Overview – What is it?
Constipation refers to the irregularity and difficulty of passing stool which is mostly caused by absorption of water from food in the colon. It can cause symptoms such as stomach cramps, loss of appetite, bloating and straining to pass stool.
To diagnose severe constipation may require a blood test, physical examination and abdominal x-ray, among other tests.
The treatment of constipation can be done using home remedies like taking a lot of foods with fibre, using lubricant laxatives, or treating the underlying cause of the constipation.
It can be prevented by taking plenty of water or other fluids and foods with fibre, staying active and managing stress, among other things.
Causes – What causes it?
Constipation can either be acute (occurring suddenly) or chronic which goes on over a long period of time. There are several factors that can cause constipation. These are:
- Slow movement of food through the digestive tract which leads to absorption of too much water from the food by the colon causing stool to be hard and dry, thereby making it difficult to pass out from the body.
- Blockage in the colon or rectum
- Problems with muscles in the rectum that help in elimination of stool from the body
- Conditions that affect hormones in the body such as pregnancy, diabetes and hypothyroidism
- Other health conditions like cancer of the colon and rectum, and irritable bowel syndrome, can also cause constipation
- Certain medications such as antidepressants and painkillers, especially for people going through chemotherapy for cancer
- Lack of fibre and not enough water in the diet
- Lack of physical activity
- Changes in routine, for example, when a person travels
- Not going to the toilet when necessary
Symptoms – What do you feel?
Constipation can bring about symptoms like:
- Difficulty starting or completing a bowel movementI
- rregular passage of stool; fewer than three bowel movements a week
- Passing small and hard stool
- Loss of appetite
- Straining during passing of stool
- Change in bowel habits
- Abdominal cramps
- Excessive gas
Diagnosis – How do you diagnose it?
The diagnosis of constipation can be done using the following ways:
- Understanding medical history: For a doctor to do a proper diagnosis, understanding the patient’s medical history is important. Some of the information the doctor may require includes; how often you have bowel movements, what your stool looks like, your level of physical activity and any more information that could help in diagnosis.
- Physical examination: This will enable the doctor to check for any abnormalities such as blockages or any blood from the anus. After a physical exam, the doctor can order other tests depending on the severity of the constipation, the patient’s age, and changes in bowel movement.
- Blood test: This is used to test for any conditions that can lead to constipation such as anaemia and hypothyroidism.
- Barium enema: This is a test that enables the doctor to see the inside of the colon through an x-ray that is outlined by liquid barium which is inserted through the anus.
- Other imaging tests: Apart from using an x-ray, images of the internal organs, in this case the colon and rectum, can be taken using a Computerized tomography (CT) scan or Magnetic Resonance Imaging (MRI) scan which gives more detailed images than an x-ray or CT scan.
- Lower GI series: This procedure involves inserting a flexible tube into the anus after taking a solution of barium which fills up the large intestines, and through an x-ray, the doctor is able to see any abnormalities that may be causing the constipation.
- Flexible sigmoidoscopy and colonoscopy: These tests are done to view the inside of the rectum and lower colon (sigmoidoscopy) or the rectum and entire colon (colonoscopy).
Treatment – How do you treat it?
The treatment for constipation depends on the cause, the severity and the period one has had it. After determining those factors, the following treatment options may be used:
- Medication: This can be over-the-counter medicines such as laxatives or prescription medications like lubiprostone which helps in reducing pain and discomfort in the abdomen or linaclotide which helps in making bowel movements regular.
- Surgery: This can be used to treat anorectal blockage or in the removal of the colon in a case where the colon muscles are not working properly. However, your doctor will need to explain the risks and benefits of this surgery.
- Biofeedback training: This is done to treat chronic constipation. The training helps to retrain the muscles using special sensors to measure bodily functions. It takes approximately 3 months of practice to improve the muscle function.
- Lifestyle changes which include:
- Exercising regularly,
- Diet changes; eating more fruits, vegetables and lots of fibre rich foods like whole grains,
- Taking lots of water and other fluids, and
- Using the bathroom as soon as you have an urge to have a bowel movement.
Prevention – How do you prevent it?
Constipation can be prevented through:
- Eating a well-balanced diet with more fibre rich foods, fruits and vegetables
- Taking plenty of water
- Visiting the toilet every time you feel the need to have a bowel movement
- Exercising regularly
- Avoiding too much caffeine as it can cause dehydration
- Avoiding too much dairy products like milk
- Getting regular check-ups, especially if you have constipation regularly