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Constipation

constipation

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By Medicover Hospitals / 2 Feb 2021
Home | symptoms | constipation
  • When a person has less than three bowel movements per week or has difficult bowel movements. Constipation can have causes that are not due to an underlying disease. Examples include dehydration, lack of dietary fiber, physical inactivity, or drug side effects.
  • Article Context:

    1. What is a constipation?
    2. Causes
    3. Signs
    4. Who are at risk?
    5. Prevention
    6. Diagnosis
    7. Treatment
    8. When to visit a Doctor?
    9. Home remedies
    10. Myths and Facts
    11. FAQ's

    What is a constipation?

  • Constipation occurs when the bowel movement becomes less frequent and passing stool is difficult. This happens mostly due to a change in diet or routine and due to inadequate intake of fiber. If the food passes slowly through the digestive tract, then the colon will absorb more water and the faeces will become harder. Constipation can be a result of a blockage in the large intestine. In this case, the person should go for a medical emergency.
  • Causes:

  • Following are the reasons for common causes of constipation:
  • Lack of Fiber:

  • People who are having food with high fiber will face fewer constipation problems. Fiber helps in promoting bowel movements.High-fiber foods are:
    • Fruits
    • Vegetables
    • Whole grains
    • Nuts
    • Chickpeas
  • Some low-fiber foods are:
    • Fat foods like cheese, meat, and eggs
    • Processed foods like white bread
    • Fast foods like chips and pre-made foods

    Physical Inactivity:

  • Less physical activity can lead to constipation. People who are physically fit will less likely to experience constipation than other physically unfit people. The increase in mobility will help in improving constipation among older adults.
  • Irritable bowel syndrome:

  • Irritable bowel syndrome is a common disorder that affects the large intestines. IBS has a high risk of constipation. Some common symptoms a person may face are:
    • Stomach cramp
    • Abdominal pain
    • Bloating
    • Gas
  • Irritable bowel syndrome is a chronic condition.
  • Aging:

  • With the increasing age, the chance of getting constipation also increases. 40-60% of older people have a high risk of facing constipation. When the food takes a long time to pass through the digestive tract, it can cause constipation. If there are any medical conditions or low intake of fiber or water, then it can also cause constipation.
  • Change in Routine:

  • A person might face constipation due to a change in their daily routine. For example, if a person is traveling and there is a change in the regular habits, then a person can face constipation.
  • Overuse of Laxatives:

  • A laxative is a substance that is used for loosening stools and increases bowel movement. Regular use of laxatives allows the body in getting used to its actions. This may impact the body negatively and can show off the side effects. Laxatives overuse can lead to:
    • Dehydration
    • Electrolyte Imbalance
    • Internal organ damage

    Dehydration:

  • Dehydration is caused due to less drinking of water, and dehydration will lead to constipation. A regular habit of drinking water will help in reducing the risk of constipation. But if a person is facing constipation, he should avoid the intake of caffeinated sodas, coffee, and alcohol.
  • Colorectal problems:

  • Some health conditions can affect the colon and restrict the passage of stool which leads to constipation. Some health conditions are:
    • Cancerous tumors
    • Hernia
    • Scar tissue
    • Colorectal stricture
    • Inflammatory Bowel Disease

    Children:

  • Constipation may also affect children and newborn infants sometimes. The below section discusses this in more detail:
    • Newborn Infants:
    • When a newborn is unable to pass his first stool within 48 hours of birth, then there is a high risk of having Hirschsprung’s disease. It’s a condition where a certain nerve cell is missing from the large intestine. The doctor will get to know about these symptoms and operate on the infant accordingly.
    • Young Infants:
    • Breastfed babies will less likely to face constipation problems. The most common cause of constipation can be when an infant has a formula feed.

    Signs:

  • The normal bowel movement differs from person to person. If you are experiencing the following problems, then there is a high risk of getting constipated.
    • Less than three bowel movements a week
    • Passing hard stools
    • Pain during bowel movements
    • Experiencing rectal blockage

    Who are at risk?

  • A person with a poor diet and less physical inactivity is at a high risk of complications. People who are at high risk:
    • More than 65 age:

    • Older people are at a high risk of getting constipation as they are physically inactive. Some of them face constipation due to underlying diseases or medical conditions and improper diets.
    • Serious medical conditions:

    • Some of the serious medical conditions like a person with spinal cord injury can face constipation.
    • Pregnant women:

    • During pregnancy, a woman can face hormonal changes and pressure in the intestine from the growing baby, which can lead to constipation.

