Constipation is a medical condition where the patient suffers from irregular bowel movements and faces difficulty in passing stools. In its chronic condition, constipation may last several weeks. In constipation, patients usually experience less than 3 bowel movements in one week.
Casual constipation is common and almost 8 out of 10 people experience it at least once in their lifetime. However, chronic constipation is a serious condition and can easily impact one’s ability to perform daily tasks. In addition, chronic constipation usually causes patients to practice undue strains for bowel movement and may lead to a range of other symptoms.
For proper treatment of chronic constipation, it is important to find its basic cause. However, in many cases, doctors are not able to find the underlying cause of chronic constipation.
There are two types of constipation. These are Primary Constipation and Secondary Constipation.
- Primary Constipation – Also referred to as Functional constipation, primary constipation is further divided in three sub types. These are:
- Slow- transit constipation
- Pelvic floor dysfunction
- Normal- transit constipation
- Secondary Constipation – Typically, Secondary constipation is caused by disturbances to metabolism. These disturbances could be created by various conditions including hypothyroidism, injuries to spinal cord, celiac disease, Parkinson’s disease, multiple sclerosis, and diseases impacting large intestine including diverticular disease and colon cancer. In addition, there are several medications that may lead to secondary constipation.
There are various symptoms of chronic constipation. Some of the most common symptoms of constipation include:
- Difficulty in passing stool (lesser than three time in a week)
- Hard or lumpy stools
- Putting undue strains for bowel movements
- Experiencing a rectum blockage
- Having hard time to empty the rectum by pressing abdomen
Typically, those experiencing 2 or more symptoms consecutively for three months may be suffering from chronic constipation.
Usually, constipation happens when excretion waste cannot be passed completely from the rectum that passes very slowly from the digestive tract. This often causes stools to become dry and hard.
There could be many possible causes for chronic constipation.
1. Rectum or Colon Blockage – A blockage in the rectum or the colon may slow down or completely blocks stool movement. Some of the primary causes for this include:
- Bowel obstruction
- Colon cancer
- Bowel stricture
- Anal fissure
- Rectal cancer
2. Problems in nerves around the rectum or colon - Neurological conditions often affect the nerves that lead to the irregular movement of rectum or colon muscles making it difficult to pass the stool through intestines. Some of the primary causes for this may include:
- Multiple sclerosis
- Autonomic neuropathy
- Parkinson's disease
- Spinal cord injury
3. Issues with muscles needed for stool elimination – Conditions that affect pelvic muscles may also lead to irregular bowel movement causing chronic constipation. Some of the primary causes of this may include:
- Weakened pelvic muscles
4. Conditions affecting body hormones – The work of hormones in the body is to balance the body fluid. Irregularity of hormones may also cause chronic constipation. Some of the primary causes for the same are:
5. Consumption of milk - Some people might get constipation due to consumption of milk or dairy products.
6. Change in routine: Sometimes due to traveling or not sticking to regular sleep schedule, a person can experience constipation. This affects the digestive system which causes constipation.
Change in routine of eating meals and going to the washroom is a major lifestyle change which increases the risk of constipation.
7. Not going to washroom when needed: When individuals ignore the urge to have bowel movements, they increase the risk of constipation. The urge may last as long as the person no longer feels the need to go. The longer you control this natural process, the stools gets harder. This practice should be avoided.
8. Lower intake of water: Regular consumption of water reduces the risk of constipation. During constipation; avoid having alcohol, soda and drinks with caffeine content as it may worsen the condition.
9. Some medical conditions: There are certain diseases that tend to slow down the feces movement and may result in constipation. These include the following health conditions:
- Neurological disorders: Diseases like Parkinson’s disease, stroke and spinal cord injuries can cause constipation.
- Endocrine and metabolic conditions: Uremia, diabetes, hypothyroidism and hypercalcima.
- Systematic disease: These diseases affect number of organs and tissues, and affect the entire body. These include Lupus, scleroderma and amyloidosis.
- Cancer: Constipation can even happen to cancer patients, due to pain medications and chemotherapy. It can also happen when a tumor blocks or squeezes the digestive system.
There are several risk factors for constipation and chronic constipation.
