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Constipation is defined as a bowel movement that occurs once every four days. A normal bowel movement is defined as an in evacuation every day or every three days. Straining at the toilet or incomplete elimination can complicate patients with constipation.

It is important to understand that bowel movements are extremely variable. The distribution of bowel habits is described above. There may be extenuating circumstances in any individual case. Medications, necessary for some conditions (such as the heart) may cause constipation. Other patients may experience a bowel movement which falls out of the "bell curve" and still be perfectly normal.

Your physician will assess several different aspects of the bowel movement in order to assess the most appropriate evaluation and remedy.

Evaluation of constipation includes a complete physical exam, routine lab work (electrolytes, renal function, calcium, thyroid function test, complete blood count etc.), a complete family history, and medication history. Further testing may include a barium enema, colonic transit study (a test where radiopaque markers are ingested and serial x-rays performed over a series of days to assess how stool is being moved through the colon), rectal manometry (a study when the anal sphincter is examined to determine if it is too tight nor too loose), barium enema, and colonoscopy. Depending upon the individual patient, any or all of the above may be useful in diagnosis.

Nonprescription laxatives should not be used on a regular basis. They may result in colonic damage called melanosis coli. Overuse of over-the-counter laxatives can also result in fat-soluble vitamin deficiencies (vitamins A, D, E, and K) or in a condition called lipoid pneumonia (use of mineral oil and other laxatives simultaneously can result in this condition).

Nonprescription laxatives can be used in order to relieve temporary constipation. Long-term treatment of constipation is based upon a structural evaluation of the colon, providing enough fluid on a daily basis, and increasing the amount of fiber in the patients died. Further techniques for management of constipation are available but should be done with the aid of a physician.