is following a healthful diet, including taking in a proper amount of fiber and fluids.

Of course, if one has persistent constipation or diarrhea, this should be reviewed by your health care provider. Following a proper medical evaluation to determine the cause of persistent constipation or diarrhea, specific additional recommendations may be made by your health care provider to get your bowel pattern back to normal.

EDITOR’S NOTE: Dr. Jim Surrell is the author of “The ABC’s For Success In All We Do” and the “SOS (Stop Only Sugar) Diet” books. Contact Dr. Surrell by email at sosdietdoc@gmail.com.