Constipation

 

Overview

Constipation is difficulty passing stools (pooing) or infrequent bowel movements. It's common in both adults and children. About 80 percent of people suffer from Constipation at some time during their lives and brief periods of constipation are normal.

The definition of Constipation varies from person to person. For most people, it is normal for bowel movements to occur from three times a day to three times a week.

Normal bowel habits are affected by diet. The average diet includes 12 to 15 grams of fibre per day, although 25 to 30 grams of fibre and about 60 to 80 ounces of fluid daily are recommended for proper bowel function. Exercise is also beneficial to proper function of the colon.

 

Symptoms

You may have constipation if you experience the following symptoms:

• fewer than three bowel movements a week
• passing lumpy, hard, or dry stools
• straining or pain during bowel movements
• a feeling of fullness, even after having a bowel movement

 

Causes

Constipation is usually caused by:

• Inadequate fluid intake
• Inadequate fibre intake
• Inadequate physical activity
• Ignoring the urge to defecate
• Stress or change in environment

You can also get constipation when you:

• are pregnant
• take certain medicines, such as some pain killers or iron tablets
• have a medical condition such as thyroid problem, Parkinson's disease, multiple sclerosis or depression
• have a problem with your digestive tract, such as irritable bowel syndrome, coeliac disease or diverticulitis

 

Treatment

Diet and Lifestyle Changes:

• Drink plenty of water and unsweetened fluids. Limit consumption of alcohol and caffeinated drinks, which cause dehydration.
• Add fiber-rich foods to your diet, including fruits and vegetables, whole grains, beans and prunes. Fiber adds bulk to stool and helps the stool hold fluids. 25 to 34 grams of fiber a day is usually recommended.
• Ensure to incorporate regular physical activity in your routine. This helps to improve the movement of stool through the colon. 30 minutes per day five times per week is usually recommended. Try walking, swimming or biking.
• Good bowel habits are important. Don’t avoid the urge to pass stool. Try to pass stool 15 to 45 minutes after a meal as digestion helps to move stool through the colon.

Over-the-Counter Medications:

If diet and lifestyle changes alone doesn’t help, you may try an over-the counter laxative. Laxative are medicines that help to move stool through the colon. There are several different types. Consult your healthcare professional about which laxative may be best for your constipation. Do not use laxatives for more than 2 weeks, as your body can develop a dependence on them.

Laxative Type	Examples	Notes
Bulk forming laxatives	Psyllium, ispaghula husk	Bulk-forming laxatives work by increasing the "bulk" or weight of poo, which in turn stimulates your bowel.   It is important to drink lots of fluids when taking these laxatives.   Side effects can include bloating and flatulence.   These usually take 2 to 3 days to work.
Osmotic laxatives	Lactulose, sorbitol, oral magnesium salts	These work by keeping water in the bowel and softening the stool.   Side effects can include bloating and discomfort.   These usually work within 2 to 48 hours.
Stimulant laxatives	Senna, bisacodyl	These stimulate the muscles that line the gut, helping to move stool.   Side effects can include stomach cramps.   These usually work within 6 to 12 hours.
Lubricants	Liquid paraffin oil	These lubricates the stool and intestines, make stool easier to pass.   If Liquid paraffin is accidentally aspirated into the lungs, it may trigger hydrocarbon pneumonitis.   Not recommended for children under 3 years old

 

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When to see a doctor:

See a doctor if you experienced the following:

• Constipation symptoms last for more than 2 weeks without relief
• Bleeding from your rectum or blood in stools
• Significant stomach pain
• Sudden changes in your bowel habits
• Lost weight without trying

 

References

https://www.healthhub.sg/a-z/diseases-and-conditions/constipation-adults

https://www.healthline.com/health/constipation

https://www.healthdirect.gov.au/constipation

 https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253