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.
Know the symptoms of Constipation.
Constipation
Constipation refers to infrequent bowel movements or difficulty passing stool, often causing discomfort. Its meaning lies in the inability to empty the bowels regularly. Various constipation medicines and treatments exist, from over-the-counter laxatives to prescription drugs. However, many prefer home remedies for constipation, such as increasing fibre intake, staying hydrated, exercising regularly, and using natural laxatives like prunes or psyllium husk. Consulting a healthcare professional is advisable for severe or persistent cases.
Causes of Constipation
This is usually caused by changes in diet or routine and poor fiber intake. When food passes slowly through your digestive tract, your colon absorbs more water, making your stool more difficult to pass. Constipation can also be caused by a blockage in your large intestine. If this is the case, you should seek medical attention.
Common causes of constipation include
A lack of fibre. People who eat foods with high fibre will have fewer problems with constipation. High-fiber foods include fruits, vegetables, whole grains, nuts, and chickpeas. Foods that are low in fibre include Fat foods such as cheese, meat, and eggs, processed foods like white bread, and other processed foods Fast foods such as chips and other pre-made foods
Irritable Bowel Syndrome IBS is a condition that affects large intestines and is a risk factor for constipation. Common symptoms of IBS include stomach cramps, abdominal pain, bloating, and gas. IBS is a long-term condition.
- Age - As you age, you are more likely to experience constipation. In fact, 40 to 60% of older adults are at risk. When food takes too long to pass through your digestive tract, constipation can occur.
- Medical conditions - If you have any medical conditions, constipation can also occur.
- Change in your daily routine - For example, if you are traveling and have to change your daily routine, constipation can be a problem.
- Laxatives—Laxatives are substances used to loosen stools and increase bowel movement. Taking laxatives on a regular basis allows the body to get used to them. However, this can have negative effects on the body, such as dehydration, electrolyte imbalance, and internal organ damage.
- Drinking less water - This can lead to dehydration, which can cause constipation. Consuming water regularly can help reduce the risk of developing constipation. However, if you are experiencing constipation, it is important to avoid caffeine, coffee, alcohol, and other caffeinated drinks. Hirschsprung's disease is a condition in which a nerve cell is not present in the large intestine, making it difficult for the stool to pass. This can lead to problems with bowel movements.
Other health conditions can also cause constipation, such as cancerous tumours, hernia, scar tissue, colorectal laxity, inflammatory bowel disease, and more.
Children and newborn infants: Constipation can occur in any age group, but it is most common when a baby is formula-fed. If a baby does not pass their first stool within the first 48 hours of being born, the doctor will be aware of these symptoms and will operate on the baby accordingly.
Signs of constipation: These can vary from person to person. If you are experiencing any of the following issues, you are likely at a higher risk of constipation:
- Having less than three bowel movements per week.
- Passing hard stools.
- Experiencing pain during bowel movements.
- Feeling rectal blockage.
Certain individuals are more susceptible to constipation due to their lifestyle and health conditions. These include:
- Older adults over the age of 65 who may have a sedentary lifestyle or underlying medical conditions that contribute to constipation.
- Individuals with serious medical conditions, such as spinal cord injuries, which can affect bowel movements.
- Pregnant women who may experience hormonal changes and increased pressure on the intestines from the growing baby.
To prevent constipation, it is important to make some lifestyle changes. Here are some preventive measures you can take:
- Stay hydrated by drinking 8-10 glasses of water daily.
- Avoid alcohol and caffeinated drinks, as they can contribute to dehydration and worsen constipation.
- Include fiber-rich foods in your diet, such as fruits, vegetables, whole grains, and cereals.
- Limit the consumption of low-fiber foods like meat, milk, and cheese.
- Engage in daily exercise for at least 30 minutes to promote regular bowel movements.
- Consider taking laxative supplements for a short period under the guidance of a healthcare professional.
Diagnosis for Constipation
In addition to a general physical examination and a digital rectal examination, physicians utilize various tests and procedures to diagnose constipation and identify the underlying cause:
- Blood tests: Your physician will check for general conditions such as hypothyroidism or high calcium levels.
- X-ray: This imaging technique helps determine if there is a blockage in the bowels and if stool is present throughout the colon.
- Sigmoidoscopy is a procedure in which a flexible tube with a light is inserted into the rectum and lower colon for examination.
- Colonoscopy: This diagnostic procedure involves using a flexible tube with a camera to examine the entire colon.
- Anorectal manometry: a test where a tube is inserted into the anus and rectum to measure muscle coordination.
