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Constipation

At some point in our lives, most people suffer from constipation. It refers to having difficulty passing stools or having fewer than three bowel movements a week. There are many reasons why people get constipated, including diet, lifestyle, medication, or medical conditions. Constipation can cause discomfort, pain, bloating, and other complications. By changing your habits, using laxatives, or seeking medical help, you can treat constipation.

What are the symptoms of constipation?

Constipation is characterized by hard, dry, or lumpy stools that are difficult to pass. Other symptoms include:

  • Having a bowel movement by straining or pushing

  • Not feeling completely empty in your bowels

  • An abdomen that is swollen or tender

  • Reduced appetite

  • Tired or irritable

Constipation can also cause complications, such as:

  • Hemorrhoids are swollen veins in the lower rectum or anus that can bleed, itch, or cause pain.

  • There is a small tear in the skin around the anus that can cause bleeding and pain.

  • In fecal impaction, a large mass of stool becomes stuck in the rectum or colon and cannot be passed.

  • Gas and fluid are prevented from moving through the intestine when stool blocks the passage.

  • In this condition, the rectum protrudes through the anus and slips out of its normal position.

What causes constipation?

Some of the common causes of constipation include age, diet, lifestyle, medication, or health status.

  • Diets with low fiber: Fiber is a type of carbohydrate that is not digested by the body and adds bulk and moisture to the stool, making it easier to pass. Low-fiber diets can result in hard and dry stools that are hard to pass. Among the foods that are high in fiber are fruits, vegetables, whole grains, nuts, seeds, and legumes.

  • You can become dehydrated if you do not drink enough fluids or lose fluids through sweating, vomiting, diarrhea, or fever. Dehydration can cause the stool to become hard and dry.

  • Lack of exercise: Physical activity stimulates the muscles of the intestine and promotes regular bowel movements. Lack of exercise can cause constipation and slow passage of stool through the colon. As well as reducing stress and improving mood, exercise also improves bowel function.

  • Due to inconvenience, embarrassment, or lack of time, you may ignore or suppress your urge to have a bowel movement. As more water is absorbed by the colon when bowel movements are delayed, the stool can become more hard and drier. It can also weaken the muscles of the rectum and anus that push out the stool.

  • The movement of stool through the intestine or the amount of water in the stool can be affected by some medications. Painkillers (such as opioids), antacids (containing calcium and aluminum), iron supplements, antidepressants, anticonvulsants, antihistamines, diuretics, and some blood pressure medications can cause constipation.

  • Inflammation or obstruction in the bowel can result from some medical conditions that affect the nerves or muscles of the intestine. Diabetes, hypothyroidism, Parkinson's disease, multiple sclerosis, stroke, spinal cord injury, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), diverticulitis, colon cancer, and pelvic floor disorders are some of the conditions that can cause constipation.

How is constipation diagnosed?

In order to diagnose constipation, your doctor will ask you about your medical history, symptoms, diet, lifestyle, and physical examination. Your doctor may also perform tests to rule out underlying conditions or complications. Some of the tests for constipation include:

  • An example of a blood test for constipation is a thyroid function test, a blood sugar test, an electrolyte test, and a kidney function test.

  • Your stool is examined for appearance, consistency, and content as part of a stool test. It is possible to perform stool tests for constipation, including fecal occult blood tests (FOBTs), which detect hidden blood in your stool that may indicate bleeding in your digestive tract, and stool cultures, which detect bacteria or parasites that cause infection or inflammation in your bowels.

  • An abdominal X-ray shows if there is a large amount of stool in your colon or rectum, or if you have an obstruction in your bowel. An abdominal X-ray uses radiation to produce an image of your abdomen.

  • In sigmoidoscopy or colonoscopy, an endoscope (a thin tube with a camera and light) is inserted into your anus and into your colon. An sigmoidoscopy examines the lower part of the colon, while a colonoscopy examines the entire colon. It will tell you if you have polyps, tumors, ulcers, or inflammation in your bowel that may cause constipation.

  • You can have an anorectal manometry performed to see if you have any dysfunction or weakness in your muscles and nerves that could affect your ability to pass stool. An anorectal manometry measures the pressure and coordination of the muscles and nerves in your anus and rectum.

  • The balloon expulsion test involves inserting a small balloon filled with water into your rectum and asking you to push it out. You can tell if you have any difficulty or delay in expelling the balloon with a balloon expulsion test, which may indicate that your pelvic floor muscles or nerves are malfunctioning.

How is constipation treated?

In order to treat constipation, you need to soften your stool, stimulate your bowel movements, and prevent recurrence. Some of the treatment options include:

  • Fiber, fluids, and probiotics can help to improve your bowel function. Fiber adds bulk and moisture to your stool, making it easier to pass. Fluids help to keep your stool soft and prevent dehydration. Probiotics are beneficial bacteria that help to balance your gut flora and improve your digestion. Foods high in fiber include fruit, vegetables, whole grains, nuts, seeds, and legumes. Probiotic foods include yogurt, kefir, sauerkraut, kimchi, and kombucha.

  • Engaging in regular physical activity is one way to stimulate bowel movements. Exercise helps to increase blood flow and muscle activity in your abdomen and pelvis, which helps move stool along your colon. As well as reducing stress and improving mood, exercise can also affect bowel function. You should aim to exercise for at least 30 minutes a day, such as walking, jogging, cycling, or swimming.

  • A laxative is a medication that helps you loosen or evacuate your stool. It can come in pills, liquids, powders, suppositories, or enemas. Various types of laxatives work in different ways, such as increasing the water content of your stool (osmotic laxatives), stimulating colon contractions (stimulant laxatives), softening your stool (stool softeners), or lubricating the passage of your stool (lubricant laxatives). When used improperly, laxatives can cause side effects such as dehydration, electrolyte imbalance, cramping, diarrhea, dependence, or bowel damage.

  • Using sensors and feedback devices, biofeedback monitors and trains the muscles and nerves involved in bowel function. By using biofeedback, you can relax and contract your pelvic floor muscles, improving their coordination with your abdominal muscles. You can also learn to sense and respond to the urge to have a bowel movement using biofeedback. It is usually performed under the supervision of a therapist who specializes in this field.

  • For patients with severe constipation or complications such as fecal impaction or bowel obstruction, surgery is an option. Part of the colon may be removed (colectomy) or an opening may be created between the colon and the abdomen (colostomy) to allow stool to pass.

How can constipation be prevented?

You can prevent constipation by following the dietary and physical activity recommendations mentioned above, as well as:

  • Having a routine

  • Managing stress

  • Avoiding medications that cause constipation

Conclusion

An individual with constipation has difficulty passing stools or has fewer than three bowel movements per week, which can cause discomfort, pain, bloating, and other complications. Constipation can be caused by diet, lifestyle, medications, or medical conditions. Your doctor can diagnose constipation by reviewing your history, performing tests, or changing your diet. In addition to dietary changes, physical activity, laxatives, biofeedback, and surgery, constipation can also be treated. Healthy habits that promote regular bowel function can prevent constipation.

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