Why Does Constipation Occur?
Very few cases of constipation are likely to be due to underlying disease. Often constipation is caused by the wrong diet, insufficient exercise, lack of fluid intake and undue concern about daily bowel movements. A bowel motion every day is not always necessary - people's bowel habits differ and some people have a bowel motion only every second or third day.
What are the Symptoms?
Constipation occurs when bowel motions become harder or drier than usual and therefore more difficult to pass. Other symptoms you may notice include:
- Infrequent stools
- Hard, pebble-like stools
- Red blood from the anus with pain
- Straining to pass a motion.
- Pain during bowel movement.
- Cramps in the abdomen.
If you suffer pain or notice any bleeding when passing stools, see your doctor. If constipation continues for a week or so and you previously had no problem with your bowels, particularly if you are over 50 years of age, see your doctor. Your doctor may ask you about your diet, perhaps prescribe a gentle bowel softener and advise you to change to a high-fibre diet. You will probably be examined to check for haemorrhoids or an anal fissure if there is pain. If there is no obvious reason for the constipation, you may be referred to a specialist for blood tests and perhaps a barium enema which helps to show up any problems in the bowel on x-ray.
Diet is an important factor in constipation. Test yourself to see if poor diet is your problem. Eat 12-14 prunes or 6 figs one morning, and if your constipation corrects itself within 24 hours, this is proof that you need to change your diet to include more fibre. High-fibre foods are particularly useful as fibre holds water in the stools and this makes them soft and easy to pass. The fibrous foods that help correct bowel movements are any root, green or raw vegetable, any form of fresh fruit (make sure you eat the skins of apples and pears), high-fibre cereals, bread and cakes. A nutritious, balanced diet is recommended. Click here for a list of dietary fibre supplements available from CyberChemist.
You should try to drink at least 1.5 litres of liquid per day. If you don’t get enough liquids, the bowel, which is a water-conserving organ, will draw out the moisture from the stools and they will become drier and harder. Exercise on its own can help reduce constipation. The pelvis and intestinal muscles respond to any exercise. A leisurely walk after a meal will help.
Check with The Pharmacists at CyberChemist about any medicines you may be taking that could cause constipation. (e.g. some antacids used to relieve indigestion and heartburn can cause constipation).
Constipation causing real discomfort can often be relieved quickly by a laxative, suppository or enema.There are several types of laxatives and they all work differently.
Bulk Forming Laxatives such as Mucilax, Metamucil, Isogel and Normacol are good first line agents. They should be taken with plenty of water and should not be used if there is bowel obstruction or if there are impacted faeces. Bulk fibre laxatives absorb extra water in your bowel and 'bulk you up'. They mix with the waste matter making it softer and easier to pass through.
Faecal Softeners, of which Coloxyl is an example, help water to penetrate the faeces, thereby making them softer and easier to pass without straining. They are particularly useful for a person who has haemorrhoids.
Osmotic Laxatives Lactitol (Importal) and lactulose (Laevolac and Duphalac) are termed osmotic laxatives. They draw water into the stool and also make it softer to pass. Their action may be delayed for 48 hours and should be taken regularly for the full effect. They should be used with caution in the elderly as there is risk of electrolyte imbalances.
Stimulant Laxatives such as Dulcolax and Senokot are useful when constipation is severe and a rapid action is required - they take around 8 hours to work. They stimulate the bowel and cause it to contract and expel the contents. After they have induced complete evacuation of the bowel it may take 2-3 days for faecal matter to build up again, so using a stimulant laxative every night is not necessary. In fact they should not be used regularly except under medical supervision, as they can cause your bowels to become lazy and sluggish. If you constantly use stimulant laxatives to get a motion, your bowels will take a very long time to get back to normal when you stop using them. Also available as Dulcolax Suppositories .
Coloxyl with Senna is a combination tablet of a faecal softener plus stimulant.
Both bulk fibre and osmotic laxatives work more slowly than the stimulant laxatives, but they are gentler on your bowels.
It is important to remember that laxatives should not be needed long-term under normal circumstances and that overuse can cause electrolyte imbalances.
Overuse of laxatives can also lead to constipation because the healthy bowel comes to rely on the purgative medicines. It ceases to react to natural reflexes and comes to rely on the laxatives completely. An unhealthy, lazy bowel may develop diverticulitis in which small growths develop on the colon and become inflamed, causing the individual severe pain and discomfort.
Be sensible. If you’ve been ill, or off food for any other reason, or if you are in a hot climate and sweat a lot, your bowel movements may not be normal. Most people suffer from mild constipation after a high fever, for example. Fevers are often accompanied by sweating which depletes the body of liquid and so the body attempts to conserve liquid by taking moisture out of the stools. Things will revert to normal when you resume your normal diet or drink plenty of water.
Constipation in Pregnancy
Progesterone is one of the hormones released in large quantities during pregnancy. It relaxes smooth muscle to enable the baby’s head to pass out through the birth canal. The muscles in the bowel also relax and this can lead to constipation.
In late pregnancy, the pressure of the uterus on the bowel can aggravate the condition. As long as you eat a good high-fibre diet and get plenty of exercise, the constipation shouldn’t become chronic. Talk to your doctor about which laxative to take.