How to overcome constipation and maintain a healthy bowel movement?

A constipation is a frequently occurring bowel disorder with no apparent cause, which may be due to several factors simultaneously. Also known as constipation, constipation is characterized by partial or complete blockage of the bowel, resulting in straining to defecate, low frequency of defecation, hard stools, or apparently incomplete defecation.

The consequence is a persistent sense of abdominal discomfort and malaise, affecting quality of life, which may be associated with a number of comorbidities, including hemorrhoids, anal fissure, distension (bloating), or flatulence.

Commonly referred to as constipation, constipation can affect people of any age, although it is more common in the elderly. It can also occur in acute, intermittent or chronic episodes.

What to do in case of constipation

Causes and risk factors

In most cases, no digestive tract disease is the cause of constipation. The most common causes are lifestyle related. The list of possibilities is long and usually includes:

  • Inadequate dietary habits, namely a diet low in fiber and fluids;
  • Changes in lifestyle, such as stress;
  • Little physical activity;
  • Psychological factors;
  • Changes in colorectal motility;
  • Pelvic or anal sphincter muscle dysfunction;
  • Dehydration;
  • Metabolic, neurological and psychiatric changes;
  • The use of certain drugs;
  • Pregnancy;
  • Not defecating when you feel like it;
  • Laxative abuse;
  • Irritable bowel syndrome and other conditions causing inflammation of the intestine;
  • Painful anal lesions (hemorrhoids or fissures).

Risk factors for constipation include.

  • Female gender;
  • Low socioeconomic status;
  • Advanced age;
  • Sedentary lifestyle;
  • Polymedication (use of multiple medications simultaneously);
  • Low fiber or low fluid diet;
  • Pregnancy;
  • Frequent travel or changes in routine due to changes in diet, meal times, and/or limited access to the toilet.

In some cases, however, constipation may be related to certain intestinal or other diseases that are not directly related to this organ.

It is a problem usually present in diseases of the central nervous system, such as Parkinson’s disease, depression or multiple sclerosis. It can also be related to spinal cord injury, stroke, tumor, autonomic neuropathy, Hirschsprung’s disease, scleroderma or amyloidosis.

It is also common in diabetes and other metabolic or endocrine problems, including thyroid disease.

Symptoms

A large proportion of the population is familiar with the most characteristic symptoms of constipation, as a high percentage of them suffer or have suffered from this problem.

The main symptoms are:

  • Hard stools that cause pain on defecation;
  • Going to the bathroom less often than normal, not evacuating as often as needed;
  • Difficulty defecating, even with regular toileting;
  • Feeling of not having evacuated everything after going to the toilet;
  • Abdominal pain or feeling of a swollen belly.

There is no “ideal” number of times a person should defecate. Everyone is different and therefore everyone has their own rhythm, which can vary from two to three times a day to three times a week.

When the frequency is less than three times a week and, as a result, the person makes great efforts to defecate, we may be dealing with a case of constipation.

Although in most cases constipation is not related to a serious situation, there are a set of signs that should serve as a warning and, in their presence, motivate a visit to the doctor as soon as possible. Some examples:

  • Profuse loss of blood in the stool;
  • Onset or worsening of symptoms at night;
  • Family history of bowel disease (colorectal cancer, Crohn’s disease or ulcerative colitis);
  • Intense symptoms that do not resolve with treatment;
  • Recent changes in usual bowel function;
  • Involuntary weight loss.

Treatment

Constipation is usually a short-term, non-serious, and fairly common problem.

When the physician suspects that it may be associated with medication, the first step is to discontinue the medication if possible. This is followed by measures related to lifestyle and dietary modification, the introduction of fibre, water and low to moderate intensity exercise into the person’s routine.

The increase in the diet of fiber-rich foods, however, must be done gradually and adapted to the tolerance of the person. Otherwise, it may cause abdominal distension or flatulence.

Foods against constipation to include in your diet

If necessary, laxatives are also used to help with overall symptom improvement, including reducing straining and pain during defecation, as well as the number of days between bowel movements.

It is important, however, that laxative use be brief, as prolonged and continuous use can lead to habituation and eventually dehydration due to increased water loss.

When none of these measures work, the physician may decide to use medications that directly stimulate bowel motility (movement of the intestines necessary for their proper functioning), called prokinetic agents. Another option is to use medications that stimulate the secretion of intestinal fluid contents, called secretory agents.

Treatment of constipation may also involve probiotics (living organisms that contribute to healthy bowel function) and transanal irrigation.

In some cases, biofeedback therapy is a successful solution. This is a process of training the muscles that are used during defecation.

How to prevent

Preventing constipation is essentially a matter of changing certain lifestyle habits. It can include:

  • Increasing consumption of high-fiber foods. Fruits, vegetables, or grains, for example, make it easier for stool to pass through the intestines ;
  • Avoid eating foods that harden the stool, such as cheese, chocolate, and rice;
  • Drink plenty of fluids (water, fruit juices and soups);
  • Engage in regular physical activity, as it stimulates the intestines;
  • Create routines for going to the bathroom. For example, in the morning, for 10 minutes after breakfast;
  • Don’t procrastinate when you feel the urge to evacuate;
  • Place your feet on a stool when sitting on the toilet (as in the squatting position). This allows the puborectal muscle to relax and makes evacuation easier;
  • Avoid stress.

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