    Prevention:

  • To avoid constipation, a person should change their regular diet and should increase physical activity. Follow the preventive majors for avoiding constipation:
    • Drink 8-10 glasses of water everybody to keep your body hydrated.
    • Avoid the consumption of alcohol and caffeinated drinks.
    • Add rich fiber foods to your diets such as fruits, vegetables, whole grains, and cereal.
    • Avoid food with low fiber such as meat, milk, and cheese.
    • Do exercise daily at least for 30minutes..
    • Take laxatives supplements for a short period.

    Diagnosis:

  • Besides a general physical exam and a digital rectal exam, physicians use the following tests and procedures to diagnose constipation and try to find the cause:
    • Blood tests:Your physician will look for a general condition such as low thyroid (hypothyroidism) or high levels of calcium.
    • X-ray:An x-ray can help your doctor determine if our bowels are blocked and if there is stool present all over the colon.
    • Examination of the rectum and the lower, or the sigmoid colon (sigmoidoscopy): In this procedure, your doctor inserts a lighted flexible tube into your anus to examine your rectum and the lower part of your colon.
    • Examination of the rectum and entire colon (colonoscopy):This diagnostic procedure allows your doctor to examine the entire colon with a flexible tube fitted with a camera.
    • Assessment of muscle function of the anal sphincter (anorectal manometry): In this procedure, your doctor inserts a narrow, flexible tube into your anus and rectum, then inflates a small balloon at the end of the tube. The device is then drawn back through the sphincter muscle. This procedure allows the physician to measure the coordination of the muscles you used to move your guts.
    • Assessment of anal sphincter muscle speed (balloon expulsion test): Often used with anorectal manometry, this test measures the time it takes you to expel a balloon that has been filled with water and placed in your rectum.
    • Evaluation of the good circulation of food in the colon (the study of colonic transit): In this procedure, you can swallow a capsule that contains either a radiopaque marker or a wireless recording device. The progress of the capsule in the large intestine will be recorded over 24 - 48 hours and will be visible on x-rays. Sometimes, you can eat food that is activated with the radiocarbon and a special camera will record its progress (scintigraphy). your physician will look for signs of dysfunction of the intestinal muscles and how the food moves in your colon.
    • An x-ray of the rectum during defecation (bowel movement): During this procedure, your doctor inserts a soft barium-based paste into your rectum. You then pass the barium paste as you would the stool. Barium shows up on x-rays and can reveal prolapse or problems with muscle function and muscle coordination.
    • MRI defecography: During this procedure, as with barium defecography, a doctor will insert a contrast gel into your rectum. You then pass the gel. The MRI scanner can visualize and assess the function of defecating muscles. This test can also diagnose problems that can cause constipation, such as rectocele or rectal prolapse.

    Treatment:

  • Treatment for chronic constipation usually begins with diet and lifestyle changes designed to increase the rate at which stool moves through your bowels. If these changes don't help, your doctor may recommend medication or surgery.
  • Diet and lifestyle changes:

  • Your physician may recommend the following changes to relieve your constipation:
    • Increase your fiber intake. Adding fiber to your diet increases the weight of your stool and makes it pass through your bowels faster. Slowly start eating more fresh fruits and vegetables every day. Choose whole-grain breads and cereals.
    • Your physician may recommend a specific number of grams of fiber to take each day. Aim for 14 grams of fiber per 1000 calories in your everyday diet.
    • A sudden increase in the amount of fiber you eat can cause bloating and gas, so start slow and hit your goal within a few weeks.
    • Exercise almost every day of the week. Physical activity increases muscle activity in your bowels. Try to work out almost every day of the week. If you don't already exercise, ask your doctor if you are healthy enough to begin an exercise program.
    • Don't ignore the urge to have a gut movement. Take your time in the bathroom, give yourself enough time to have a gut movement without distractions, and feeling rushed.

    Laxatives:

  • Several types of laxatives exist. Each works a little differently to make it easier to saddle up. The following products are available over the counter:
    • Fiber supplements: Fiber supplements add bulk to your stool. Bulky stools are softer and easier to pass. Fiber supplements include psyllium, polycarbophil calcium, and methylcellulose.
    • Stimulants: Stimulants such as bisacodyl and sennosides cause your intestines to contract.
    • Osmotic: Osmotic laxatives help stool move through the colon by increasing fluid secretion from the intestines and helping to stimulate bowel movements. Examples like oral magnesium hydroxide, magnesium citrate, lactulose, polyethylene glycol.
    • Lubricants: Lubricants such as mineral oil make it easier for stools to move through your colon.
    • Stool softeners: Softeners such as docusate sodium and docusate calcium moisten the stool using water from the intestines.
    • Enemas and suppositories: Tap water enemas with or without soap suds can help soften the stool and cause a bowel movement. Glycerin or bisacodyl suppositories also help move stools out of the body by providing lubrication and stimulation.