- Older age
- Gender (Female are more prone to chronic constipation)
- Low fiber diets
- Medications (narcotics, antidepressants, sedatives)
- Eating disorder
If not treated properly, chronic constipation may lead to several complications.
- Anal fissure.
- Fecal impaction
- Rectal prolapse
In order to diagnose chronic constipation, doctors may run general tests. In addition, doctors may also prescribe digital rectal exam.
- Blood tests
- Anorectal manometry
- Balloon expulsion test
- Colonic transit study
Typically, treatment for chronic constipation is provided to speed up and ease the passage of stools through the intestine. The treatment may include dietary and lifestyle changes. In addition to these, doctors may also prescribe surgery or medication to help relieve from the condition of chronic constipation.
Doctors may prescribe laxatives for effective treatment of chronic constipation. There are different types of laxatives. These laxatives ease the bowel movement and help in smoother passage of stool through the intestine. Here are just some of the many laxatives that are easily available at ones’ disposal.
- Stimulants. [bisacodyl (Ducodyl), Correctol, senna-sennosides oral (Senokot) and Dulcolax]
- Fiber supplements - [calcium polycarbophil (FiberCon), methylcellulose fiber (Citrucel) and psyllium (Metamucil, Konsyl)]
- Osmotics. [Oral magnesium hydroxide (Phillips Milk of Magnesia), magnesium citrate, lactulose (Kristalose), polyethylene glycol (Miralax), polyethylene glycol (PEG) (Golytely, Nulytely)]
- Enemas and suppositories. [Sodium phosphate (Fleet), soapsuds or tap water enemas, Glycerin or bisacodyl suppositories]
- Stool softeners. [Docusate sodium (Colace) and docusate calcium (Surfak)]
In case a patient is not getting relief from chronic constipation by using over-the-counter laxatives, doctors may prescribe some prescription medicines. Some of these prescription medicines are:
- Linaclotide (Linzess)
- Lubiprostone (Amitiza)
- Botulinum toxin type A or Botox
- Misoprostol (Cytotec)
- Colchicine/probenecid (Col-Probenecid)
If all other treatment options fail, then doctors may recommend surgery. Doctors typically suggest a surgery when the chronic constipation is caused by anal fissure, stricture, rectocele or blockage.
Those experiencing slow stool movements through colon even after a range of different treatment methods may be required to undergo surgery to remove a part of the colon. There are rare chances when a patient requires undergoing a surgical procedure to remove the colon completely.
It is easy to identify the signs and symptoms of chronic constipations and prevent the condition from getting worse.
- Adding a prolific amount of high-fiber items in one’s diet. These high-fiber items may include vegetables, fruits, beans, bran and whole grain cereals.
- Avoiding excessive consumption of food items with lower fiber. It is prudent to avoid excessive intake of meat, dairy products and processed foods.
- Keeping body hydrated by drinking prolific amount of fluids.
- Indulging in regular exercise to stay active and fit.
- Managing stress and keeping away from stressful situations.
- Ensuring discipline in terms of bowel movements.
- Ensuring prolific amount if fiber in the diet of children who have just started eating solid food.
Constipation can happen to people from any age group. But old age people are more likely to be affected with this disorder. Apart from medications, a balanced lifestyle and certain tips can help prevent constipation.
- Drink more beverages during morning
- Add more vegetables and fruits in your diet.
- Increase the intake of fibrous cereals and water in your daily routine.
- Consume diet more of fiber intake, which includes vegetables, legumes and bran.
- Reduce the intake of milk
- Exercise regularly for at least 30 minutes in a day.
- Go to the washroom whenever necessary.
- Cut down on eating processed food
- Avoid stress
- Making a routine to use the washroom.
In case traces of blood or mucus on stools are seen, then consult the doctor immediately.
Myth #1: Including fibrous food in diet can help cure constipation.
Fact: Fibrous food items are perhaps best to ensure regular digestion and bowel movements. These fibrous food items can be categorized into two different types: Soluble fiber and insoluble fiber.
Soluble fibrous food item dissolves easily in water turning into a gel-like substance; whereas insoluble fibrous food item do not dissolve in water and help move the food through the digestive tract rather quickly.
