What is constipation?
Constipation is defined as passing hard, dry stool that is difficult to pass. It occurs when the colon absorbs too much water from stool, making it hard and dry.
In most cases, it lasts from a few days to a few weeks and goes away when your diet changes or you start taking a fibre supplement. In some cases, it can be due to an underlying condition such as neurological disorders, spinal cord injury, pregnancy, Hirschsprung’s disease, hypothyroidism, pelvic floor dysfunction, and diabetes mellitus. You should inform your doctor if it comes with symptoms such as abdominal pain, cramps, bloating, vomiting, nausea or fever.
Experiencing dry stool that is difficult to pass?
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What causes constipation?
Causes of constipation aren’t really consistent so they can vary. Here are some of the common reasons why you may develop constipation:
- Not drinking enough fluids, such as water or juices each day: Being dehydrated can cause stool to become hard and dry.
- Lack of exercise: Fiber is important for healthy bowel movements. It can be difficult to get enough fibre if you’re not eating a balanced diet or getting enough physical activity each day. In addition, lack of exercise slows food movement through your intestines, which delays the passage of stool.
- Certain medicines or side-effects from taking medicine: Some medications such as narcotic pain relievers, antacids containing aluminum and calcium supplements, antidepressants, antihistamines, antispasmodics, non-steroidal anti-inflammatory drugs (NSAIDs), iron supplements, diuretics, and calcium channel blockers may cause constipation. Narcotics can slow down the transit of stool by affecting intestinal contractions. Antacids containing aluminium and calcium supplements decrease the acidity in your intestines, which allows for the stool to move more slowly through your gut.
- Not making enough time for a bowel movement: It can be easy to put off having a bowel movement when you’re busy or try to ignore it because it can be painful or uncomfortable. But if you don’t have a bowel movement every day or two, the stool will become hard and dry – leading to constipation.
- Some diseases such as Parkinson’s disease, spinal cord injuries, some cancers, hypothyroidism, and multiple sclerosis can cause constipation.
- Inability of the muscles surrounding the anus (anal sphincter) to relax: The anal sphincter is the muscle that surrounds your anus (the opening where stool passes outside of your body). When this muscle doesn’t relax as it should, you may find it difficult to have a bowel movement.
- Not eating enough fibre can cause constipation. Fibre adds bulk to stool and increases its water content, making it softer and easier to pass. People who eat a high-fibre diet produce larger stools that move through their digestive systems more quickly than those who don’t get enough fibre in their diets. Eating plenty of fresh fruits and vegetables and whole grains will give you ample amounts of dietary fibre. Also, try drinking prune juice or warm water with lemon juice before breakfast, which will help clean out the colon.
- Pregnancy: During pregnancy, the growing uterus can press on your rectum and make it difficult for stool to pass easily. This can cause constipation.
- Laxatives: Overuse of laxatives can cause the muscles in your digestive tract to become dependent on them to move stool through. If you regularly use laxatives, you may have constipation because not enough fibre is reaching your colon to keep it soft and able to pass stool easily.
What are the symptoms that accompany constipation?
Some people with constipation don’t have any symptoms at all. However, most do experience some discomfort in their lower abdomen or back, along with one or more of these problems:
- Stools that are hard to pass
- Stomach cramps
- Bloating or gas
- Slight nausea or vomiting
- An urge to have a bowel movement that isn’t relieved by passing stool
Experiencing any of the above symptoms?
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What are the risk factors for constipation?
Having constipation is not usually an emergency, but it can lead to more serious problems. If you suspect that you’re having trouble with constipation, talk to your doctor or other health care professional right away.
- Eating poorly
- Little regular exercise,
- Certain medications causing constipation (such as narcotic pain relievers)
- Some diseases, such as Parkinson’s disease
- Bowel disorders like colitis or diverticulitis
- Inability of the muscles surrounding the anus (anal sphincter) to relax
- Irritable bowel syndrome
- Sudden changes in how much fluid and fibre you’re getting each day
- Travelling through different time zones
- Irritable bowel syndrome
- Cancer of the colon
- The side effects of some medications.
What is the treatment for constipation?
The diagnosis of constipation may be made if a person has two or more of the following symptoms for at least 12 weeks in a year:
- Straining during bowel movement.
