Constipation

What is constipation?

Constipation is a condition in which a person has fewer than three bowel movements a week or has bowel movements with stools that are hard, dry, and small, making them painful or difficult to pass. Some people think they are constipated if they do not have a bowel movement every day. Bowel movements may occur three times a day or three times a week, depending on the person. Most people get constipated at some point in their lives.  Understanding the causes, prevention, and treatment of constipation can help many people take steps to find relief.

Causes of constipation:

Constipation is caused by stool spending too much time in the colon. The colon absorbs too much water from the stool, making it hard and dry. Hard, dry stool is more difficult for the muscles of the rectum to push out of the body.

Common factors or disorders that lead to constipation are:

  • diets low in fiber

  • lack of physical activity

  • medications

  • life changes or daily routine changes

  • ignoring the urge to have a bowel movement

  • neurological and metabolic disorders

  • GI tract problems

  • functional GI disorders

Signs and symptoms:

  • Few bowel movements

  • Trouble having a bowel movement (straining)

  • Hard or small stools

  • A sense that everything didn’t come out.

  • Swollen abdomen or abdominal pain.

Natural remedies for constipation:

Taking of the following food may help to get relief from constipation-

  • sesame seeds

  • Molasses

  • Fiber

  • Mint or ginger tea

  • Lemon water

  • Coffee

  • Raisins

  • Prunes

  • Castor oil

  • Beside food exercise may also help in relieving constipation

First-line treatments for constipation include changes in eating, diet, and nutrition; exercise and lifestyle changes; and laxative medicines. If you don’t respond to these first-line treatments, you should talk with your doctor about other treatments.

Constipation: Myths and Misconception

Is it dangerous for stool to remain in the colon for a long time period? Can this cause other diseases?

This belief dates from ancient times. Now, colon cleansing (colonics) is promoted by some to maintain “colon health.” However, there is no foundation in science for this theory.

Can changes in hormones cause constipation?

There is no evidence for a cause and effect relationship between hormones and constipation.

Is constipation caused by low intake of fiber or fluid?

Fiber clearly increases stool bulk and frequency, and decreases transit time in healthy people, and may benefit individuals with relatively minor or occasional constipation. However, for chronic or more severe constipation no significant benefit has been demonstrated.

So far, research does not support increasing fluid intake to relieve constipation, but dehydration should be avoided.

Is the long-term use of stimulant laxatives for constipation unhealthy or unsafe?

In the only controlled study conducted to date, constipated patients treated with stimulant laxatives did not develop damage to their colons when compared to controls who did not receive laxatives. Hence, it is unlikely that stimulant laxatives are harmful when used at recommended doses. Nevertheless, the use of excessive laxatives over long periods has led to some serious metabolic consequences.

Are stimulant laxatives habit forming?

Although tolerance to laxatives has not been well studied in humans, animal data do not support development of tolerance. There are no data that suggests that laxatives are addictive or habit forming. Overall, the available data indicates that laxatives are safe and effective treatments for constipation. If patients with constipation find that their treatments are becoming less effective, then it is time to consult a doctor about alternatives.

How long can a person go without having a bowel movement before seeking medical attention? Could this ever become urgent and warrant a trip to the emergency room?

Most people have their own ‘personal’ bowel habit. They may have a few bowel movements a day or a bowel movement every few days. Doctors usually define constipation as less than three bowel movements per week and may define severe constipation as waiting more than a week for a bowel movement. However, some people have less than a bowel movement a week and are not bothered by this at all, while others may find this physically uncomfortable or emotionally distressing.

Most cases of constipation are chronic, having lasted for years, and are not associated with ‘alarm symptoms.’ It is usually related to a functional bowel disorder, such as irritable bowel syndrome (IBS). However, there are other possible causes of chronic constipation including medication use, hormonal problems, pelvic floor disorders, neurological disorders like Parkinson’s disease, and other conditions. Thus, if any of these possibilities appears relevant, a non-urgent medical evaluation would be logical.