Constipation

 

Constipation can be a difficult condition to live with What is constipation? The food we eat passes through our digestive system to fuel our bodies, minds and lives. Digestion is the breakdown of food into smaller components that are more easily absorbed by the body. 95% of nutrients are absorbed in the small intestine while water and salts are reabsorbed back into the blood in the large intestine (colon) and waste material is eliminated during defecation. Constipation is a common disorder that is often described as the passage of small, hard stools, resulting in infrequent or uncomfortable bowel movements. Some people describe constipation as a feeling that the rectum has not been completely emptied or having to strain (push) during a bowel movement. It occurs when the colon absorbs too much water or if the colon's muscle contractions are slow which can result in stool moving too slowly through the colon making stools hard and dry. How many bowel movements you have each day varies from person to person. There is no hard and fast rule for frequency of bowel movements. Some people may empty their bowels several times a day while others may only have a bowel movement once every few days. The general range is from three times a day to three times a week. Less than 3 movements a week may indicate constipation, and more than three watery stools a day could indicate diarrhea. It is important to realize that whatever is normal for you is “normal”. When changes in bowel habits occur, there may be cause for concern and the need to consult a physician.

 

Tests and Diagnosis

 

How do I know Who gets constipated? For some, constipation sometimes develops suddenly and lasts for a short time. For others, particularly those who are aging, constipation may begin gradually and last for an extended period of time. Several factors, including dehydration, lack of non-caffeinated fluid intake, changes in diet (particularly, not ingesting enough soluble fibre), travel, lack of exercise, stress, pregnancy, enlargement of the rectum, impaired coordination of the pelvic and anal muscles, and certain medications may slow transit of stool. Getting a proper diagnosis Most of us will suffer from constipation at some point in our lives. In most cases, a diagnosis of constipation by a physician isn't necessary and constipation can be treated at home with noninvasive methods. This is particularly true of young people who do not have a history of constipation or digestive disease. However, for older adults or those with complex medical histories, constipation may be a symptom of a more serious illness and should be investigated. To determine the cause of your constipation, your physician may ask you a series of questions and suggest changes. You can help your physician help you by being prepared with the following information : ‐ how often you have a bowel movement ‐ describe your stool (i.e. shape, hard or soft, etc.) ‐ if you are able to get to a washroom to have a bowel movement when you have the urge ‐ if you strain while having a bowel movement ‐ summarize your diet ‐ comment on your level of stress ‐ summarize how often you exercise, and ‐ if you experience pain or other symptoms associated with your constipation.

 

If the cause of your constipation cannot be easily determined through conversation, your doctor may order tests to rule out other causes like bowel cancer. Tests to diagnose constipation may include:

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Blood tests Digital rectal exam —this simple test involves the physician lubricating the index finger on a gloved hand and inserting that finger into the anus. This exam, which may reveal the presence of blood or mucus can provide your doctor with important information about the anus and the condition of the anal sphincter. Colonic transit rate test which shows how long it takes a substance to move through the colon. With this test, you will swallow a capsule containing tiny markers that are clearly visible on an x-ray. A series of abdominal x-rays will be taken at timed intervals to determine the time it takes for the markers to move through your colon. Barium x-ray which uses contrast dye to make the colon more visible and show any irregularities such as a blockage. Lower Bowel Endoscopy such as flexible sigmoidoscopy and colonoscopy which are safe procedures performed by a trained doctor who will use a slim flexible tube equipped with a tiny camera to see the inside of your colon.

 

Treatment Options

 

Finding Relief from Constipation For most, constipation can usually be treated successfully. There are simple steps you can take to improve your bowel habits. These are listed below. Increase the amount of fibre in your diet Foods that are high in soluble fibre include whole grains, bran, and fresh vegetables and fruits. These fibre-containing foods help move feces through the intestines by attracting water and adding bulk. Depending on your age, gender and lifestyle, adults should aim to consume between 25 – 40 grams of fibre per day. Increase the amount of liquids you drink Drinking 8-10 glasses a day of clear fluids is the recommendation for most people. Liquids can include water, juices, milk, soup or other beverages. Liquids with caffeine or alcohol increase urination and should not be included in this total. Get – or stay – moving Leading an active lifestyle is good for your overall health. This is true for digestive health as well. A sedentary lifestyle decreases bowel activity. Regular exercise, including walking, swimming, cycling, dancing or playing sports is recommended to help keep your bowels moving. Develop a regular lifestyle and bowel routine Irregular eating and sleeping patterns may lead to irregular bowel habits. If you can set aside the same time each day to relax and have a bowel movement, your body will become accustomed to this pattern over time. Listen to your body By responding to your body’s urges promptly, your bowel reflexes are more likely to become normal and regular. Familiarity with local facilities is important, so that when you feel the urge to pass stools, there is no delay. Remember to avoid straining

 

Use of laxatives There are different types of laxatives. Many foods are considered to be natural laxatives. These include grapes, flax seed, licorice, dates and prunes among many others.

 

Some herbal laxatives stimulate contractions of the colon. Other laxatives help the colon retain more water in the stool and prevent constipation. Regular use of certain stimulant laxatives may decrease tone in the bowel that may lead to poor bowel function. Regular use of laxatives should be approved by your doctor. Eating a high-fibre diet, exercising regularly, drinking water, reducing stress and paying attention to the needs of your digestive tract are the best ways to prevent constipation.

More Learning Information for this section is provided by the Canadian Digestive Health Foundation (CDHF). The CDHF provides trusted, unbiased, science-based information that empowers people like you to take control of your digestive health with confidence and optimism. To learn more, please visit: www.CDHF.ca. To receive the most up to date information on digestive health and disease from medical experts across the country, subscribe to the CDHF e-newsletter Appetite for Information. It’s informative, free and written just for you. Subscribe Now