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Demystifying Constipation, a comprehensive guide

Demystifying Constipation, a comprehensive guide.

 

Constipation is slow, difficult transit of food in the digestive tract or infrequent bowel movements, excessively firm feces (hard stool) or a feeling that the rectum is not totally empty after a bowel movement (incomplete evacuation). Many people believe they are constipated if they do not have a bowel movement every day.
Constipation may be categorized as :

1. Acute (normal transit constipation)
2. Chronic
– Primary
– Secondary
The main difference between acute & chronic constipation is how long the constipation lasts. Acute constipation begins suddenly and noticeably while chronic constipation may begin gradually and persists for months or years.

1. ACUTE CONSTIPATION

Also known as Normal transit constipation is the most common type. It is generally short- term, with reduction in bowel movement frequency and often straining may be experienced to help evacuate the stool. it’s not frequent- lasting only a few days & can be brought on by a change in diet or routine, travel or lack of exercise and can be relieved by getting back your routine, exercise, or a high-fiber diet with water.

Recommended Intervention

A  Meal plan with regular hydration schedule and workout plan

Get supplements support from either of these

  • ConstiRelax Is composed of fructo-oligosaccharides FOS, which are soluble dietary fiber. These type of dietary fiber  have a prebiotic effect which  stimulate the growth of good bacteria (nonpathogenic intestinal microflora). The fiber help form fecal bolus and enable defecation regularly, hence prevent & treat constipation.
  • Inulin is a soluble fiber (a non-digestible oligosaccharide) this means it reaches the colon undigested and is further selectively fermented by colonic microflora. It helps to regulate bowel peristalsis and transit, stool consistency and frequency.
  • Bael  has been used in Ayurveda medicine to help manage constipation as it loosens the stools due to its laxative property
  • Gasex is a blend of herbals that help in improving digestion, relieving bloating & promoting proper bowel movement through the intestine.

2. CHRONIC CONSTIPATION

Chronic is generally long-term, lasting for more than three months. It disrupts a person’s personal or work life and is not relieved immediately by a change in diet or exercise.
There are two types of chronic constipation
– Primary constipation
– Secondary constipation

PRIMARY CONSTIPATION

Basically means, this type of constipation is the primary medical problem rather than a symptom of another underlying medical issue. It is also referred to as functional constipation. The term functional is applied to indicate the body’s normal activities, in terms of : the movement of food in the digestive tract & sensitivity of nerves of the intestines or the way which the body controls some of its functions is impaired. This disorder results due to atony/ weakness in musculature of the large intestine.

Some predisposing factors to  functional constipation

  • Improper diet ; with insufficient fiber rich foods, fermented foods and water intake. Consequently, the intestinal lining is not stimulated and weakened
  • Physical inactivity– exercise and being active stimulate the reflex to defecate
  • Irregular bowel habits – nervous tension or being in a hurry ignores the biological call to defecate hence the body lose the intestinal reflex
  • Abuse of laxative  – this produces a perpetual state of inflammation in the intestinal mucosa which results in desensitization to normal stimuli

Recommended Intervention

A  Meal plan with regular hydration schedule and workout plan

Get supplements support from either of these

SECONDARY CONSTIPATION

Secondary constipation is constipation that occurs as a result of something. This may include:

  • An underlying health issues
  • Pelvic floor dysfunction (Outlet constipation)
  • Hormonal changes in women
  • A side effect of medication / supplement use

 1. Some Underlying health issues that may cause constipation

Neurological and Metabolic Disorders
Certain neurologic problems such as  multiple sclerosis, Parkinson’s disease, spinal cord injury or stroke  and some metabolic disorders can cause food to pass through the digestive system too slowly, leading to constipation.

Metabolic disorders, such as diabetes and hypothyroidism, disrupt the body processes used to get energy from food. Hypothyroidism, a disorder that causes the body to produce too little thyroid hormone, can cause many of the body’s functions to slow down. Manage these conditions.

Mental health issues

Conditions such as Stress, depression, eating disorders , anxiety and diseases that affect the brain or blood vessels, such as dementia  can interfere with neurotransmitters such as serotonin, hence reduce gut motility and slow bowel movements, leading to constipation. Mental health care

Bowel diseases

Conditions such as Crohn’s disease, colon cancer, diverticulosis, and irritable bowel syndrome (IBS) are some of the bowel diseases that can cause severe inflammation, which can block or slow the passage of stool or digested food through the bowels, leading to constipation. Digestive health

Vitamin or mineral deficiencies & physical problems

For example : Severe vitamin B-12 deficiency can cause constipation and other gastrointestinal symptoms.

