Constipation is personal. Not only is it a topic people may not like to talk about, frequency of bowel movements is personally unique to each of us. Defined as infrequent bowel movements or stool that is difficult to pass, what constitutes constipation is highly variable from person to person.

“Normal” frequency ranges from one bowel movement a day to one per week. If once a week is normal for you, no intervention is needed. Cause for concern arises when people go to great degrees to have more frequent bowel movements or when persistent changes to bowel movement frequency or consistency is experienced.

Occasional constipation can be normal. Bowel movements are dependent on many things, including regular exercise, which helps stimulate the colon to contract.

Fluid intake and diet also play an important role in stool consistency. High-fiber diets lead to bulkier stools which are more easily moved by the muscles in the colon, while low-residue diets may contribute to constipation as they result in smaller stool. Many people experience travel-related constipation as a result of changes in their diet and amount of regular exercise.

There are other, less common causes of constipation. Rare causes of constipation include slow transit time or digestion in the gastrointestinal tract, pelvic floor issues or cancer. Constipation can also result from using laxatives — medications used to stimulate the colon to produce a bowel movement.  Any persistent abnormalities should be discussed with your physician.

Fiber can help prevent constipation. Occasional constipation can be treated or even prevented by eating a high fiber diet. We need 25-40 grams of daily fiber, but the typical American doesn’t get more than 10-15 grams per day. Slowly adding a fiber supplement to your diet, about 6 additional grams daily every two weeks, is a safe way to acclimate your body to increased fiber. Remember, fiber supplementation must include increased water intake. For every 6 grams of fiber added to your diet, be sure to drink an additional 12 to 16 ounces of water each day.

In addition to warding off constipation, there are many other benefits of a high-fiber diet. It promotes healthy microbiota — the group of bacterial organisms that live in your digestive tract — which is important in the body’s ability to fight off infection. High-fiber diets can also prevent diverticulosis, the forming of pockets in the digestive tract called diverticula that can lead to inflammation called diverticulitis.

When to see your doctor. If you experience any of the following, schedule an appointment to discuss with your doctor:

• Persistent change to frequency of bowel movements
• New or worsening abdominal pain
• Pain with bowel movements
• Bloating
• Hemorrhoids
• Blood in stool
• Unintended weight loss

What to expect at your doctor visit. Your doctor will perform a thorough general physical to identify masses, impaction or other abnormalities, and take a complete medical history to look for risk factors for colon cancer, inflammatory bowel disease or trauma to the pelvic floor. Following your visit, your doctor may also order a small number of blood tests to rule out other causes of constipation, such as anemia, diabetes or thyroid issues. Your doctor may refer you to a gastroenterologist for further evaluation.

Just as it’s important to know your baseline blood pressure or cholesterol levels, you should also understand your unique “normal” in terms of bowel movements and see your doctor if you experience any changes. To encourage healthy bowel movements and gut bacteria, survey your diet on occasion to ensure you’re getting the appropriate amount of fiber and water to prevent future constipation as well as other issues.

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