- The balloon expulsion test measures the time taken to expel a water-filled balloon from the rectum.
- Colonic transit study: involves swallowing a capsule with a marker to track its progress through the large intestine over 24-48 hours.
- An X-ray of the rectum during defecation involves inserting a soft barium-based paste into the rectum, which is then passed out along with the stool. Barium is visible on X-rays and can help identify issues like prolapse or muscle coordination problems.
- MRI defecography, similar to barium defecography, involves inserting a contrast gel into the rectum and passing it through. The MRI scanner visualizes and evaluates the functionality of the muscles involved in defecation. This test is useful in diagnosing conditions that may lead to constipation, such as rectocele or rectal prolapse.
Treatment for chronic constipation
This typically starts with changes to your diet and lifestyle to improve the movement of stool through your bowels. If these changes are not effective, your doctor may suggest medication or surgery.
To relieve constipation, your doctor may recommend the following diet and lifestyle modifications:
- Increase your fibre intake: Fiber can increase the weight of your stool and promote faster bowel movements. Gradually incorporate more fresh fruits, vegetables, whole-grain breads, and cereals into your daily meals.
- Follow a recommended fibre intake: Your doctor may advise a specific amount of fibre to consume each day. Aim for around 14 grams of fibre per 1000 calories in your regular diet.
- Start slowly and progress gradually: A sudden increase in fibre intake can lead to bloating and gas. Begin with small changes and work progressively towards your fibre goal over a few weeks.
- Engage in regular exercise: Physical activity helps stimulate muscle activity in your bowels. Strive to exercise almost every day of the week. If you are not currently active, consult your doctor to determine if you are fit enough to start an exercise program.
- Respond to the urge to have a bowel movement: Take your time in the bathroom and allow yourself sufficient time without distractions or feeling rushed.
In addition to lifestyle changes, there are various types of laxatives available over the counter to help with constipation:
- Fiber supplements: These supplements add bulk to your stool, making it softer and easier to pass. Examples include psyllium, polycarbophile calcium, and methylcellulose.
- Stimulants: Stimulant laxatives like bisacodyl and sennosides stimulate contractions in the intestines.
- Osmotic laxatives: These laxatives increase fluid secretion from the intestines, aiding in the movement of stool through the colon. Examples include oral magnesium hydroxide, magnesium citrate, lactulose, and polyethene glycol. Remember to consult your doctor before starting any new treatment or medication for chronic constipation.
If non-prescription drugs are not effective in treating your chronic constipation, your healthcare provider might suggest prescription medications, particularly if you have irritable bowel syndrome.
Pelvic muscle training: Biofeedback training entails collaborating with a physician who utilizes devices to assist you in mastering the relaxation and contraction of the muscles in your abdomen. Properly relaxing your pelvic floor muscles during a bowel movement can facilitate easier stool passage. Throughout a biofeedback session, a specialized tube (catheter) is inserted into your rectum to gauge muscle tension.
Surgical intervention: Surgery could be considered if alternative treatments have been unsuccessful and your chronic constipation is due to an obstruction, rectocele, or stricture. For individuals who have exhausted other treatment options without success and experience abnormally slow stool movement through the colon, surgical excision of a portion of the colon might be considered. Complete removal of the large intestine through surgery is seldom necessary.
If you experience any of the following symptoms, it is advisable to seek medical attention promptly: discomfort or a worsening condition.
- Sudden onset of constipation
- Constipation is unresponsive to dietary changes
- Presence of blood in stool
- Rectal bleeding
- Persistent abdominal or lower back pain
- High fever; vomiting
- Unexplained weight loss
Constipation can be a result of an irregular diet or an unhealthy body, as well as underlying medical conditions. It can be managed with home remedies such as consuming high-fibre foods and engaging in regular physical activity. However, if severe symptoms persist, it is crucial to consult a healthcare professional without delay. Home Remedies:
To alleviate constipation naturally, consider the following guidelines for a healthier lifestyle: Increase fiber intake to 25–31 grams daily through fresh fruits, vegetables, and fiber-rich cereals.
Stay hydrated by drinking an adequate amount of water to aid in constipation relief.
Engage in regular physical activity to promote bowel movement. - Establish a routine for visiting the restroom daily. - Avoid delaying bowel movements to prevent complications.
Citations
https://www.nejm.org/doi/full/10.1056/nejmra020995
https://link.springer.com/article/10.1007/BF01318172
https://www.nature.com/articles/nrdp201795
