Constipation means having less than three bowel movements a week.
Your stools harden and become difficult to pass as the bowel movements are not frequent.
Constipation does affect people occasionally however if it lasts for several weeks, it becomes chronic constipation.
What is Constipation?
You get constipation if your stools are dry and hard.
You have pain while passing stool and it is hard to pass them.
Constipation is very common. 2.5 million Americans visit their doctor each year for constipation.
People of all ages can get constipation. However, certain people are at more risk of getting constipation.
More about that later.
If you have constipation you are probably
- having less than three bowel movements in a week
- straining to pass the lumpy and hard stools
- using your finger or hand to help pass the stool
- feeling a blockage in the rectum that is preventing you from passing stool
- not feeling that you have emptied the still completely after having a bowel movement
- bloating in your belly
- having stomach ache and cramps
- having blood in stools and on the toilet paper when you wipe
Occasional constipation is considered normal but if you experience more than two symptoms consecutively for three months then you probably have chronic constipation.
What Causes Constipation?
Waste and stool moves very slowly in the digestive tract and does not pass completely through the rectum.
So, due to the slow movement, the colon absorbs too much water from waste. This hardens and dries the stool.
However, chronic constipation occurs consistently due to other issues.
Colon and Rectum Blockage
Your stool’s movement may slow down or block due to blockages in the colon and rectum.
These can occur due to other health problems like colon cancer and rectal cancer.
Tears in the skin lining the anus lead to anal fissure which makes it difficult to pass stool and rectal bleeding.
A rectocele, a bowel stricture (narrow colon), an obstruction in the intestines and abdominal cancers can result in colon or rectum blockage.
Muscle and Nerves Problems
Nerves allow muscles in the colon and rectum to contract and push stool.
However, some neurological diseases affect these nerves.
These include diseases and medical conditions like Parkinson’s disease, stroke, spinal cord injury, nerve damage of nerves responsible for bodily function, and multiple sclerosis.
Pelvic muscles are able to contract and relax to release stool.
Weakened pelvic muscles that are not able to relax to allow a bowel movement and pelvic muscles being unable to coordination the relaxation and contraction coordination can lead to chronic constipation.
Hormones regulate the fluids in your body.
Therefore, if you have any condition related to hormones and unbalance hormones then they can cause constipation.
This can also lead to constipation in older adults.
You will mostly get occasional constipation due to a lack of fiber in your diet and drinking less water.
Consuming a lot of dairy products can also cause constipation.
Especially if you have lactose intolerance then constipation can occur by eating dairy products.
It may also happen when you change your diet suddenly.
Moreover, a lack of exercise, stress, and overuse of laxatives can also cause constipation.
If you resist the urge to have a bowel movement and delay it, that can also lead you to get constipated.
Laxatives overuse and irritable bowel syndrome can increase your chance to get constipated.
Moreover, using antacids, sedatives and antidepressants can cause constipation as a side effect.
Eating disorders and mental health problems also lead to constipation.
The elderly and women are more at risk to get constipated.
Complications of Constipation
Occasional constipation will go away in a while and will not cause any complications.
However, chronic constipation leads to hemorrhoids.
Straining can lead to swelling in veins and around the anus.
Anal fissure happens because of tiny tears around the anus.
Constant constipation can tear the skin around the anus.
Moreover, Hard stool can accumulate and stuck in your large intestine.
This stool cannot pass through. This is called fecal impaction.
Chronic constipation can also cause rectal prolapse where regular straining causes a part of the rectum to protrude from the anus.
Diagnosis and Treatment
The doctor will take your physical examination, history and digital rectal exam.
However, for chronic constipation, they may also take a few other tests to look for complications and finding the cause.
First, you will get a blood test. This will help identify hypothyroidism or increased calcium levels.
Your doctor will insert a flexible tube in your anus. This examines the lower colon and rectum in a procedure called a sigmoidoscopy.
You may also be asked to get a colonoscopy which is the examination of the whole colon.
An X-ray identifies any blockage in your intestines and the presence of stool in the colon.
Anorectal manometry is done to measure the muscle coordination required for moving your bowels.
Your doctor will insert a small tube in your anus and a small balloon inflates at its tip. This device is pulled through the sphincter muscle whose coordination and function are examined.
A balloon expulsion test determines the time you require to push a balloon filled with water from your rectum.
This test examines the anal sphincter muscles’ speed.
