Constipation means different things to different people. For many people, it simply means infrequent passage of faeces. For others, however, it means hard stools, difficulty passing them (straining), or a sense of incomplete emptying after a bowel movement.
Constipation is a condition of the digestive system where an individual has hard faeces that are difficult to expel. In most cases, this occurs because the colon has absorbed too much water from the food that is in the colon.
The slower the food moves through the digestive tract, the more water the colon will absorb from it. Consequently, the faeces become dry and hard.
The digestive system is very efficient. In just a few hours it extracts nutrients from foods and drink, processes them into the bloodstream, then gets ready for waste disposal through poo.
Being constipated means your bowel movements are tough or happen less often than normal. Almost everyone goes through it sooner or later.
Although it’s not usually serious, you'll feel much better when your body is back on track.
How often should I poo?
The normal length of time between bowel movements varies widely from person to person. Some people have them three times a day. Others have them only once or twice a week.
A lot depends on diet, age and daily activity, but 'being regular', not getting constipated and not straining is the important thing.
The longer waste material stays in the colon, the harder the poo gets, making it difficult to pass. Normal poo should not be either unusually hard or soft.
Going longer than 3 or more days without one, though, is usually too long. After 3 days, the stool or faeces become harder and more difficult to pass.
What Are The Symptoms?
You may have:
Few bowel movements
Lower abdominal discomfort
A sense of incomplete evacuation (the feeling that you still have to "go")
Straining to have a bowel movement
Hard or small stools
Swollen belly or belly pain
Rectal bleeding and/or anal fissures caused by hard stools
What Causes Constipation?
Some causes of constipation include:
Changes of routine, including holidays, starting school
Not eating enough fibre
Not drinking enough water or fluids
Not taking enough exercise, being sedentary
Ignoring natural urges to go to the toilet, sometimes due to not being near a toilet you are comfortable using
Emotional and psychological problems
Health conditions, including Parkinson's disease, an under-active thyroid gland and depression
Age and circumstances
Bottle-feeding for babies
Some medications, including narcotic-type pain killers such as codeine, iron supplements and some drugs used to control blood pressure.
Eating a lot of dairy products
Irritable bowel syndrome
Overuse of laxatives
Problems with the nerves and muscles in the digestive system
Because occasional constipation is so common, it does not usually need medical attention. However, if it is a recurring problem, seek medical advice.
Health professionals will ask about symptoms, medical history and will often examine your abdomen for any sign of a hardened mass and conduct a rectal examination with a lubricated gloved finger.
Further tests may be arranged, including blood tests or a colon examination.
When to Seek Medical Advice
Seek medical advice about constipation if:
Constipation is associated with a fever and lower abdominal pain, and your stools are thin or loose. This could be a sign of diverticulitis or other bowel conditions.
There is blood in poo. As well as being caused by anal fissures or piles, it is a possible symptom of bowel cancer.
Constipation begins after starting a new medication or supplement.
Constipation lasts 2 to 3 weeks, with abdominal pain. This could be a sign of lead poisoning or other serious problems.
You are elderly or disabled and have been constipated for a week or more, which may indicate an impacted stool.
There is unplanned weight loss
There is severe pain with bowel movements.
When to seek emergency medical care for constipation
Although constipation may be extremely uncomfortable, it is usually not serious. However, it may signal a serious underlying disorder such as cancer of the bowel. Because constipation may lead to complications, go to a hospital's emergency department for any of the following reasons:
Swollen veins in your anus (hemorrhoids). Straining to have a bowel movement may cause swelling in the veins in and around your anus.
Torn skin in your anus (anal fissure). A large or hard stool can cause tiny tears in the anus.
Stool that can't be expelled (faecal impaction). Chronic constipation may cause an accumulation of hardened stool that gets stuck in your intestines.
Intestine that protrudes from the anus (rectal prolapse). Straining to have a bowel movement can cause a small amount of the rectum to stretch and protrude from the anus.
Treatments for Constipation
In the majority of cases, constipation resolves itself without any treatment or risk to health.
The treatment of recurring constipation can include:
Drink two to four extra glasses of water a day, unless your doctor told you to limit fluids for another reason.
Try warm liquids, especially in the morning.
Add fruits and vegetables to your diet.
Eat prunes and bran cereal.
With the assistance of your physician and pharmacist, determine if there are drugs that you are taking that could be contributing to constipation. See if the drugs can be discontinued or changed.
Increase the fibre in your diet by consuming more fruits, vegetables, and whole grains.
It may be difficult to get enough fibre in the diet to effectively treat constipation, so don't hesitate to take fibre supplements if necessary (wheat bran, psyllium, etc.).
Use increasing amounts of fibre and/or change the type of fibre consumed until there is a satisfactory result.
Don't expect fibre to work overnight. Allow weeks for adequate trials.
If needed, use a very mild over-the-counter stool softener like docusate or a laxative like magnesium hydroxide. Laxatives should only be used as a last resort. Don’t use laxatives for more than 2 weeks without calling your doctor. If you overdo it, your symptoms may get worse.
Surgery may be an option if you have tried other treatments and your chronic constipation is caused by a blockage, rectocele, anal fissure or stricture.
For people who have tried other treatments without success and who have abnormally slow movement of stool through the colon, surgical removal of part of the colon may be an option. Surgery to remove the entire colon is rarely necessary.
How Can I Prevent Constipation?
Constipation cannot always be prevented, but steps to help avoid it include some lifestyle changes such as:
Eat a well- balanced diet with plenty of fiber. Good sources of fiber are fruits, vegetables, legumes, and whole-grain bread and cereal (especially bran).
Drink 1 1/2 to 2 quarts of water and other fluids a day (unless your doctor has you on a fluid-restricted diet). Fiber and water work together to keep you regular.
Avoid to much caffeine. It can be dehydrating.
Cut back on milk. Some people may need to avoid it because dairy products may be constipating for them.
Exercise regularly. Do something active for at least 30 minutes a day, most days of the week.
Go to the bathroom when you feel the urge. Don't suppress urges to defecate. When the urge comes, find a toilet
Constipation can be uncomfortable to talk about, but even more uncomfortable to deal with. So take a close look at your daily habits and lifestyle and see if you can pinpoint what might be causing your constipation. A healthy body means healthy digestion and feeling great inside and out.