Constipation

Constipation: An important reminder to be able to pass stools regularly

Did you grow up with the home-training of always having to sit on a potty stool or the toilet, and your parents making sure that something comes out of you before heading out?

If the answer is mostly yes, it must have been hard when there was nothing. 

We shall dive into what constipation is and how it affects both children and adults differently.

What is Constipation?

To understand how it is classified as constipation, the term means that a person has three or fewer bowel movements in a week, and sometimes it is painful to pass motion. It commonly occurs when waste or stool moves too slowly through the digestive tract or cannot be eliminated effectively from the rectum, which may cause the stool to become hard and dry. 

The term constipation might mean differently to different people who experience it. For many people, it simply means infrequent passage of stool (faeces). And for others, it might mean difficulty in passing stools (straining), hard stools, or a sense of incomplete passing after a bowel movement.

At one time or another, almost everyone gets constipated. In most cases, it lasts a short time and is not serious. Constipation can occur in babies, children and adults. The condition affects twice as many women as men and is also more common in older adults and during pregnancy.

Constipation is a very common problem in kids, but usually nothing to be concerned about because it can be prevented by healthy eating and establishing exercise habits.

How does constipation happen?

As food moves through the digestive tract, nutrients are absorbed. The partially digested food (waste) that remains moves from the small intestine to the large intestine, also called the colon. The colon absorbs water from this waste, which creates a solid matter called stool. 

If you have constipation, food may move too slowly through the digestive tract. Constipation happens because your colon absorbs too much water from the waste created in the body (stool/ poop), which dries out the stool and makes the consistency hard. This causes it to be difficult to be pushed out of the body.

Signs and Symptoms of Constipation

The signs and symptoms of constipation may vary in different individuals, but mainly include:

  • abdominal bloating
  • anal bleeding or fissures from the trauma caused by hard faeces
  • colonic perforation 
  • haemorrhoids
  • hard and/ or small faeces
  • infrequent bowel movements
  • lower abdominal discomfort/ stomach ache or cramps
  • occasionally distension (bloating)
  • occasionally diarrhoea due to obstruction of the colon by hard stool
  • psychological distress and/or obsession with having to go to the bathroom, and possible aggravation of the diverticular disease,
  • rectal bleeding and/ or anal fissures that are caused by hard or small stools
  • rectal prolapse
  • sense of incomplete evacuation after going to the bathroom
  • straining when going to the bathroom and to have a bowel movement

Causes of Constipation

The cause for each of these symptoms of constipation will vary, therefore different approaches have to be considered to tailor to the various symptoms.

Some of the common causes of constipation include:

  • a change in your routine or lifestyle, such as a change in your eating habits
  • abuse of laxatives: there is a possibility that stimulant products can damage the colon, therefore it is advised they are to be used as a last resort.
  • aging – constipation is more common in the elderly because of a few factors, including reduced intestinal muscle contractions and reliance on regular medications.
  • anxiety or depression
  • hormonal disorders – high levels of estrogen and progesterone during pregnancy.
  • ignoring the urge to pass stools – bowel movements are under voluntary control and suppressing the urge too frequently can lead to a decrease of urges and result in constipation.
  • lack of water/fluids – constipation can occur from a high-fibre diet if insufficient water is consumed.
  • eating little fibre, such as fruit, vegetables and cereals – fibre is important in maintaining a soft, bulky stool.
  • side effects of certain medications
  • other diseases primarily of other parts of the body that also affect the colon
  • eating lots of processed food such as cheeses, white bread and bagels, and meats

The two disorders that causes constipation are:

  1. colonic inertia – also known as a motility disorder; which is an abnormal passage of waste through the digestive system.
  2. pelvic floor dysfunction – the inability to correctly relax and coordinate your pelvic floor muscles to have a bowel movement.

In some cases, constipation is caused by more serious illnesses and events, including tumours and systemic diseases.

Chronic Constipation

Chronic constipation is also another underlying problem that might need constant attention in order to solve the issue. Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.

Chronic constipation may also cause people to strain excessively in order to have a bowel movement.

Some of the complications of chronic constipation include:

  • Haemorrhoids – caused by the constant straining to open the bowel, where it can damage the blood vessels of the rectum.
  • Faecal incontinence – an overfull bowel can cause involuntary ‘dribbling’ of diarrhoea.
  • Faecal impaction – faeces are collected and become so full in the lower bowel and rectum that the muscles of the bowels cannot push it out.
  • Rectal prolapse – happens when the constant straining pushes a section of rectal lining out of the anus.
  • Urinary incontinence – the constant straining can weaken pelvic floor muscles. This makes the involuntary passing of urine more likely, especially during coughing, laughing or sneezing.

Preventing and Treating Constipation

  • Consume more liquids: Drinking enough water and other liquids like two to four extra glasses of water a day can help the stool move easily through the intestines. You can also include apple, pear, or prune juice each day, and warm liquids in the morning.
  • Consume more fibre: High-fibre foods that can help prevent constipation include fruits, vegetables, whole-grain bread and bran cereal. You can also try adding apples, pears, beans, oatmeal, oranges, ripe bananas, whole-grains breads, and popcorn. 
  • Get enough exercise: Physical activity helps the bowels get into action.
  • Encourage/ Remind yourself to go to the toilet: Never fight the urge to go to the bathroom. 

Making diet and lifestyle changes can also help to reduce your risk of developing constipation in the first place.

If the suggestions are not effective for your situation, you may consult a pharmacist or your healthcare professional for some medication like laxatives as a last resort to assist in getting your bowel movement consistent.

NEVER ignore your body’s signs of passing stool

Constipation is a condition that usually happens based on our lifestyle habits, as well as our diets, therefore it is easy to prevent as well with some of the suggestions stated.

However, chronic constipation might take more than just the suggested ways to treat it, therefore it is important to talk with your doctor or other healthcare professional for the proper treatment for your constipation based on the various causes – especially if you are experiencing severe pain that worsens.

To also keep in mind, the symptoms of constipation may resemble other medical conditions or problems, therefore always consult your doctor for a diagnosis. 

WhatsDoc is a platform filled with general practitioners and pharmacists that may assist in your constipation issues. You can message them accordingly on the application for consultations. 

References:

https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253#:~:text=Constipation%20most%20commonly%20occurs%20when,constipation%20has%20many%20possible%20causes.

https://my.clevelandclinic.org/health/diseases/4059-constipation

https://www.webmd.com/digestive-disorders/digestive-diseases-constipation

https://www.nhs.uk/conditions/constipation/

https://www.medicalnewstoday.com/articles/150322

https://www.niddk.nih.gov/health-information/digestive-diseases/constipation

https://emedicine.medscape.com/article/184704-overview

https://www.healthline.com/health/constipation

https://www.hopkinsmedicine.org/health/conditions-and-diseases/constipation

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/constipation

https://medlineplus.gov/constipation.html

https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/constipation

https://kidshealth.org/en/parents/constipation.html

https://www.medicinenet.com/constipation/article.htm