Constipation, clinically addressed as obstipation, is a relatively frequent problem that may lead to an overall malaise and discomfort in people who suffer from this condition.
Even though the bowel function is not under a regular and equal pattern in every individual, it’s considered normal to defecate less than three times a day and over three times a week. When the number of bowel movements is very distant from this reference range, then we may be facing a case of constipation that needs an adequate medical assessment.
What is constipation
If you have less than three bowel movements per week, or your stools are hard, dry, or uneven; if you struggle with defecating, and if you have a feeling that you did not empty your bowels, you may have a condition called constipation.
Some of the risk factors for constipation are:
- Low social and economical status
- Late-stage of life
- Sedentary lifestyle or change in routine and eating habits
- Low-fibre and low-fluid diet
- Travel, which entails a change of habits or lack of privacy to use the toilet room
- Autoimmune diseases or of the central nervous system
- Anxiety and/or depression disorders.
Obstipation may be portrayed when:
- There is an ongoing struggle to defecate.
- Defecation implies effort and/or pain.
- There’s a need to resort to digital manoeuvres to aid in the excretion of faecal matter.
- The individual will have two or fewer weekly bowel movements.
- There is a significant decrease in the normal bowel movements. Analytically we can say that the number of excretions would be less than three times a week.
Apart from all the aforementioned red flags, constipation is, still, linked to other important symptoms, such as: hardened and cracked faeces, an overall sense of malaise and abdominal discomfort, haemorrhoids, anal fissure, distension, flatulence, complete inability to defecate, without resorting to medication.
Overall, constipation is a result of hardened and of fewer volume faeces. This situation could lead to a slower intestinal function. One of the reasons for this to happen may be related to the amount of water present in the faeces.
When the level of water is low and/or faeces remain for longer periods in the bowels, it’s more likely that they’ll become harder and of a less volume and, therefore, more difficult to excrete.
Aside from water, faecal matter also contains fibre, which facilitates water absorption and, consequently, helps soften stools. Other possible causes for constipation can be:
- Lifestyle and rhythm changes, such as stress and low physical activity
- Changes in colon motility
- Pelvic muscle or anal sphincter dysfunction
- Neurological diseases (multiple sclerosis, Parkinson’s disease, spinal cord injuries)
- Metabolic diseases (diabetes, hypothyroidism, and renal failure)
However, it’s worth mentioning that constipation may not have an unidentifiable cause, which means, the bowels may have slow movement or difficulties in triggering faecal excretion for no apparent reason.
Sometimes, constipation may be also induced by taking a certain type of medication (antidepressants, AINEs, diuretics, opioids, etc.) or it can be manifested following other diseases that harm the good intestinal function, such as:
- Intestinal or anus issues (inflammation, stenosis areas (narrowing) in the intestines, tumours, anal fissures).
- Haemorrhoids and subsequent anal bleeding.
- Rectal prolapse.
- Faecal impaction.
Diagnosis and treatment
Given the described symptoms, we recommend seeing a doctor and having a health assessment, bloodwork, and screenings, namely: a rectal and anal scan (proctoscopy), barium enema, a colonoscopy, readings of time for bowel movements, stool sampling and/or anorectal manometry.
Once the problem is detected, the treatment can go through:
- Have a more enriched-fibre diet (25-30g a day)
- Remaining hydrated (ingesting around 1,5 to 2 litres a day)
- Having frequent physical exercise (walking, gymnastics, swimming)
- Taking medication, like laxatives (volume expanders, osmotic, lubricants, stimulants, emollients)
- Having surgery (only in rare cases).
Sidenote: You should always seek a gastroenterologist specialist if constipation worsens; in case you have bloody stools; if you have anaemia; and/or if you lose weight suddenly.
How to avoid constipation
As it’s now clear, in many cases, constipation may be prevented through the adoption of some behaviours, like physical exercise and having a fibre-enriched diet, combined with a regular water intake throughout the day. It’s also important not to ignore the urge to go to the bathroom
In fact, a balanced diet may help avoid constipation. Furthermore, the ones who suffer from constipation must bet on an especially fibre-enriched diet, such as:
- Cereal: bran, flakes, bread, and wholegrain crackers
- Fruit: plum, peach, pul fruits, and tropical fruits
- Vegetables: kale, beans, grain, peas, broad bean, and salad.
However, all of these foods should be introduced gradually into your diet, in a way to avoid other issues, like abdominal distension, flatulence, meteorism, or abdominal gas.