Constipation

Introduction

Constipation is an embarrassing, albeit common problem. There is some confusion as to what constitutes constipation. For some people, constipation might mean difficulty in passing stools, or not defecating every day. Medically, it is defined by the Rome III Diagnostic Criteria as having at least 2 of the following criteria in the last 12 weeks:

  • Hard stools for more than a quarter of your bowel movements
  • Feeling like your bowel movement is incomplete for more than a quarter of your bowel movements
  • Straining for more than a quarter of your bowel movements
  • Having fewer than 3 bowel movements per week
  • Needing to use your fingers to help with defecation

Signs & Symptoms

Besides the signs mentioned above, constipation sufferers might also experience:

  • Pain when passing motion
  • Constant feeling that there is a need to pass stools
  • Bloating in the abdomen

When to Seek Medical Attention

  • Unexplained weight loss
  • Blood in stools
  • Dizziness and pale skin
  • Nausea and vomiting
  • If you are above 50 and your bowel movements have changed suddenly

Causes

There are many causes for constipation. These include:

  • Having a diet lacking in water and fibre
  • Taking medications such as mood medicines, some blood pressure medications and pain medications
  • Supplements like iron and calcium that can induce constipation
  • Stress
  • Medical conditions such as irritable bowel syndrome, diabetes, thyroid problems and spinal cord injuries
  • Pregnancy
  • Aging, which might cause your intestinal movements to slow down, leading to increased water loss from stools

Lifestyle modifications

Eating more fibre in food and drinking water can help your bowel movements. If you find it difficult to increase your fibre intake by eating more fruits, vegetables and whole grain, fibre supplements such as psyllium might help.

Regular exercise can also help to promote healthy bowel movements.

If your supplements like iron and calcium are giving you constipation, try to get it from natural foods instead of supplements. However, if you are under doctor’s directions, always check first.

Do not suppress your urge to go to the bathroom.

Treatment options

Lactulose works by pulling in water into your colon. It is relatively well-tolerated, and can be used for children and pregnant ladies as this medication is not absorbed by your body. Drinking more water with this laxative would also assist the medication.

Glycerin suppositories act by drawing water into the colon, giving you an urge to go to the bathroom. They have a fast onset time of around 15 minutes.

Lubricant laxatives like liquid paraffin help to lubricate your stools, making it easier to go to the toilet. However, it sometimes leaks out from the anus. Do not give this medication to bedridden patients.

Stimulant laxatives include senna and bisacodyl. They cause your muscles to contract, promoting bowel movement. These medications act faster than fibre and osmotive laxatives. Bisacodyl is also available in suppository form.

An enema increases the amount of water in your colon, making it easier to go to the bathroom. However, overuse of enemas can be harmful as it can interfere with the salt balance in your body. Do not give enemas to children under the age of two.

If your constipation is not adequately relieved by over-the-counter options, see your doctor for evaluation and if necessary, prescription medication.

 

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