Constipation
Constipation is defined as stools which are hard, difficult and often painful to pass. There is also infrequent bowel movements, typically less than 3 times a week. The sensation of incomplete bowel evacuation is often experienced as well.
Constipation is a common problem which most people face at some point in their lives, although it tends to be more common in women, children and the elderly. Most of the time, it tends to be a transient problem which lends itself to simple remedies. Occasionally, however, it can become chronic, especially in the bed-bound, elderly or chronically ill.
CAUSES
Many factors predispose one to developing constipation.
The main causes are as follows:
1. Hardening of faeces due to
- inadequate fluid intake
- insufficient dietary fibre
- medication eg. Iron, calcium, diuretics
2. Slow transit through colon resulting in excess reabsorption of water. Stools thus become dry and hard. Causes include:
- medication containing codeine, excessive anti-diarrhoeal medication, certain anti-depressants
- diseases such as hypothyroidism, diabetes, post-stroke, Parkinson's disease
- hypokalemia
- decreased physical activity eg. In bed-bound individuals
3. Some form of Mechanical Obstruction to Stool Passage such as:
- tumours
- anatomical abnomalities of the colon eg. Rectal prolapse, rectocele, adhesions post-surgery
4. Psychological causes
- irritable bowel syndrome (IBS – constipation-predominant form)
5. Causes unique to infants
- switching from breast milk to formula milk
- Hirschsprung's disease
- potty-training anxiety
COMPLICATIONS
Constipation, if left untreated, can result in the following complications:
• Hemorrhoids (piles) or painful anal fissures
• Faecal impaction which may require manual evacuation by your doctor
• Rectal prolapse
• Hernias due to excessive straining
PREVENTION and MANAGEMENT
Constipation is generally easier to prevent than treat. You can take some simple steps to help prevent and manage constipation:
• Drink plenty of fluids
• Include plenty of fibre in your diet eg. Fruits, vegetables, whole-grain foods
• Exercise regularly
• Do not ignore urge to have bowel movement
• Try to schedule time after a meal for bowel movements
• Avoid medication which are known to aggravate constipation
There are some over-the-counter medication which can help relieve constipation:
• Fibre supplements
• Laxatives eg lactulose
• Stimulants eg senna, bisacodyl
• Enema preparations
Note: Check with your doctor should a change in bowel habits occur!
The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.