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Do you feel uncomfortable when passing stool? Do you strain unduly before you pass stool? Are the stools you pass hard, dry and lumpy? If so, you might be suffering from ‘Constipation’.
Constipation refers to the condition wherein a person experiences difficulty passing stool or emptying the large bowel in the absence of any disease causing large bowel obstruction.
If a person’s frequency of passing stool is less than 3 times a week, he or she is most likely suffering from constipation.
But people generally are more concerned with stool consistency and ease of passage than stooling frequency as self-reporting about constipation by frequency of stooling could be subjective and influenced by culture and social customs.
Although the accurate rate of occurrence of chronic constipation in diverse African populations is unknown, it has been estimated for example, that 29 per cent of the population of South Africa, and 48.4% of people in Cotonou, Benin Republic self-reported suffering from constipation.
Worldwide, women. the elderly and those living alone form the majority of those who seek care for chronic constipation. Constipation can however occur in all age groups including children and babies.
Chronic constipation is physically and mentally troublesome for many people, and can significantly diminish the quality of daily living and well-being.
The following symptoms clearly indicate that one may be suffering from constipation:-
Constipation can be uncomfortable, but it is not typically life threatening.
Left untreated or in the presence of more serious underlying problems, chronic and severe constipation may cause additional damage, like:
Seeking early medical advice for constipation may help prevent complications.
The causes of constipation are diverse. They range from eating habits to the kind of lifestyle one adopts. The most common causes include:-
Lack of fibre in the diet
Fibre, combined with proper hydration, promotes regular bowel movements. Therefore, those whose diet lacks fibre are more likely to have constipation. Fibrous foods such as vegetables, fruits, nuts, whole grains, lentils, chickpeas, and other legumes are, therefore, absolutely necessary in one’s diet.
Insufficient intake of fluids
Insufficient intake of fluids daily can cause chronic constipation as the gut absorbs as much of the little water available in stool. This results in a hard, lumpy and dry stool that proves difficult to pass.
People who have a completely sedentary lifestyle with very low levels of physical activity have a higher risk of constipation. Some studies conducted in the past have concluded that fit people are less likely to experience constipation than other people. In 2013, a study found increased mobility to improve constipation among older adults.
Ignoring the urge to pass stool
Whether for reasons of pressure on one’s time or other reasons, ignoring the urge to pass stool whenever the urge is there can be a trigger for constipation. The longer stool stays in the large bowel un-evacuated the more water is absorbed from it and the harder, lumpier and drier it becomes.
Some medications are known to increase the risk of constipation. Such medications include:
Co-occurring medical conditions
Various medical conditions including anxiety and depression, underactive thyroid, irritable bowel syndrome (IBS) and some other gut disorders and conditions, may cause poor bowel movements and therefore constipation. IBS for example is a functional intestinal difficulty with a high risk of constipation. IBS patients experience abdominal pain, bloating, distension, and changes in the frequency or consistency of stools. The exact cause of IBS is not known, but risk factors include; overactive or underactive contraction of muscles of the bowel, abnormalities in the nerve supply to the bowel, severe infection and inflammation of the bowel and changes in bowel microflora (I.e., the good bacteria that are essential to healthy life).
As people grow older, the occurrence of constipation tends to increase. As many as 60 percent of older people in institutions may experience constipation.
In most cases of constipation, there is no need for prescription treatment. A bottom up management approach to constipation is advised generally (see below):
Natural remedy/Education regarding stool hygeine.
This options may help to keep constipation at bay, and include:
In case constipation persists after instituting this approach, it is advisable to see a doctor.
Doctors may consider it necessary to prescribe medications for your constipation especially when making lifestyle changes have not helped.
These medication include:
In case even medications do not work, it might be necessary to remove impacted stool manually or surgically. Also, when constipation is caused by disorders associated with the anus like rectal prolapse, anal fissure, anal cancer, special surgery will be needed to take care of such conditions.
Diagrammatic representation of a management approach to constipation. Click image to enlarge. Credit
Constipation can be prevented if you adopt the following lifestyle changes
Constipation is a common functional large bowel disorder that is caused by poor dietary habits, lifestyle practices, medical conditions and other factors. In case you suffer from severe constipation and experience a lot of discomfort, it would be wise to consult a doctor early who check you out, make accurate diagnosis, run some tests and most probably prescribe appropriate medications or surgery especially when natural remedies and lifestyle changes have failed to take care of your problem.
Sanchez, M.I., Bercik, P.: Epidemiology and burden of chronic constipation. Can J Gastroenterol. 2011 Oct;25 Suppl B(Suppl B):11B-15B. doi: 10.1155/2011/974573.
Sehonou, J., Kpossou, A.R., Sokpon, C.N.M., Cataria, H., Azandjeme, C., Vignon, K.R.: Functional Constipation in the General Population in Cotonou: Prevalence and Associated Socio-Demographic Factors. Open Journal of Gastroenterology, Vol.8 No.9, 2018
Liu, L.W.: Chronic constipation: current treatment options. Can J Gastroenterol. 2011 Oct;25 Suppl B(Suppl B):22B-28B.
Published: February 28, 2020
Updated: February 21, 2023
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