What is constipation?
Do you know the feeling of being uncomfortable, straining for bowel movement, abdominal cramping and bloating, called constipation? Constipation is considered the most common gastrointestinal complaint.
Four million people in the United States have frequent constipation, which results in 2.5 million visits to the doctor annually.
Chronic constipation is when stool frequency is less than three times per week, lasting for several months.
What are the symptoms?
Symptoms of constipation:
- Abdominal pain
- Bowel movement fewer than three times per week
- Difficult and painful bowel movement
- Feeling bloated and uncomfortable
- Feeling sluggish
- Feeling a sensation of blockage in the rectum that prevents bowel movement
- Can't completely empty the stools from the rectum
- Unable to pass stools, which are small and semi-formed stools
- Pressing on your abdomen or using a finger to empty stools from the rectum
- Firm tummy
Why does it happen?
Constipation happens because your colon absorbs too much water from waste (stool/poop), which dries out the stool making it hard in consistency and difficult to push out of the body.
Constipation is multifactorial and it is not possible to know the exact cause of it, but there are some causes such as:
- Diet with low fibres or not drinking enough fluid (dehydration)
- Anxiety
- Depression
- Resisting the urge to have a bowel movement
- Changes in regular routine as travelling or changes in time of eating or sleeping
- Medications may cause constipation as
- Strong painkillers
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Antidepressants
- Antacids
- Iron tablets
- Antihistamines
- Certain blood pressure medications as calcium channel blockers and beta blockers
- Anticonvulsant/ seizure drugs
- Anti-nausea medicines
- Medical and health conditions:
- Endocrine conditions as hypothyroidism, diabetes, uremia and hypercalcemia
- Colorectal cancer
- Irritable bowel syndrome is a common condition affecting the digestive system, it is an unknown cause, characterised by bloating, constipation, and diarrhoea, and lasts for days, weeks or months. Has no cure, but diet changes and medicine can control the condition
- Neurologic disorders such as Parkinson’s disease, stroke, multiple sclerosis, and spinal nerve injury.
- Lazy bowel syndrome: the colon contracts poorly and retains stool
- Pregnancy due to physiological and hormonal changes and iron intake and decrease of intestine movement
- A structural defect in the digestive tract
Who is more affected by constipation?
Constipation, its complications, and discomfort affect the quality of many people's lives.
Constipation affects 1 in every seven adults and up to 1 in every three children in the UK.
It occurs more in the elderly over 65 years, affecting women twice more than men and more common in pregnant women.
Complications of constipation
- Haemorrhoids: swollen and inflamed veins in the rectum, characterised by pain when defecating.
- Anal fissures: trauma to the anus. It is painful and itchy, and there is blood in the stools.
- Rectal prolapse is when the last portion of the colon (rectum) protrudes beyond the anus and is visible on the outside of your body
- Faecal impaction: due to prolonged constipation when the stools are too dry and hard that it can't pass during normal bowel movement
How can I prevent constipation?
Some actions can be taken to avoid developing chronic constipation
- Diet modification includes eating fewer foods with low amounts of fibre, such as processed foods, and dairy and meat products. Therefore, eating more high-content fibre foods such as vegetables, fruits, whole cereals, and beans. Increase intake of fibrous foods to 25-30 grams daily
- Drink plenty of fluids and water
- Be active and exercise regularly
- Less stressful life
- Manage a regular schedule for bowel movements
How to relieve constipation stomach pain?
Relieve stomach pain by changing lifestyle, using laxatives as we will mention and medication that prevent and treat constipation.
Medical treatment for constipation
Some medications may help in case of constipation
- Medications that draw water into your intestine and facilitate bowel movement
- Serotonin 5-hydroxytryptamine four receptors move stools through the colon
- Peripherally acting mu-opioid receptor antagonists (PAMORAs), drugs are taken if opioids are the cause of constipation to reverse the effect of opioids on the intestine to keep bowel movement
Surgery can be an option for the treatment of constipation when other treatments are used with no success, and the cause of constipation is the slow movement of stools through the colon, so removal of part of the colon may be a treatment for constipation.
Laxatives for constipation treatment
- Fibre supplements: These add bulk to the stools, where bulky stools are softer and easier to pass.
- Stimulants: that allow intestines to contract as bisacodyl and genocides
- Osmotics: laxatives that help stools move through the colon by stimulating bowel movement and increasing the secretion of fluid from the intestine.
- Stool softeners: soften the stools by taking water from the intestines
- Lubricants that allow stools to move through the colon more easily, lubricant as mineral oil
- Enemas and suppositories help soften stools and promote bowel movement. Glycerine or bisacodyl suppositories lubricate the bowel and stimulate bowel movement.
Constipation home remedies
As mentioned before, exercising regularly, drinking plenty of water, and eating fibrous foods is important.
- According to Dr. Arielle Miller Levitan, an Illinois-based internal medicine specialist, coconut oil may help to lubricate your intestines and prevent constipation
- Research has shown that coffee could act as a colonic stimulant, and its action is like having a meal, hence preventing constipation
- Check how you sit on the toilet, as it affects bowel movement. Raising your feet and squatting will help bowel movement become easier
Consume probiotics
Probiotics are beneficial bacteria which are naturally present in fermented food.
They enhance the gut microbiome, and these beneficial bacteria in your digestive system will regulate inflammation, immune function and digestion.
Summary
Constipation is a common everyday life problem that affects many people. It is essential to think about it and consider how to prevent constipation and treat it to improve patients’ quality of life.
References
- NHS choices. NHS;. Available from: https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/#:~:text=Irritable%20bowel%20syndrome%20(IBS)%20is,It's%20usually%20a%20lifelong%20problem.
- Person. 6 constipation remedies that work (plus 3 that don't). Nebraska Medicine. Nebraska Medicine; 2022. Available from: https://www.nebraskamed.com/gastrointestinal-care/6-constipation-remedies-that-work-plus-3-that-dont
- Constipation. Mayo Clinic. Mayo Foundation for Medical Education and Research; 2021. Available from: https://www.mayoclinic.org/diseases-conditions/constipation/diagnosis-treatment/drc-20354259
- Link R. Probiotics for constipation: Everything you need to know [Internet]. Healthline. Healthline Media; 2019 [cited 2022Nov19]. Available from: https://www.healthline.com/nutrition/probiotics-for-constipation#downsides