Physical disabilities or immobility  can make it difficult to coordinate muscle contractions in the rectum .Also anal fissures, which are small tears in the anal tissue can cause a lot of discomfort leading to constipation. See supplements

2. Outlet constipation (Pelvic floor dysfunction)

Outlet constipation occurs as a result of damage to the pelvic floor muscles. (Muscles that support the bowel, bladder & uterus in women.) Damage to the pelvic floor muscles or nerves makes it difficult to pass stools. Some causes include :

  • Traumatic injuries to the pelvic area
  • pregnancy and childbirth.
  • Pelvic surgery.
  • Being overweight.
  • Advancing age.
  • Overusing the pelvic muscles ( pushing too hard during evacuation eventually leading to poor muscle coordination)

Some possible symptoms of outlet constipation include:

  • Straining to empty the bowels
  • Delaying bowel movements due to pain
  • Needing to use the hands to assist bowel movements
  • Straining or pushing really hard to pass a bowel movement
  • Having to change positions on the toilet

Hormonal changes in women

Before the period starts, progesterone builds up in your body and this can slow down the digestive system, possibly resulting in constipation just before and during the monthly period.

Examples of medication / supplements which may cause chronic secondary constipation

  • Iron supplements (certain forms of iron may be less likely to cause constipation)
  • calcium supplements (excess intake)
  • Some protein powders and drinks cause constipation and bloating.
  • Excessive intake of vitamin D as a supplement can cause hypercalcemia (too much calcium in the blood)
  • Other supplements reported to cause constipation, although less frequently include cinnamon, berberine, nattokinase, chlorella, NAC (N-acetyl cysteine) and beta-sitosterol
  • Opioids.
  • Anti-inflammatories.
  • Antihistamines.
  • Antacids.
  • Calcium channel blockers.
  • Antipsychotics.

COMPLICATIONS OF CONSTIPATION

Complications of constipation include:

  • Hemorrhoids – due to excessive straining during bowel movements, pressure increases on the veins around the anus and can lead to bleeding
  • Rectal prolapse – this is protrusion of the rectum through the anus due to straining
  • Anal fissure – Passing hard stool can cause a split (crack) in the skin of the anus
  • Diverticular disease – this develops if the walls of the large intestine are damaged by the increased pressure required to move small, hard stools. Damage to the walls of the large intestine leads to the formation of balloon-like sacs or out pockets (diverticula), which can become inflamed (diverticulitis).
  • Fecal impaction – this occur when stool in the rectum & the last part of the large intestine hardens and completely blocks the passage of another stool. Fecal impaction leads to cramps, rectal pain and strong but futile efforts to defecate. Sometimes, watery mucus or liquid stool oozes around the blockage, which gives the false impression of diarrhea (overflow diarrhea).

Each of these complications can make having a bowel movement uncomfortable and make people reluctant to move their bowels. Putting off bowel movements can cause a vicious circle of worsening constipation and complications.

Overconcern with regular bowel movements causes many people to abuse their bowels with laxatives, suppositories, and enemas. Overusing these treatments can actually inhibit the bowel’s normal contractions and worsen constipation.

People with obsessive-compulsive disorder (OCD) often feel the need to rid their body daily of “unclean” wastes or “toxins.” Such people often spend excessive time on the toilet or become chronic users of laxatives.

 

Who is at risk for chronic constipation

Constipation is one of the most common chronic gastrointestinal disorders in adults. The following people are at a higher risk of experiencing chronic constipation:

  • People who are poor in a healthy diet
  • Women in general, but more  who are pregnant
  • People over the age of 65
  • People who don’t engage in physical activity  or people confined to bed due to a physical disability such as a spinal cord injury

Warning signs during constipation

See a doctor if you experience any of the following:

  • Constipation that does not respond to at-home treatment
  • An inability to have a bowel movement without taking laxatives
  • Constipation following the use of a new medication

Additional symptoms, such as:

  • Severe stomach pain
  • Bloody stools or painful bowel movements
  • Hemorrhoids
  • Distended, swollen abdomen
  • Vomiting
  • Blood in stool
  • Weight loss

How to check for constipation

Check the following:

  • Stool frequency, consistency, and the need to strain or use maneuvers (such as pushing on the area between the scrotum or vagina and the anus [perineum] during defecation)
  • Feeling of incomplete evacuation
  • Satisfaction after defecation, including how often and how long people have used laxatives or enemas
  • Diet and physical activity level, particularly any change in these factors
  • Prescription and nonprescription drug use (particularly those known to cause constipation)
  • Doctors also ask about symptoms of metabolic (such as hypothyroidism and diabetes) and neurologic (such as spinal cord injury) disorders.

During the physical examination, doctors look at the following:

  • The abdomen for distention and masses
  • The rectum for fissures, hemorrhoids, blood, or masses (including fecal impaction) and also anal muscle tone and sensation
  • Signs of body-wide (systemic) disease, including weight loss, fever, and severe wasting away of muscle and fat tissue (cachexia). Book an appointment with our specialist