Things you need to know about constipation

Constipation occurs when a person is having trouble emptying the large intestine. Home remedies and changes in lifestyle can often help resolve it, but sometimes, medical attention may be required.

Constipation can occur for many causes, such as when stubble moves too slowly through the colon. The quicker the food passes through the digestive tract, the more water the colon consumes and the harder it becomes for the feces.

Individual who poops less than three times a week can get constipation.

A blockage in the large intestine often results in constipation. A person would need urgent medical attention in this situation. Many times it may just be because of a lack of fiber or water.

This article will deal with the main causes of constipation and how to treat or avoid constipation.

Symptoms

Constipation makes it difficult to pass stools.
Constipation makes it difficult to pass stools.

The main symptoms of constipation are:

  • difficulty passing stool
  • straining when passing stool
  • passing less stool than usual
  • lumpy, dry, or hard stool

Other symptoms include:

  • pain and cramping in the abdomen
  • feeling bloated
  • nausea
  • a loss of appetite

Complications

Constipation alone may be painful but it is not usually life-threatening.

However, if it is a symptom of a more serious underlying disease, such as colorectal cancer, or if it begins causing more harm, it can become a concern.

Harm which could result from severe constipation includes:

  • rectal bleeding after straining
  • anal fissure, which is a small tear around the anus
  • symptomatic hemorrhoids (piles), which are swollen, inflamed blood vessels in the anus
  • fecal impaction, which occurs when dried stool stagnates and collects in the rectum and anus, potentially leading to a mechanical obstruction

Certain possible complications include lower quality of life and increased depression.

Looking for constipation medical advice will help to prevent complications.

Causes

The following are some common causes of constipation:

Lack of fiber in the diet

People with high dietary fiber intakes are less likely to get constipation.

This is because fiber promotes regular bowel movements, especially when combined with proper hydration by a individual.

High fiber foods include:

  • fruits
  • vegetables
  • whole grains
  • nuts
  • lentils, chickpeas, and other legumes

Low fiber foods include:

  • high fat foods, such as cheese, meat, and eggs
  • highly processed foods, such as white bread
  • fast foods, chips, and other premade foods

Physical inactivity

Low physical activity levels can contribute to constipation, too.

Several past studies have found that people, including marathon runners, who are physically fit are less likely to experience constipation than others, although the exact reasons for this remain unclear.

Increasing mobility may help improve constipation among older adults, a 2013 study states.

People who stay in bed or sitting in a chair for several days or weeks may be at a higher risk of constipation.

Some medications

Some medications can also increase the risk of constipation. These include:

Opioid pain relief drugs: These include codeine (present with acetaminophen in Tylenol #3), oxycodone (OxyContin), and hydromorphone (Dilaudid).

Tricyclic antidepressants: These include amitriptyline (Elavil) and imipramine (Tofranil).

Certain anticonvulsants: Examples include phenytoin (Dilantin) and carbamazepine (Tegretol).

Calcium channel blockers: These lower blood pressure, and certain types lower heart rate. They include diltiazem (Cardizem) and nifedipine (Procardia).

Antacids that contain aluminum: These include Amphojel and Basaljel.

Antacids that contain calcium: One example is Tums.

Diuretics: These remove excess fluid from the body. They include hydrochlorothiazide (Hydrodiuril) and furosemide (Lasix).

Iron supplements: Doctors prescribe these to treat iron deficiency anemia.

Irritable bowel syndrome

People with functional intestinal disability, such as irritable bowel syndrome (IBS), have a higher risk of constipation compared with those without the disease.

A person with IBS may experience:

  • abdominal pain
  • bloating
  • distension
  • changes in the frequency or consistency of stools

Constipation with IBS can fluctuate with time. There may be loose stools with diarrhea when constipation is not present.

Aging

The frequency of constipation is starting to rise when people age. Constipation may occur in up to 40 percent of older people in the community and up to 60 percent in institutions.

The exact cause of that is still unknown. It may be that food takes longer to move through the digestive tract as humans age. Often, many people become less mobile, which can lead to constipation too.

Several factors that lead to constipation with age may be medical conditions, medications and a low intake of fiber or water.

Changes in routine

For example, when a person is moving their usual routine changes. That can have an effect on the digestive system. Scientists asked 83 people in a 2008 survey about the intestinal changes they experienced when traveling outside the U.S.

The results showed that when they went to another country, 9 percent of people experienced constipation.

Eating meals, going to bed, and at different times than usual using the bathroom may increase the risk of constipation.