This is the reason why experts believe that insoluble fiber speeds up the movement of waste through the digestive tracts. Some of the many food items that contain insoluble fiber are whole grains, fruit skins, seeds and whole-wheat bread. But these insoluble fibers often lead to gas formation in intestines and worsen the condition of chronic constipation.
Myth #2: Excessive fluid consumption may improve bowel movement.
Fact: Constipation doesn’t just mean that condition where one suffers from the inability to pass stools. It is also a condition where one suffers from the painful passing of hard, lumpy stools. A large number of people believe that excessive consumption of fluids may soften the stools and help relieve the symptoms of constipation. However, researchers have confirmed that excessive water intake doesn’t really help with bowel movements or stool consistency.
Myth #3: Constipation is not a serious illness.
Fact: A large number of people dismiss chronic constipation as a serious illness. Most people believe that it is a temporary condition and would get better on its own. However, this is not true. Chronic constipation can lead to several life-threatening diseases and may disturb one’s ability to perform daily tasks effectively. Chronic constipation is a serious illness and those suffering from it must ensure proper treatment, dietary and lifestyle changes to get rid of the condition.
Myth #4: Constipation creates toxins in body.
Fact: Since constipation is related to excretory waste of the body, many people believe that constipation may create toxins in the body. People, at large, believe that constipation may lead to the body absorbing poisonous substances from stools and these substances may eventually lead to life-threatening diseases including asthma, colon cancer and arthritis. However, researchers have not yet found any concrete evidence that suggests that stools produce toxins or poisonous substances and that it can retained by body when suffering from constipation.
Myth #5: Laxative are addictive in nature.
Fact: This is yet another myth that plagues the world of constipation. However, the truth is akin to this fact. Laxatives are not addictive in nature. One can easily eat or consume laxative without having to worry about the situation of getting addicted to it. In fact, it is even safe for breastfeeding mothers.
Ans: Medical experts and doctors believe that the bowel movements must be formed and soft. They believe that stools must pass easily to ensure complete protection against the state of constipation.
Ans: No! Laxatives are not addictive and can be consumed by people suffering from constipation. In fact, laxatives are even safer for lactating mothers.
Ans: Yes. Medical researchers have found that women suffer 3 times more from constipation as compared to men. Researchers have not yet found any reasons for the same. However, one of the most widely accepted theories is that women suffer from hormonal changes or disorders during pregnancy or menopause and that may lead to the condition of constipation.
Ans: No. Researchers have found no evidence that explicitly reveals that stools carry any poisonous or toxic substances. Constipation doesn’t cause toxins to build-up in the body. In addition, there is no conclusive evidence found that constipation may lead to bowel cancer.
Ans: Constipation remains one of the most common conditions faced by pregnant women. This is because of the hormonal changes and these hormonal changes often slow down the bowel movement. In order to prevent constipation during pregnancy, one must ensure nutritious and healthy diet and consume fiber content. Ensure adequate consumption of water and other fluids such as juices. In addition, it is important to do a little exercise and take proper rest.
Ans: Constipation in infants is very common. A kid who is suffering from constipation would often pass lumpy and hard stools. Talking about newborn babies, babies on breastmilk are less prone to constipation as against those on bottled mild. This is because breast milk contains enzymes that safeguard children against cases diarrhea and also breast milk is easily digestible.
It is often noticed that some new born babies pass stool whenever they are fed, whereas some of them would not pass stools for as long as a week. There is nothing to worry in such cases as this is absolutely normal.
Ans: Fibrous food items are perhaps the most important part of a healthy diet. Fiber adds bulk to the stools. But too much fiber intake is also not advisable. Therefore, people must remain cautious of the amount of fiber they are consuming. An average person may include at least 50-70 grams’ fiber daily. Also, take enough of fluid in your diet, like beverages and juices.
Also keep in mind, that fiber can worsen the constipation, when there is less of water along with more of fiber food.
Ans: Constipation is a very common problem affecting people from all age groups. With the increasing population and use of essential oils, many people are using it as it gives relief from constipation. Essential oils can be used by diluting them with carrier oil.
Peppermint oil, fennel oil, ginger oil and lavender oil are some of the essential oils that can be used for treating constipation.
