To be constipated in literal sense simply means to be repressed or inhibited. When such inhibition occurs in the digestive tract, very often leads to a condition in which the normal bowel movement is hampered. Such condition, if persists for excessive duration, becomes a diseased condition called as constipation. The condition has multiple causes and its severity depends upon the intensity of the underlying condition and the duration of time it has been prevalent.
Let us assume a situation. In case when we try to squeeze out the toothpaste out the tube, we often squeeze it in the direction of the nozzle. Due to the applied pressure the toothpaste is passed from the nozzle. Body has a very similar design of action, due to the functioning smooth muscles, which allows the feces to pass. But obstruction in such process, either by non-functioning/weakly functioning muscles or due to accumulation of masses that does not allow the easy bowel movement, somehow the flow is hindered thus leading to constipation.
So, medically, “Constipation may be defined as a condition in the body related to difficulty in defecation, infrequent defecation or in advanced cases the complete absence of the defecation which is associated with abnormal retention of feces within the colon and the rectum.”
The above condition is often accompanied by discomfort, pain and indigestion. Usually constipation can frequently occur and then eased off on its own without much trouble. But when the problem persists for considerably longer duration such that it becomes a nuisance often indicates an underlying abnormal body condition or any chronic disorder.
But before moving ahead it is essential to understand the problem in the bowel system. There have been existing an awful lot of myths related to constipation. These misconceptions very often lead to rather complicating the problem than finding any cure. Like people often believe that the blockage might lead to absorption of toxins from the retained feces, but that is a myth. Also it is isn’t necessarily important that having bowel once a day marks that you are not constipated, there are few cases in which people have bowels thrice in a week but are not constipated. So the rate of bowel cannot be correlated with constipation, however any further delay than that means that the person is constipated. This is rather just another myth.
SYMPTOMS OF CONSTIPATION
- Infrequent or fewer bowel movements (depends on individual habits)
- Problem during tenesmus (act of defecating)
- Hard or small pelleted stools (which are difficult to defecate)
- Unsatisfactory sense of defecation or feeling of something left over to come out.
- Swollen abdomen with abdominal discomfort (due retention of bowel leading to piling up of food in the gastro intestinal tract, causing stretching of the tissues and thus pain)
- Sense of vomiting and nausea
- Weight loss along with mild diarrhea which only allows liquid to pass
TYPES OF CONSTIPATION
Common constipation – occasional constipation
Chronic idiopathic constipation
CAUSES OF CONSTIPATION
There are numerous causes for the bowel to be blocked in the digestive tract. Based on the type of origin and severity they are often divided into Congenital, Primary & Secondary causes respectively. In older people lack of dietary fiber, lesser fluid intake, medications etc. can lead to constipation. Also females are more susceptible to constipation than that of the males in case where no cause of the disease is known.
There are numerous conditions responsible for the inadequate bowel which have been illustrated below.
Ingestion of foreign material which might be retained in feces (in children), inadequate water intake (basically due to dehydration related other issues which includes alcohol and caffeine in excess), lower amounts of dietary fiber (cause less clearance of the GIT and thus leads to piling up of feces in rectum or colon)
Hospitalization, lack of physical activity (usually old aged and tight scheduled office workers), change in the daily routine (example- while traveling to different parts of the world), deliberately not allowing the bowel movement.
PAINFUL DEFECATION –
Anal sac impaction or abscess, perineal fistula, perianal wound (like that in the case of piles, cellulitis or abscess), pseudocoprostitis etc.
RECTOCOLONIC OBSTRUCTION –
Extraluminal (prostatoegaly- tumor, cyst or prostatitis, pelvic fracture or malunion, perianal tumor, perianal hernia), Intraluminal (foreign body, rectocolonic stricture, neoplasia, atresia ani)
Spinal disease or injury, injuries of pelvis, hip joints or pelvic limbs.
lumbosacral spinal cord disease, bilateral pelvic nerve injury, dysautonomia (Key Gaskel syndrome), idiopathic megacolon.
FLUID AND ELECTROLYTE ABNORMALITIES –
Dehydration, hypokalemia, hypercalcemia.
Hhypothyroidism, hyperparathyroidism/pseudohyperparathyroidism, phaeochromocytoma.
Opiates, anticholinergics, antihistamines, barium sulfate, diuretics, aluminum hydroxide antacids, iron supplements, phenothiazines, kaolin-pectin, vincristine.
Voluntary withholding of the stool. Fear of pain due to other causes might lead to holding of bowel, or public embarrassment, laziness and many other behavioral or psychological factors.
DIAGNOSIS OF CONSTIPATION –
It is based upon the patient’s description of the disorder. Bowel movement is considerably hindered and usually consists of hard masses of the feces in the form of pellets. Diagnosis is based upon the patient’s history and physical examination, with a goal of determining the underlying cause of the disease. In addition to abdominal palpation, digital rectal examination and neurological examination, a complete blood count, serum biochemical profile, urinalysis, and thyroid function tests should be performed to rule out problems that may cause peripheral neuropathies or electrolyte imbalances.
