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A brief account of Constipation

Constipation is one of the very common complaints associated with gastrointestinal functionalities. The general perception is people who do not pass stool at least once a day are thought to be constipated. The truth is much more complex. Here are the many facts on constipation.

Criteria of constipation

The observations should serve as a wake-up call to people and check if they are really constipated. If you think you have any of the two symptoms underlined below, then you may be constipated.

  • Straining when passing the stool at least 25% of the time when sitting in the toilet
  • Feeling a blockage when passing the stool.
  • At least 1/4th of the stool passed is lumpy or hard
  • The initial stool might be dry and hard to push outside
  • Having a sense of passing the stool incompletely. This factor can be accompanied by having more than three bowel movements a day. Most of the people (mothers in case of children) confuse this with loose motion. This is more like people passing stools in instalments in a single day. In every single instance of passing stool they pass hard stool along with some degree of difficulty accompanied with a sense of passing incompletely.

The above criteria emphasize the point that not passing stool daily alone is not a criteria for constipation. Similarly even people who have regular toilet habits in the morning may be suffering from constipation unknowingly.

Reasons for constipation in women

People who report constipation more are women. Women are generally constipated because of the pelvic shape to bear the child. Young women or girls who have PCOD and other menstrual problems  undergo hormonal changes which can cause constipation. If thyroid is functioning less (hypothyroid), common in women compared to men, can cause constipation.

During pregnancy the weight and size of the baby causes constipation. The growth of the foetus in the uterus compresses the intestine which can slow the movement of food through the intestine causing constipation. During the labor (during the delivery), the pelvic floor muscles stretches to the maximum causing fissure-in-ano. This can lead to constipation or can worsen the already existing constipation.

Reasons for constipation in children

Following are the reasons why children are more frequently constipated.

  • Generally poor toilet training
  • The gastrointestinal track to develop fully will take 13 years. So digestive power is less. Any new food that are added to diet can cause constipation. SO they are usually constipated till their teen.
  • Childhood obesity

Reasons for constipation in aged people

The in-take of food itself will come down as we age. So when there is less input, the output also reduces. The physical activity as we age also becomes lesser and hence the movement of intestine also becomes sluggish. The body’s metabolism slows as we age. The muscles do not work well to contract as we age. This can result in slow movement of intestine and can lead to constipation.

Invariably most old people will be taking medications for diabetes and other ailments associated with old age. These medications in general can cause constipation.

Other General Causes of Constipation

Food Habit

This is the number one cause of constipation. A food that is skewed heavily towards carbohydrates and has very less fibre content is a sure thing to cause constipation. Refined fluor like maida, polished rice etc, are stripped of their fiber content and hence they need to be avoided. High fibre food (millets, vegetables, greens, unrefined grains like millets, brown rice, etc) are known to promote healthy bowel movement.

Physically Inactive

When you become physically inactive with desk jobs, or have become too old that you cannot perform any physical activity, you may become constipated. Some amount of workouts and exercises increases the bowel movement. At least bending and touching your feet for few minutes a day can help trigger healthy bowel movement.

Some medications

Certain drugs and medications are said to cause constipation. If you have been prescribed these drugs for some other medical conditions for few days, the constipation might be short lived. This is okay. Generally speaking, over-the-counter medication is not recommended at all because any prolonged in-take of some medicines can cause constipation. Pschiatric drugs are known to induce constipation.

Some diseases

Underlying medical conditions like Irritable Bowel Syndrome (IBS), hypothyroid, diabetes, certain cancer (particularly of colon), stroke, etc. can cause constipation. Any previos conventional abdomen surgery can cause constipation.

Certain habits

Not going to toilet when there is a bowel movement by postponing, not drinking enough water, drinking excess of beverages with caffeine like colas, coffee, etc. which promotes dehydration, over use of laxatives, etc. are some of the habits that can induce constipation.

Dr Maran of Springfield Wellness Centre on Constipation

Dr. Maran, a gastro surgeon by profession, who regularly treats people for constipation and piles, is of the view that constipation is preventable in the first place. He recommends healthy food habits like including more fibre in the food and more physical activities. He is of the firm view that these two alone has the power to eliminate constipation if at all there are no other underlying medical causes.

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