Overuse of laxatives

Some people worry they don’t use the bathroom often enough, so they take laxatives to try to fix it problem. For bowel movements, laxatives can aid, but repeated use of certain laxatives helps the body to get used to their action.

This can cause a person to start taking laxatives when they do not need them any more. The patient may need higher doses to have the same effect, too.

In other words, it can be habit forming laxatives — especially stimulating laxatives. This means that the more laxatives a person depends on, the greater their risk of constipation when they cease to use them.

Overuse of laxative drugs can also contribute to:

  • dehydration
  • an electrolyte imbalance
  • internal organ damage

Some of these complications might turn life-threatening. For this reason people should speak with a healthcare professional before beginning to use laxatives.

Not using the bathroom when necessary

If a person ignores the urge to have a bowel movement, the urge can slowly go away until they no longer feel the need to go.

The longer they delay, however, the drier and stronger the stool becomes. This raises the risk of fecal impaction.

Not drinking enough water

Drinking enough water at regular intervals can help reduce the risk of constipation.

Other suitable fluids include fruit or vegetable juices that are naturally sweetened, and clear soups.

It’s important to note that some liquids can increase the risk of dehydration for some people and make constipation worse. Those who are prone to constipation, for example, should limit their intake of coffeinated sodas, coffee and alcohol.

Colorectal problems

Some health conditions that affect the colon can impede and restrict the passage of stool, leading to constipation.

Examples of such conditions include:

  • cancerous tumors
  • a hernia
  • scar tissue
  • diverticulitis
  • colorectal stricture, which is an abnormal narrowing of the colon or rectum
  • inflammatory bowel disease (IBD)

Other conditions

Some other medical conditions can also cause or contribute to constipation.

These include:

Neurological conditions: Multiple sclerosis, Parkinson’s disease, stroke, spinal cord injuries, and chronic intestinal pseudo-obstruction can lead to constipation.

Conditions that involve hormonal function, electrolytes, or renal function: These include uremia, diabetes, hypercalcemia, and hypothyroidism.

Intestinal blockage: This can occur if a tumor blocks or squeezes part of the digestive system.

Conditions that affect the digestive system: Constipation can occur with celiac disease, IBD, and other inflammatory conditions.

Cancer treatment: Chemotherapy and opioid pain relief medications, can also trigger constipation.

In children and babies

Constipation can sometimes affect babies and children. A detailed discussion of this is in the following sections.

Newborns

If a neonate does not pass meconium, their first solid stool, they may have Hirschsprung’s disease within 48 hours of birth.

This is a condition in which certain nerve cells from a part of the large intestine are absent. In the affected area of the colon, stool is unable to move forward which creates a backup.

Usually, a healthcare provider may note these symptoms and administer surgery as a cure. The outlook is positive in most situations for babies born with this disease.

Young infants

If a breastfed baby goes a week without having to pass the stool, this is usually not a problem. Infants who are breastfed typically don’t suffer constipation.

However, if parents or carers are worried about bowel movements of a baby, they should seek medical advice.

More commonly, constipation can occur:

  • when an infant first starts taking formula feeds
  • during weaning
  • during potty training
  • at times of stress

If a child develops constipation when consuming formula feed, they can benefit from drinking additional water between feeds. Parents and carers should not also add extra water to the mixture.

If the child already eats solids, their diet will need more fiber and water. Fruit can be an excellent option. Also, if they don’t want to eat, don’t force children to eat as this can cause or add to stress.

During potty training, constipation can occur if a child feels upset, particularly if other changes are occurring, such as beginning at nursery. Giving the child plenty of time to empty their bowels could help.

Apart from not passing stool, some signs that suggest constipation in children include:

  • a firm or distended abdomen
  • low energy
  • reduced appetite
  • irritability

In pregnancy

Around 40 percent of women experience constipation pregnancy, according to one source.

This can result from:

  • hormonal changes
  • physical changes, such as when the uterus presses on the intestines
  • dietary or physical activity changes

During pregnancy, many women take the iron supplements. These may improve constipation and other improvements in bowel habits.

Treatment

Constipation usually resolves itself without having to be treated with a prescription. Making changes in lifestyle — such as having more exercise, eating more food, and drinking more water — can help in most cases.

It may also help to allow time for defecation, without any discomfort or disruption. Individuals should not ignore the need to have a bowel movement, either.

In the short term, laxatives may boost symptoms but individuals should use them cautiously and only if necessary. This is because other laxatives can have serious adverse effects.

The Food and Drug Administration (FDA) is advising people to consult with their doctor before using them, and closely follow the label instructions.

People will see a doctor if constipation persists. We may need more medication. The doctor is therefore permitted to check for any underlying conditions.