A defecography evaluates the presence of prolapse or muscle coordination issues. A paste made of barium is inserted into your rectum. You pass that paste with your stool which will be apparent in your X-ray.
Colonic transit study examines how well food passes through the colon.
You are given a capsule with a radiopaque marker and its progress is noted for one to two days.
You may also eat radiocarbon-activated food whose progress will be monitored through a camera in a process called scintigraphy.
The progress is shown on an X-ray and it determines if food is moving slowly or not, or is there any intestinal muscle dysfunction. You may also get abdominal X-rays.
An MRI defecography examines the defecation muscles’ functionality and identifies problems like rectal prolapse.
Similar to barium defecography, your doctor inserts a gel that you pass through in stool. However, this time you use MRI.
Home remedies for constipation and diet changes are usually enough to cure constipation.
However, if they fail to work, your doctor may recommend some medicines and laxatives.
These treatments aim to increase the flow of stool movement in your intestine.
Include fiber in your diet. Fiber increases the weight of the stool and allows it to pass speedily through the intestine hence it is very effective in treating constipation.
However, do so slowly because a sudden increase in fiber can also cause gas and bloating.
Add fruits and green vegetables to your diet alongside whole-grain bread.
Ideally, you should eat about 14 grams of fiber for every 1000 calories in a day.
Set up your routine slowly and reach up to 14 grams daily in a matter of weeks.
Moreover, drink plenty of fluids and water.
Exercise Regularly and Stop Controlling the Urge
An inactivity body means inactive muscles.
Regular exercise and increases muscle activity of the muscles in your intestine. Therefore, the stool does not move slowly.
Exercise has many benefits besides bodybuilding. Physical activity keeps you active and your entire body’s muscles and bones active as well.
Do not stop your bowel movement. If you resist the urge, you will most likely get constipation.
Take your time in the washroom, without any distractions and hurry.
Different laxatives work differently to counteract constipation.
Fiber supplements include psyllium and methylcellulose that make a bulky stool.
This stool passes easily and speedily through the intestine and excreted out of the body.
Osmotics help bowel movement by stimulating the intestines to secrete more fluids. These fluids help stool to pass easily through the intestine.
Stool softener laxatives aim at moistening the stool. Water is drawn from the intestine to soften the stool.
Stimulants lead to contractions in the intestine and lubricants like mineral oil allow easy stool movement in the intestine.
Tap water enemas with soapsuds soften stool and glycerin suppositories provide lubrication and cause a bowel movement passing stool out of the body.
Your doctor will prescribe medicines if home remedies for constipation and over-the-counter medicines fail to work.
These include medicines like Lubiprostone that draw water from the intestine to soften the stool and increase the speed of stool passing through the intestine.
If opioid pain medications cause constipation then Peripherally acting mu-opioid receptor antagonists (PAMORAs) help in reversing the effect of opioids in the intestine to stimulate bowel movement.
Medicines like Prucalopride are Serotonin 5-hydroxytryptamine 4 receptors which help the movement of the stool to pass through the colon.
Furthermore, you can also train your pelvic floor muscles to relax and tighten during defecation.
If none of these work and you have a serious case of chronic constipation then you may require surgery to remove a part of the colon.
You can prevent yourself from getting constipated.
You will have to incorporate a few lifestyle changes that will not only cure your occasional constipation but also your chronic constipation.
Avoid low fiber foods like dairy products, meat and fried processed food.
In fact, eat more high-fiber foods like fruits, vegetables and beans, prunes and whole-grain cereals.
Drink a lot of water and juices. Add at least 2 to 4 more glasses of water to your regular routine and try to at least drink a minimum of 8 glasses of water per day.
You can also add warm water to your routine, especially early in the day.
Manage stress through exercise. Stress and lack of physical activity both cause constipation.
So why not manage them together?
You will notice a difference in your stress levels if you exercise regularly.
Start with 15 minutes of aerobics and then increase the time slowly.
You should also not resist the urge to pass stool. In fact, try to make a schedule for your bowel movements after a meal.
Also, take care of children and make sure they also consume enough fiber because they are likely to get constipation because of bad eating habits and low appetite.
Constipation is curable and treatable.
Mostly constipation results from improper lifestyle and eating habits.
As soon as you start taking care of your wellness, your body will start functioning well.
So, do not ignore your quality of life and do not indulge in habits that harm it.