Abdominal radiography and sonography can help determine the extent of the colonic impaction and may identify predisposing causes. After the colon has been evacuated, contrast radiography with a barium enema or endoscopy can be used to identify intraluminal masses.
CHRONIC CONSTIPATION –
Majority of the people suffering from constipation often deal with the hampered bowel movements for duration more than a month or so. Based on duration and frequency of reoccurrence of the disease, such an anomaly in the body can be delineated under the term chronic constipation.
Chronic simply describes a phenomenon which has lasted or tends to last for a longer duration and has a very frequent reoccurrence. In this case when the insufficiency in the bowel disposal has been running for a very long period of time or occurs again all over within the gap of day or so can be depicted as a case of chronic constipation. The patients mainly suffer with insufficiency in the bowel movements, hard and pelleted feces, infrequent defecation and unsatisfactory or no result even after trying to defecate for comparatively longer period of time.
There can be numerous causes of this disorder. But mostly it because of age, prolonged dietary fiber inadequacy or under the influence of prolonged use of certain drugs (for instance the opiates or aluminum hydroxide).
The condition is often very perplexed. As the frequency of defecation has an individual variation, so the chronic condition also varies for individuals. But for general understanding, if the problem persists for longer than a month is called chronic. The causes are similar to those illustrated above, only difference is the persistence of the abnormality.
In cases where the chronic condition is not the result of any other underlying disorder, the condition can be called as “functional constipation”. Now functional flaw can occur due to either normal transit constipation which means when the passage rate is normal, but the patient have a belief that they are constipated. Another cause is slow transit constipation in which the passage rate is decreased leading to retention of stool and thus the symptoms. Another cause is evacuation disorder in which the muscles are weakened or any other anatomical anomaly which leads to blockage and thus retention of feces which cause the symptoms. The diagnosis is similar as above.
CONSTIPATION REMEDIES –
The primary cause of constipation is related to the hindrance in the passage of the stools. Which also means that once properly diagnoses and the source of such hampering known, the problem can be very well dealt with. This however is applicable in the situation when the constipation is the outcome of any other underlying disease. But in the case of dietary defect or chronic constipation the remedial measures are slightly different on the whole. The trouble with constipation is the reoccurrence which can be cured and patient can be relieved with natural and the home remedies.
However in the case of severe constipation the manual removal of the fecal material is required along with the colonic irrigation. In other cases the treatment is simply based on the principle of aiding gradual passage of the feces. For this additional water content is supplemented to the bowel which further leads to the softening of the hard pellets and thus giving the relief to the patient by easy passage. Now this increment in the fluid in the lower GI tract can be achieved either by direct consumption of hydrating agents (as simple as water) or by altering the electrolyte shift in such a manner that it allows body to have maximum adequate in the feces for easy passage.
In other cases in which the constipation is linked with the underlying diseases, the treatment of primary disease relieves one from the constipation. However in some cases the patients still require the additional laxatives or drugs in order to accelerate the curing process. But on the whole the cure for the primary disease in the body is enough to relieve one from constipation.
Following are the drugs that are prescribed during constipation –
- Docusate is a stool softening drug
- Glucomannan is a dietary fiber
- Lactulose acts as purgative and as a laxative
- Lubiprostone is a chloride channel activator thus allows the electrolyte shift finally softening the stools
- Methyl naltrexone Bromide is a mu-opioid receptor antagonist and can be prescribed when patient suffer due to use of opioid drugs
- Senna is a stimulant laxative
- Sodium Picosulphate actions as a contact laxative
- Linaclotide increases the bowel movements
- Polyethylene Glycol is the osmotic laxative and retains water in the stool thus causing easy bowel movements.
CONSTIPATION HOME REMEDIES –
These remedies are effective mostly during chronic constipation. When the cause of constipation is secondary, usually the drugs are ineffective because of its frequent reoccurrence. But however there are remedies in the form of simple changes and supplementation in the dietary habits which can make the problem go disappear permanently. These methods are based upon the conditioning of the body in a manner that changes are difficult to revert.
As soon as one suffers with the problem of constipation, the one easy and sure remedial measure we run to is the use of laxatives. Laxatives are mild cathartic (a purging medicine which stimulates the evacuation of the bowels) doses which eases off one suffering with constipation. However the use of laxatives which might seem easy can be troublesome for the longer run. They are habit forming and they also cause damage to the colon (may even cause permanent damage). In some cases laxatives also tend to interrupt the effect of other medications as well as it mitigates the bowel retention and some of the drugs need retention for their desired therapeutic action.
The following are few of the home remedies for constipation-
1.ADDITIONAL DIETARY FIBER
To start with the home remedies, what else can be as simple as the food on your table. It might sound absurd, but change of equation in your meal composition can be all that you need. When we learnt about nutrition in the high school we learnt about carbs, proteins and fats along with vitamins and minerals. We keep up our diets to meet these nutrients. But what we often forget is the importance of roughage and water. And chronic constipation in majority of the cases is an outcome of such naïve ignorance.
