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    In difficult times, storing a good supply of long-shelf-life food is a wise move. Folks in the preparedness community have, for decades, filled pantries and freezers with enough food to get them through any disaster. Long-lasting food items, however, can sometimes cause digestive issues when combined with the stresses associated with apocalyptic settings. One of these is constipation.

    Constipation is usually defined as having less than three bowel movements a week. Stools tend to be hard, dry, “lumpy,” and difficult to pass. Patients complain of abdominal bloating and discomfort. In some cases, there’s significant pain associated with prolonged efforts to have a bowel movement. Afterwards, there may be a feeling that the evacuation of feces was incomplete

    One-sixth of the general population experiences constipation, with percentages rising significantly higher with age. There are millions of doctor visits due to problems relating to it and 250 million US dollars spent on treatment each year. Women have the problem more often than men.

    What happens in the body that leads to constipation? The body absorbs nutrients as food moves through the digestive tract. Partially digested food travels from the stomach to the small intestine and, then, the large intestine (also called the “colon”).  Your large intestine absorbs water from digested contents, leading to solid feces (also called “stool”). When food moves too slowly through the colon, too much water is absorbed, causing stool to become dry and hard in consistency. This makes it difficult to push out.

    CAUSES OF CONSTIPATION

    Source: Cabot Health

    Constipation is not a disease itself, but it can be a symptom of a number of dietary and medical problems. Common causes of constipation include:

    DIET

    Constipation is often caused by failing to stay well-hydrated and maintaining a diet rich in high-fiber foods like fruits, vegetables, and whole grains. A diet consisting only of high-fat meats, dairy products, eggs, or sugary items also predispose you to having problems with bowel movements. You can see how difficult it might be to maintain a balanced diet in a post-disaster situation, where your choice of foods (and the availability of them or even water) may be limited.

    Prepared families have a store of preserved foods in case of a major catastrophe. These tend to have low fiber content, which can lead to constipation. If water is rationed, dehydration may contribute to worsening the situation. Indeed, the family medic must enforce the adequate intake of (clean, disinfected) fluids in order to prevent the problem.

    DISEASE

    Many medical conditions can cause constipation:

    • GI disorders like irritable bowel syndrome (IBS). Diverticulosis, obstruction, cancer, and structural defects.
    • Hormonal problems like hypothyroidism, diabetes, and kidney disease.
    • Nerve disorders like spinal cord injury, stroke, multiple sclerosis, and Parkinson’s disease.
    • Diseases that affect multiple organs, such as autoimmune systemic lupus, scleroderma, and amyloidosis.
    • Pregnancy.
    Constipation is common in pregnancy

    Many medicines have constipation as a likely adverse reaction, including:

    • Pain medicines (opiates and others).
    • NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen (Advil, Motrin) and naproxen (Aleve).
    • Antacids containing calcium or aluminum (Tums, Mylanta).
    • Iron supplements.
    • Antidepressants.
    • Blood pressure medicines like calcium channel blockers and beta-blockers.
    • Diuretics.
    • Anti-seizure medications like clozapine (Clozaril).
    • Anti-diabetic medications like semaglutide (Ozempic).
    • Anti-nausea medications like ondansetron (Zofran).

    The above is just a partial list. Ask your physician if your meds are causing your constipation before a disaster knocks out medical infrastructure.

    LIFESTYLE

    Stress can lead to constipation

    Many people have habits or behaviors that predispose them to constipation. They include:

    • Not getting enough exercise.
    • Irregular routines that affect the composition and timing of meals.
    • Frequent travel schedules.
    • Stress.
    • Ignoring the urge to go due to work or other responsibilities.
    • Ignoring opportunities to hydrate.

    TREATMENT

    What’s the right number of bowel movements to have? It’s different for each person. For some, it can mean bowel movements twice a day. For others, having movements three times a week is normal.

    In most cases, constipation is manageable with simple measures:

    HYDRATE: You’ll be surprised to know the quantity of fluids recommended by the U.S. National Academies of Sciences, Engineering, and Medicine. They determined that daily fluid intake should be 3.7 liters for men and 2.7 liters for women (Some of these fluids are present in dietary solid foods). Drink an extra two to four glasses of water a day if you’re constipated.

    CHANGE YOUR DIET: Add more fruits, vegetables whole grains and other high-fiber foods to your daily routine. Eat foods known to help you go, like prunes, prune juice, and bran cereal.  Watch the number of high-fat foods, like meat, eggs and cheese you consume daily.

    Prune juice can really work!

    ON THE TOILET: Certain positions are more effective in evacuating your bowels. Raising your feet, squatting, or leaning back may help. Don’t spend more than ten minutes on the toilet at a time, as excess pressure on the anus can lead to hemorrhoids. Interestingly, taking your phone to the bathroom doubles the amount of time you spend on the toilet!

    EXERCISE: Get moving and your bowels may do the same. 30 minutes of walking or other activity can help.

    OTC OPTIONS: Over the counter fiber supplements, stool softeners, laxatives, and enemas are options when you need extra help. For the survival medic, they’re useful items for survival storage. It’s important to know that frequent use of these strategies can worsen the situation, so use only when necessary.

    Fiber supplements: Metamucil, Fybogel, Benefiber, Citrucel.

    Stool softeners: Colace, Surfak

    Oral bowel muscle stimulants: Dulcolax, Senokot

    Laxative suppositories: Glycerin, Dulcolax

    Enemas: Saline solution, sodium phosphate, mineral oil

    Be sure to follow the instructions.

    NATURAL OPTIONS: A number of herbal teas are thought to be helpful for those suffering from constipation. They include:

    Senna tea: Thought to have a laxative effect.

    Dandelion Tea: laxative effect.

    Cascara Tea: A strong laxative. Use sparingly.

    Peppermint tea and green tea: May be useful in cases of chronic constipation.

    Black coffee is also commonly used to help stimulate a bowel movement.

    WHEN CONSTIPATION MAY BE A SIGN OF SOMETHING WORSE

    While most cases of constipation can be treated without major intervention, certain symptoms should alert you to seek modern medical care if available.

    • Blood in the stool or from the anus.
    • Constant abdominal pain or distention.
    • Inability to pass gas.
    • Nausea and vomiting.
    • Fever.
    • Weight loss.

    In my next article, I’ll discuss what happens when stool become so hard it isn’t coming out by itself, a condition called “fecal impaction.” I’ll also talk about the survivalist’s and military’s go-to for food on the go: Meals Ready-to-Eat, also known as MREs or “Meals Refusing To Exit.”

    In the meantime, if you have tried and true methods to treat constipation, let me know!

    Joe Alton MD

    Find out more about minor wounds and 200 other medical topics off the grid in the Book Excellence Award winner in Medicine, The Survival Medicine Handbook: The Essential Guide For When Help Is NOT On The Way. Plus, check out quality medical kits for beach outing and other scenarios at store.doomandbloom.net.

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