By Dr Saravana.K
Constipation is caused by infrequent bowel movements or difficult passage of stools. What’s considered normal frequency for bowel movements varies widely. In general, however, you’re probably experiencing constipation if you pass fewer than three stools a week, and your stools are hard and dry. Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing it to become hard and dry.
Normally, the waste products of digestion (stool) are propelled through your intestines by muscle contractions. In the large intestine (colon), most of the water and salt in this waste mixture are reabsorbed because they’re essential for many of your body’s functions. However, when there is not enough fluid or fibre-rich food in your diet — or if the colon’s muscle contractions are slow — the stool hardens, dries and passes through your colon too slowly. This is the root cause of constipation. You may also experience constipation if the muscles you use to move your bowels aren’t properly coordinated.
A number of factors can cause an intestinal slowdown, including:
- Inadequate amounts of fluid intake and fibre in diet
- Ignoring the urge or delaying until later
- Lack of physical activity
- Irritable bowel syndrome
- Changes in lifestyle or routine, including pregnancy, aging and travel
- Frequent use or misuse of laxatives
- Specific diseases, such as stroke, diabetes, thyroid disease and Parkinson’s disease
- Problems with the colon and rectum, such as intestinal obstruction or diverticulosis
- Certain medications
- Hormonal disturbances, such as an underactive thyroid gland
- Anal fissures and haemorrhoids, producing a spasm of the anal sphincter muscle
- Loss of body salts through vomiting or diarrhoea
- Injuries to the spinal cord, which can affect the nerves that lead to and from the intestine.
Fortunately, most cases of constipation are temporary. Simple lifestyle changes, such as getting more exercise, drinking more fluids and eating a high-fibre diet, can go a long way toward alleviating constipation. Constipation may also be treated with over-the-counter laxatives. Constipation may signal more-serious medical conditions, such as colorectal cancer, hormonal disturbances or autoimmune diseases.
When to see a doctor?
- Unexplained onset of constipation or change in bowel habits
- Symptoms are severe and last longer than three weeks
- Bowel movements occurring more than three days apart, despite corrective changes in diet or exercise
- Intense abdominal pain
- Blood in your stool
- Constipation that alternates with diarrhoea
- Rectal pain
- Thin, pencil-like stools
- Unexplained weight loss, fever, lethargy
Your doctor or nurse will decide which tests you should have based on your age, other symptoms, and individual situation.
- There are lots of tests, but you may not need any.
- Rectal exam – Your doctor will look at the outside of your anus. He or she will also use a finger to feel inside the opening.
- Colonoscopy – For this test, the doctor puts a thin tube into your anus. Then, he or she threads the tube into your large intestine. The large intestine is also called the colon. The tube has a camera attached to it, so the doctor can look inside your intestine. During these tests, the doctor can also take samples of tissue to look at under a microscope.