Roughage basically helps making way for the fresh bowel and easy passage of the old dried one. It is like cleaning the pipeline. Fiber cannot be broken by the body and what it does is to add bulk to the bowel absorbing the water. The additional bulk helps removal of feces that are hard to pass (usually after heavy protein diet). Fiber consumption along with adequacy in water consumption can save one from the appointments of doctors and laxatives.
Fiber can be attained from
Whole grain bread
Oat meal with added bran
“An apple a day, keeps the doctor away.”
Well! Maybe two or three may do it. But whoever said that, has said it all right. Fruits which are rich in fiber are effective and provide fiber along with the water content. Eating of whole fruit has its double advantage than merely taking juice.
It won’t be a bad idea ordering salad along with wine. Salad has all the fiber and water that you need in order to keep the bowel running. Cellulose is indigestible and thus helps pushing the bowel. So it is favorable to have a little salad of green ingredients at least once in a day.
2.BEVERAGE CUT DOWN
Since coffee, tea and alcohol have a common affect over the digestive system and body, which is excess urination and thus gradual dehydration. By reduced amount of water in the gut makes the stools hard and thus difficult to pass.
If you are already suffering with constipation then the above three must be avoided in order to give your hydration to facilitate the easy bowel motion and thus give constipation relief.
Note – In people who are used to morning coffee, it can actually help things running. Coffee despite being a diuretic has a direct action on body as a stimulant which also stimulates the gut, and makes easy motion down below. But excess of anything can be harmful and can complicate the condition. If coffee is helping you, then its positive action can be supplemented by keeping the body hydrated.
In other cases it is beneficial to avoid the coffee, tea and alcohol.
Almost every abnormal condition is directly or indirectly linked with the effort that you are making to keep your body fit and running. In the modern era of today, it is often a headache to find time for exercise. And with the lack of exercise, the body falls short in the muscular movements which can make defecation difficult. Morning workout stimulates body for defecation. Also there are certain exercises that are specific for getting motion down the gut boosted.
Squats is one of such exercises which can help bowel movement. Long before the invention of toilet seats the squat position was what the whole human race used to follow in order to get the defecating thing done. Now sometimes it is not bad idea looking back in history. Squats generally provide sufficient muscle movement as well as desired positon for defecating and thus act as constipation relief.
Yoga is another physical workout regime that one can adopt in order to find a permanent solution to not only constipation but many other disorders connected to physical wellbeing. Following are few of the Asana that have specific effect over the bowel movement. 15-20 minutes of physical strain might be helpful preventing the strain of doctor, medication and the deduction from your pockets. It absolutely requires nothing but your valuable time and relieves constipation.
Pawan Mukta Asana
The oil itself has a very positive effect on the bowel movements. Its combination with oranges provides both soft stools and bulk obtained from the orange pulp which in turn provides all that you need for your lower GIT to function appropriately.
Flaxseed flour along with kefir can also be used in vivid combinations in order to make the problem of stool retention disappear. This method is very helpful in the chronic case of constipation relief
All you need is the adequate amount of the elixir of life and you can see the difference in your bowel movements. The method to stimulate the frequent bowel movement by just drinking a full large glass of water has been followed since ancient ages in the Indian culture. This is effective and has a very positive hydrating effect on body on the whole. The water of moderate temperature is preferred. The plus point is that it has no harmful affect at all.
In some cases a few drops of aloe Vera extract can also be helpful for constipation relief.
COLON CLEANSING JUICES –
Organic juices of all types tend to have a very positive impact on the body on the whole. They work for not only hydrating the body on the instant but also aid rejuvenating the body with all the essential vitamins, minerals antioxidants and in some cases the fiber as well.
There are plentiful types of juice that act positively and meritoriously on the GIT (Gastro Intestinal Tract). Some of them have miraculous action potential, and therefore can help the patients recover from all form of GIT disturbances, Constipation being one of them. The following are few of the juices.
Aloe Vera Juice is effective in cleansing and repairing the intestinal wall
Apple Juice has a considerably gentle laxation and is thus recommended for adults.
Prune Juice is arguably the most effective juice to rectify the constipation. A glass of it in the morning and one in evening is all you need to see the overwhelming results. (Because of Sorbitol present in prunes)
Grape Juice has adequate amount of fiber in it and relieves constipation by meeting the dietary fiber requirement. It is effective in children as well.
Pear Juice has very fair amount of sorbitol which works as a natural laxative and thus helps relieve constipation.
Cabbage Juice is very fair source of fiber and thus helps cure constipation. It can be mixed with carrot and other vegetables for vivid variety in order to achieve constipation relief.
- 1 SYMPTOMS OF CONSTIPATION
- 2 TYPES OF CONSTIPATION
- 3 CAUSES OF CONSTIPATION
- 4 DIAGNOSIS OF CONSTIPATION –