Constipation—A Moving Problem

 At one time or another, almost everyone gets constipated. Poor diet and lack of exercise are usually the causes. In most cases, constipation is temporary and not serious. Understanding the causes, prevention and treatment will help you solve the problem faster.

Constipation is the passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.

Some think they are constipated when in fact, their bowel movements are regular. For example, some people believe they are constipated, or irregular, if they do not have a bowel movement every day. However, there is no right number of daily or weekly bowel movements. “Normal” may be three times a day or three times a week depending on the person.

 Common causes

To understand constipation, it helps to know how the colon (large intestine) works. As food moves through the colon, it absorbs water while forming waste products, or stool. Thereafter, muscle contractions in the colon push the stool toward the rectum. By the time stool reaches the rectum, it has become solid because most of the water has been absorbed.

·        Lack of fibre People who eat plenty of high-fibre foods are less likely to become constipated. The bulk and soft texture of fibre help prevent hard, dry stools that are difficult to pass.

·        Not enough liquids Liquids like water and juices add fluid to the colon and bulk to stools, making bowel movements softer and easier to pass.

·        Lack of exercise This can lead to constipation. For example, constipation often occurs after an accident or during an illness when one must stay in bed and cannot exercise. A sedentary lifestyle is a major cause of constipation.

·        Ignoring the urge to have a bowel movement People who ignore the urge to have a bowel movement may eventually stop feeling the urge, which can lead to constipation.

·        Specific diseases Diseases that cause constipation include irritable bowel syndrome, neurological disorders, metabolic and endocrine disorders, and systemic conditions that affect organ systems. These disorders can slow the movement of stool through the colon, rectum, or anus. The medications used to treat these diseases can also contribute to the slow passage of bowels.

Treatment of constipation

Treatment depends on the cause, severity, and duration. But in most cases, following these simple tips will relieve symptoms and prevent recurrence of constipation:

·        Eat a soluble fiber-based diet with the careful incorporation of insoluble fiber.

·        Drink plenty of liquids.

·        Exercise regularly.

·        Set aside time after breakfast or dinner for undisturbed visits to the toilet.

·        Do not ignore the urge to have a bowel movement.

·        Understand that normal bowel habits vary.

·        Whenever a significant change in bowel habits occurs, check with a doctor.

Using laxatives

Laxatives help relieve constipation, but you have to make sure you really are constipated before you take them. It is important to remember that over-use of laxatives can cause the bowels to become “lazy” and not work properly.

If you are in reasonably good health, a balanced diet that includes fibre, such as fruits, vegetables, whole grain cereals, and an adequate fluid intake should keep your bowel movements regular. If you do get constipated, it's worth trying to increase your fibre intake and drink more water before taking laxatives.

There are different types of laxatives that are available over-the-counter in pharmacies.  They are classified into the following:

·        Bulking agents (e.g.  lactulose, fibre supplements)

·        Stool lubricants (e.g. liquid paraffin)

·        Mild stimulants (e.g. Senna-based products)

·        Strong stimulants (e.g. Bisacodyl)

It is recommended that you consult your doctor or pharmacist first to determine whether you need a laxative. Only they can determine which form would be best for your condition.