    Other drugs:

  • If over-the-counter medications aren't helping your chronic constipation, your doctor may recommend prescription medication, especially if you have irritable bowel syndrome.
    • Medicines that draw water into your intestines.Many prescription drugs are available to treat chronic constipation. Lubiprostone (Amitiza), linaclotide (Linzess), and plecanatide (Trulance) work by sucking water into your intestines and making stool move faster.
    • Serotonin 5-hydroxytryptamine 4 receptors.(Motegrity) helps move stools through the colon.
    • Peripherally acting mu-opioid receptor antagonists (PAMORAs).If constipation is caused by opioid pain relievers, PAMORAs such as naloxegol (Movantik) and methylnaltrexone (Relistor) reverse the effect of opioids on the bowel to keep the bowel moving.

    Train your pelvic muscles:

    • Biofeedback training involves working with a physician who uses devices to help you learn to relax and tighten the muscles in your abdomen. Relaxing your pelvic floor muscles at the right time during a bowel movement can help you pass stool more easily.
    • During a biofeedback session, a special tube (catheter) is inserted into your rectum for measuring muscle tension. The physician guides you through workouts to alternately relax and tighten your pelvic muscles. A machine will measure your muscle tension and use sounds or lights to help you understand when you've relaxed your muscles.

    Surgery:

    • Surgery may be an option if you've tried other treatments and your chronic constipation is caused by a blockage, rectocele, or stricture.
    • For people who have tried other treatments without success and have unusually slow movement of the stool through the colon, surgical removal of part of the colon may be an option. Surgery to remove the entire large intestine is rarely necessary.

    When to visit a Doctor?

  • A person should rush to the hospital if he/she is facing these signs:
    • Discomfort or worse sign
    • Sudden start of constipation
    • Constipation that has not responded to diet changes
    • Blood in stool
    • Bleeding from the rectum
    • Regular pain in the abdomen or lower back
    • High fever
    • Vomiting
    • Abnormal weight loss
  • Constipation occurs because of an irregular diet or due to an unfit body. Also, this can be caused due to medical conditions. This can be cured with the help of home remedies such as eating foods that are high in fiber and through regular exercise. If a person faces some serious symptoms then in such cases the person should consult the doctor immediately.
  • Home Remedies:

  • Through the help of home remedies, you can get rid of constipation. Follow the below-mentioned points for a healthy life:
    • Increase intake of fiber: A person should have 25-31 grams of fiber every day. This includes fresh fruits, vegetables, and cereals which have high fiber.
    • Drink Water: Water will keep your body hydrated and will help in the treatment of constipation.
    • Regular exercise: Regular exercise
    • Follow the routine: Fix a time for visiting the washroom daily.
    • Don’t hold stools: Avoid holding stools for a longer time, as you may face the problem.

    Myths and Facts:

    Myths
    Facts
    Regular bowel movement Gums which are swallowed can be stuck
    Constipation creates Toxins Travelling can be an issue
    Adding more fiber Mood swings can affect constipation
    Holding constipation won’t create any problem Medicines can be a cause
    Coffee can fix constipation Dried plums are powerful
    Cleansing of colon helps Hydration plays a vital role in constipation

    Frequently Asked Questions:

  • Constipation occurs when the bowel movement becomes less frequent and passing stool is difficult. This happens mostly due to a change in diet or routine and due to inadequate intake of fiber.
  • Constipation can be cured by adding fiber to your food and doing regular exercise for keeping your body physically fit.
  • Home remedies that help in relieving constipation are:
    • Drinking more water
    • Eating food with high fiber
    • Regular exercise
  • Constipation is caused due to poor diet and lack of exercise. The other causes can be IBS, pregnancy, laxative, traveling, and hormonal disturbances.
  • Foods that can cause constipation are:
    • Alcohol
    • Gluten-containing foods
    • Processed grains
    • Red meat
    • Processed grains
  • Foods that will help to poop the right way are:
    • Apple
    • Prunes
    • Kiwi
    • Flax seeds
    • Beans
    • Vegetables
  • The following treatments can help you in bowel movement quickly:
    • Fiber supplement
    • Hydration
    • Laxative stimulant
    • Enema
  • Vitamin B-1, or thiamine, helps digestion. If your thiamine levels have dropped, your digestion may be slowed down. This could lead to constipation.
  • Vitamin B-12 deficiency may cause constipation. If the constipation is due to low levels of B-12, increasing the daily consumption of this nutrient could help relieve the symptoms. Users may prefer eating more rich foods in this vitamin than to take a supplement.
  • Citations:

  • https://www.nejm.org/doi/full/10.1056/nejmra020995
  • https://link.springer.com/article/10.1007/BF01318172
  • https://www.nature.com/articles/nrdp201795