Ans: There are various natural ways to get relief from constipation. It can be relieved by drinking a lot of water as it keeps one hydrated. By increasing the intake of fiber can increase the bulk of bowel movements. Also, increasing the intake of coffee can relieve this issue as it urges you to go washroom by stimulating the muscles.
If you are taking medicines, then do not stop the medication on your own. Habits like yoga can also help in keeping stress at bay. One can even meditate or take warm bath. Go for brisk walk and a dedicated exercise routine keeps the bowels move.
Ans: People suffering from constipation should drink extra liquid that helps to soften and move bowels. Also, eating high-fiber food may add bulk in the movement of bowels. High fiber foods like fruit, vegetables, cereals and beans.
Patients need to inculcate a habit of training themselves in order to have regular bowel movements. Sit in the washroom for at least 10 minutes, even if you do not have a bowel movement.
Ans: The standard time frame for bowel movements ranges from three bowel movements per day to three bowel movements per week. It is important how much the individual is comfortable with his bowel frequency.
Body positions can help move one’s bowels. While sitting in the toilet, place your feet on a stool that can position rectum at an angle that makes the bowel movements easy to pass.
Ans: Medications for colon depends for the person. The stool softeners are safe and budget-friendly, but are only effective in treating mild constipation.
Ans: If the muscles of the pelvic floor are not functioning properly, then physical therapy can retrain those muscles. Physical therapy helps in connecting mind to the body that allows muscles to work properly during bowel movement. This therapy helps in muscle strengthening and decreases spasm.
Ans: No. Constipation does not cause build-up toxins in the body. Also, there is no evidence yet that constipation can cause cancer.
Ans: Constipation is always unbearable. It is usually a short-term problem but is important to know when it requires emergency care. Here are the following conditions when one should seek help:
- Abdominal pain
- When stomach is bloating
- When there is a blood in the stool.
- When it lasts for more than 2 weeks.
Ans: No. There is no such evidence that constipation comes back soon as one stop taking laxatives.
Ans: Apart from irregular stools, children might suffer with issues like loss of energy and appetite, bad smelling and stomach ache.
Ans: Constipation can happen to kids as well. In children, diet plays an important role. Just like adults, they too need to increase the intake of fiber. Apart from this, if a child is feeling stressed for going to toilet, it can cause him constipation. Let them try going to washroom on their own.
During school hours, children might avoid the urge of going to washrooms which makes them hold on their bowel movements. Keep an eye on your child’s routine for their better lifestyle.
Ans: Men should follow their diet, like they should start taking more fiber and do exercise more often. Make these habits a routine. If these measures are not helpful, seek help from a doctor.
As constipation is not only symptom of bowel cancer, if an individual is seeing some unexpected changes they must visit their physician.
Ans: Ideally, laxatives should be taken only for short term and one should stop them once constipation is cured. In case if an individual is suffering with this condition due to any other medicine or medical condition, then it is advised to continue taking them.
But this needs to be done only under medical supervision.
Ans: There are 4 types of constipation:
- Diet and medication controlled constipation: In this condition, the colon moves the stool along within 2-3 days.
- Dysynergic constipation: The muscles of the pelvic floor do not function properly and function opposite as they usually do. In this condition, patients complain of not being able to empty. They even use their fingers to pass the stools. This condition may be coupled with an outlet obstruction where there is a rectocele coming from the stool.
- Slow transit constipation: In this condition, the colon moves slowly. The bowel movements get infrequent, may be once in 2-3 weeks.
- Combine dysynergic and slow transit constipation
Ans: There are varieties of tests that are conducted for constipation. Testing includes colonoscopy and anal-rectal manometrics. These tests evaluate the colon or problems with muscle function that may cause constipation.
If you are thinking for surgery that is the last option as this condition can be resolved with lifestyle changes, diet and laxative therapy. Surgery is advised in conditions when slow moving colon has failed all treatments or if there is a structure that blocks the way in constipation. This condition blocks the way of stool in passing through the anal canal.
Changes in one’s daily routine can cause constipation as it can disturb your bowel habits. Changes like traveling or new job can take some time to get back to the routine.
Although, one might feel embarrassed by talking about this medical condition, but it is important to be checked by the doctor in case if pain persists or worsens. Find solutions by reaching out to the doctor or adapting new lifestyle tips.
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