Constipation

Constipation can happen to anyone – let’s look at types of constipation and treatment options. It is known as a medical condition where an individual produces less than three bowel movements per week. The digestive tract extends from the mouth to the rectum. The stomach and small and large intestines are all involved in the process of digestion. The churning of food and peristalsis are responsible for propelling the food forward. When going through the tract, nutrients are absorbed, food is broken down, waste is accumulated, and is then released out.

The soft and bulky stool activates the intestines and the pelvic floor muscles to push the stool out from the rectum. However, when there is a problem in completing this process, it results in constipation. The stools are often lumpy, hard, dry, and painful to pass. Also, once the stool has passed, there is still a lingering feeling of not having a clean stomach. Constipation is not a disease, but it might lead to a different medical problem.

Constipation is very common in the United States and has a prevalence in all age groups. According to American Gastroenterological Association (AGA), approximately 33% of adults above the age of 60 experience symptoms of constipation. In the US, about 4 million people suffer from constipation — resulting in 2.5 million annual visits to the doctor.

There are certain groups of people who are at a higher risk of getting constipated. For example, women during pregnancy or after childbirth, older adults with digestion issues, and people with non-Caucasian ethnicity. Alongside this, people with little or no fiber in their diets or those who are on certain medications or dietary supplements are also prone to constipation.

Types of Constipation

1. Dys Synergic Defecation: These types of constipation is when the nerves and muscles in the pelvic floor do not function properly. This might result in chronic constipation.
2. Slow Transit Constipation: In these types of constipation there is reduced motility of the large intestine because of abnormal enteric nerve function. This unusual slow passage of waste through the large intestine leads to constipation.

Causes of Constipation – Symptoms of Constipation

The common causes of constipation are as follows:

• Not drinking enough fluids
• Inactive lifestyle
• Diet poor in fiber
• Change in daily routine or a side effect of medication
• Stress, depression, or anxiety

Complications of Constipation

Hemorrhoids are a result of complications caused by constipation. They occur because of one’s straining to have a bowel movement. This strain can also cause anal fissures, which are often accompanied by rectal bleeding. Sometimes, a rectal prolapse occurs where a small amount of intestinal lining pushes out from the anal opening. Constipation causes fecal impaction (hardening of the stool), though this is more common in children and older adults. This hard stool packs the intestine and rectum tightly, thus making the typical bowel movement difficult.

Diagnosis for Constipation

A doctor would recommend some tests that would be based on the duration and severity of one’s constipation. The doctor will weigh in if the symptoms of constipation are severe, like blood in the stool or sudden weight loss, and then recommend a treatment plan.

The doctor may ask about medical history, perform a digital rectal exam, or, to avoid complications, recommend an abdominal x-ray, lower GI series, colonoscopy, colorectal transit study, or anorectal function tests.

Treatment of Constipation

• Making simple changes in one’s diet and daily routine can aid in the treatment of constipation!
• Drinking plenty of fluids and avoiding alcohol
• Increasing the fiber content in your diet by introducing a variety of fruits, vegetables, and fiber-rich carbohydrate sources (e.g. oatmeal, flaxseeds, chia seeds, quinoa, and non-processed cereals). The foods will help soften up the stool and relieve the pain while passing the stool.
• Improve the toilet routine. Regulating the time and place will definitely help provide comfort. Do not delay or hold back whenever you have bowel movements though.
• Exercise and daily physical activity
• In case of severe constipation, the doctor may advise suitable laxatives. These laxatives should be used only for a short period of time as they may have other side effects.
• Prescription drugs will aid in the treatment of constipation such as:
  – Lubiprostone: This helps increase the fluid levels in the intestine.
  – Linaclotide: This medication helps regulate bowel movements in patients having long-term constipation or having IBS.
  – Prucalopride: This medication aids in having a smooth movement of stool.
  – Osmotic Agents: Milk of Magnesia, lubricants like mineral oil, or stimulants may be prescribed too.

Other strategies that may help relieve constipation in more extreme cases are biofeedback therapy, surgery, or treating the patient with an enema.

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FAQ

1. How should stool feel during a normal bowel movement? The stool should be soft and leave your body easily.
2. How much fiber should I consume to avoid constipation? It is recommended to have 25-35 gm of fiber per day.
3. I started eating more fiber on my doctor’s recommendation, but my symptoms have gotten worse. Why is this? There are many types of constipation. Each kind cannot be treated by just eating fiber alone. People with dys synergic defecation or slow transit constipation may experience their symptoms worsening if they increase fiber intake.

Healthier Me Today is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Never ignore professional medical advice in seeking treatment. Always consult with your healthcare professional. Stay healthy!