- Lumpy or hard stools.
- Sensations of incomplete evacuation, which is associated with straining and passage of small amounts of stool.
- Involuntary staining in patients who have a normal anal sphincter tone
The diagnosis can also be made in patients who present with symptoms such as reduced number of bowel movements, reduced fluidity of stools, increased straining, sensations of anorectal obstruction/blockage, excessive time spent on defecation, etc.
The treatment of constipation can be mainly divided into lifestyle changes, increased fibre intake, bulking agents, osmotic laxatives, stimulant laxatives, and enemas.
- Drink enough liquids every day to have soft, regular stools. You should drink more if it’s hot outside or if you are exercising strenuously. But don’t overdo it – large amounts of fluid can wash essential nutrients out of your body along with fluids, so try not to drink too much liquid. This is especially important for older people who are sensitive to fluid imbalances in their bodies because they may have heart or kidney disease.
- Eat more foods that contain fibre and drink fruit juices. Foods high in fibre include whole-grain bread and cereals, fresh vegetables and fruits (especially those with edible skins or seeds), beans, peas, and lentils. Slowly increase your intake of these foods as you adjust to them. Try to eat at least 20 – 35 grams of dietary fibre every day for good health.
- Whole wheat bread instead of white bread
- Oatmeal instead of cream of wheat/rice
- Bananas instead of applesauce
- Cooked carrots, pumpkin, and winter squash in place of mashed potatoes
These agents are designed to help bulk the stool and maintain regular bowel function. They help normalize stool consistency and soften hard or lumpy stools. They also shorten transit time through the colon. They should not be used as a long-term treatment because they may cause nutritional deficiencies by blocking nutrient absorption from food.
These agents promote softening of the stool by increasing fluid content in the intestine and drawing water into the bowel from surrounding body tissues. The increased fluid within the bowels stimulates peristalsis, which facilitates defecation without straining. These agents are generally safe to use over long periods of time.
effective for both hard and loose stools because both types cause reduced transit time in the intestine.
Side effects include cramping, nausea, vomiting, and diarrhoea. These agents are best used within one hour of a bowel movement to reduce the likelihood of cramping.
Care should be taken when using stimulant laxatives with pelvic floor dysfunction, cardiac disease, renal disease, or if taking other medications that can affect gastrointestinal motility because these conditions may worsen symptoms or lead to complications in some cases. Patients who have not experienced defecation after taking a stimulant laxative should not attempt to self-induce defecation.
They are effective for treating both hard and loose stools because they reduce surface tension in the bowel lumen to prevent water reabsorption from forming dry, hard stools that are difficult to pass. These agents also help normalize stool consistency by increasing the fluidity of stool and improving its ability to slide past one another.
In summation, the best way to prevent and/or treat constipation is by increasing dietary fibre intake, using bulking agents and osmotic laxatives as necessary, and maintaining regular bowel habits. If these methods do not work or fail to produce lasting results, consult a physician for advice on administering more aggressive therapies, which may include, stimulant laxatives, or stool softeners etc.
You may have heard your mum tell you at least once not to spend too much time straining on the toilet bowl, otherwise it would result in painful piles. Mothers know best — chronic constipation is indeed one of the causes of piles, or haemorrhoids.
Haemorrhoids are swollen blood vessels in the anus and lower rectum that become enlarged and swollen due to pressure. They are felt as small, round lumps around your anus or outside the anal canal. While they sound serious, haemorrhoids are actually very common in Singapore and occur in adults from time to time.
What are the symptoms to look out for, and is surgery necessary if you have piles? Let’s find out.
Your bowel habits aren’t the nicest and most socially appropriate topic to talk about, but it’s a huge part of our functioning body and a greater indicator of your health than you might think. When I see patients, I usually try to get a gauge of their bowel movement to assess their colon health — how often are they pooping? Is the process difficult?
An anal or rectal abscess is a condition where an infected cavity filled with pus develops near the anus. It is extremely painful and can cause fatigue, fever and rectal discharge. Most patients experience perianal abscess, a painful burning sensation near the anus. About 50% of patients with an anal abscess will develop a complication known as a fistula, a small tunnel which abnormally connects the site of the abscess and the skin of the anus.