Keeping a record of bowel movements, stool characteristics, nutritional and other variables may help identify an appropriate diagnosis for this.

Laxatives

There are some laxatives available over the counter, while others with a prescription are available.

People should consider using laxatives only when it has not helped to make lifestyle changes. Before using it, it is best to check with a doctor.

Some laxatives and stool softeners that can help ease constipation are as follows:

Fiber supplements: Also known as bulk-forming laxatives, these may be the safest option. FiberCon is one example. People should take these with plenty of water. Bulk-forming laxatives are available from pharmacies.

Stimulants: These cause the muscles in the intestines to contract rhythmically. Senokot is one example.

Lubricants: These help the stool move smoothly through the colon. One example is mineral oil (Fleet).

Stool softeners: These moisten the stool. Examples include Colace and Surfak.

Osmotics: These draw water into the colon to hydrate the stool and ease movement. Saline laxatives are a type of osmotic.

Neuromuscular agents: These include opioid antagonists and 5-HT4 agonists. They work at specific receptors to regulate movement through the gut.

Other treatment options

If laxatives do not work, a doctor may need to remove impacted stool manually or surgically.

When constipation does not respond to medication or if there are other signs, a doctor might recommend an abdominal imaging examination— like a CT scan, MRI scan, or X-ray — to see if there is a blockage in the intestine due to an underlying disease process.

If any, a person may need different prescription drugs or surgery to fix it. They may also need more care, depending on the test results and the person’s reaction to medical or surgical therapy.

Natural remedies

Some methods of easing constipation without using medication include:

Increasing fiber intake

Adults should eat 25–31 grams of fiber every day. Fresh fruits and vegetables, as well as fortified cereals, have a high fiber content.

Adding bulking agents containing fiber to meals can help soften the stools and make them easier to move. One choice is to sprinkle a spoonful of wheat bran onto cereals for breakfast or add it to a yogurt or smoothie.

Drinking water

Water can help rehydrate the body and prevent constipation.

Getting regular exercise

This can help make bodily processes more regular, including the passing of stools.

Establishing a routine

Have a usual place and time of day to visit the bathroom without forcing a stool.

Avoiding holding in stools

Responding to the body’s urges to pass stools can help prevent constipation.

Elevating the feet

Many people find it easier to pass stools with their knees above hip level during a bowel motion if they position their feet on a low surface, such as a stair.

Complementary and alternative remedies

Many potential treatments include acupuncture, massage, herbal remedies and moxibustion, which includes relaxing points of acupuncture with the mugwort of herbs.

One 2015 study concluded that acupuncture and herbal remedies may help, but there is a need for more evidence to confirm the efficacy of such methods.

That being said, herbal remedies are difficult to use and people should always speak to a doctor before trying something different, as they can have adverse effects.

Anybody who has constipation problems will talk to their doctor.

When to see a doctor

If the following symptoms also arise, people should seek medical attention for constipation:

  • severe discomfort or worsening symptoms
  • constipation that starts suddenly without a clear reason
  • ongoing constipation that has not responded to lifestyle changes
  • blood in the stool or bleeding from the rectum
  • constant pain in the abdomen or lower back
  • difficulty passing gas
  • fever
  • vomiting
  • unexpected weight loss

Summary

Constipation is a common occurrence which may result from dietary habits, medical conditions and a number of other factors.

If possible, the best way to resolve it is to use home remedies, such as eating more food, drinking more water, and regular exercise.

If a person has severe symptoms or pain, if constipation unexpectedly happens, or if the symptoms get worse, they should talk to their doctor.

Q:

I have heard that if you have constipation, you should avoid bananas, rice, and yogurt. Is this true?

A:

Many health professionals consider yogurt with probiotics to be beneficial to colon health, and probiotics may help in treating constipation. However, consuming too much may lead to loose stools.

Green bananas do have a higher starch and tannin content than bananas that are ripe and yellow, so a person may want to avoid eating less ripened bananas if they worsen their constipation symptoms.

A diet heavy in starch, such as that which occurs in rice, may also give rise to constipation.

When eating any type of food — even healthful ones — people should consider the amount they eat, how their body reacts to certain foods, and the overall balance of food groups. People should try to eat a diet that is healthful and well-balanced, which will help prevent or treat constipation. Such a diet should include a good balance of vegetables, legumes, fruits, and whole grains, which contain vitamins, minerals, and fiber. Staying well-hydrated and physically active will also help prevent or relieve constipation.

If a person has specific questions regarding a diet to address constipation, they should talk to their physician, who will be able to help make suggestions to best accomplish this. Stacy Sampson, DO

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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