What is constipation?

Constipation means different things to different people. For many people, it simply means infrequent stools. For others, however, constipation means hard stools, difficulty passing stools (straining), or a sense of incomplete emptying after a bowel movement. The cause of each of these “types” of constipation probably is different, and the approach to each should be tailored to the specific type of constipation

The number of bowel movements generally decreases with age. Ninety-five percent of adults have bowel movements between three and 21 times per week, and this would be considered normal. The most common pattern is one bowel movement a day, but this pattern is seen in less than 50% of people. Moreover, most people are irregular and do not have bowel movements every day or the same number of bowel movements each day.

Medically speaking, constipation usually is defined as fewer than three bowel movements per week.

Severe constipation is defined as less than one bowel movement per week. Going without a bowel movement for two or three days does not cause physical discomfort, only mental distress for some people.

What causes constipation?

Theoretically, constipation can be caused by the slow passage of digesting food through any part of the intestine. More than 95% of the time, however, the slowing occurs in the colon.

Medications that cause constipation

A frequently over-looked cause of constipation is medications. The most common offending medications include:

  • Narcotic pain medications
  • Antidepressants
  • Anticonvulsants
  • Iron supplements
  • Medicines with Calcium & Aluminium
  • Diuretics
  • Stopping cigarette smoking.
  • Abuse of laxatives Endocrine disorders like – under active thyroid.
  • Any severe illness like stroke, paralysis.
  • Major changes in life like pregnancy, old-age or traveling.
  • Psychosomatic causes like depression and anxiety neurosis.
  • Biochemical imbalance ‘ low potassium levels in blood.
  • Lead poisoning.
  • Conditions that obstruct the normal passage of the stools within the intestines ‘ foreign bodies in intestines, strictures, adhesions, tumors, etc.
  • Abdominal surgeries.
  • Weakened pelvic floor muscles.
  • Constipation can occur sometimes as part of a condition called ‘irritable bowel syndrome’ where it alternates with diarrhea.

Diagnosis

A proper clinical history and physical examination usually suffices to diagnose constipation.
The presence of hard stools, difficulty in eliminating them and feeling of incomplete voiding of stools usually indicate the presence of constipation. Very hard, small, pellet-like stools which are eliminated with a lot of difficulty certainly indicate constipation even if stool occurs every day.

In very severe constipation of long standing, a physical examination may reveal the presence of hard lumps over the abdominal surface.

Other tests that your doctor may advice are:

  • Anorectal function tests – identify constipation caused by abnormal functioning of the anus or rectum.
  • Sigmoidoscopy or colonoscopy.
  • Colorectal transit study – shows how well food moves through the colon.
  • Defecography – evaluates completeness of stool elimination, evaluates rectal muscle contractions and relaxation and abnormalities in the anal canal or the rectum.
  • Barium enema X-rays of the abdomen to detect the presence of any foreign bodies or other structural abnormalities within the intestines.
  • Tests to rule out an under active thyroid.

Prevention

Constipation is a condition easier to prevent than to cure. Tackling the problem at its onset can prevent many years of discomfort and sufferings.

Tips to Prevent Constipation

  • Have more fibers in your diet. 25 to 30 grams of daily intake can prevent constipation. Fibers help retain water in the stools thus making them softer and easier to expel.
    • Whole grain cereals and breads
    • Dried fruits, such as prunes and raisins
    • Popcorn, nuts, and seeds
    • Beans and legumes
    • Raw fruits and vegetables
  • Drink plenty of fluids, preferably water. 8 glasses a day will help. Have more if you are physically active. Prune (manukka) juice, and other fruit drinks are known to normalize bowel motility.
  • Cut down on soft drinks and alcohols. Dehydration is a major contributor for hard, lumpy & irregular stools. Overuse of colas, alcoholic and caffeinated products can contribute to constipation. They are dehydrating agents.
  • Check your medicine closet. Identify your routine medications that may contribute to constipation. Let your doctor help you find an alternative.
  • Don’t curb your natural tendencies! Do not ignore your body’s natural urge to defecate. Over time, your body will stop having these natural urges and constipation will set in. Train your child to void himself when he has the urge, even if he’d rather play.
  • Stop the regular use of laxatives and enemas. Their long-term use can aggravate constipation. If you must take laxatives, then try starting with very low doses. Avoid randomly self-medicating oneself.
  • Exercise, Exercise, Exercise!! Physical inactivity can certainly make bowel movements very sluggish! People tend to cut down on physical activities as they age, for many reasons. Walking is a great way to exercise and prevent constipation.

Treatment

Changes in living and diet can alleviate the symptoms of chronic constipation. An under active thyroid disorder or mood disorders like anxiety neurosis will require treatments specific to them.

A major part of treatment consists of adding more fiber and fluids in the diet; engaging in more physical activities and modifying the stress factors that contribute to constipation.
Constipation not improving with life-style changes is managed with

  • Laxatives
  • Enemas

However, long term use of laxatives can cause further symptoms of distention and bloated feeling, not to mention an ever increasing dependence on them.

Homeopathy offers promising cure for constipation. Chronic constipation results from various constitutional problems such as stress, genetic predisposing, altered sleep pattern, etc. Homeopathy offers treatment which is based on the patient’s individual case pattern. Homeopathy is strongly recommended for all cases of constipation..

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