For those who experience infrequent bowel movements or difficult passage of stools for several weeks or more, there is cause for concern when it comes to persistent constipation.
Less than three bowel motions per week are usually indicative of constipation. Although occasional constipation is common and usually not harmful, some people suffer from chronic constipation, which can cause them to miss work or even strain excessively when they try to urinate.
Finding and treating the underlying cause of persistent constipation is essential for effective therapy, as this might differ from person to person. However, in certain cases, even after a careful study, a particular underlying reason might not be found.
Table of Contents
Clinical Symptoms of Constipation
A common digestive issue called constipation is typified by difficult or infrequent bowel motions. Constipation's clinical symptoms can range in intensity, and people may encounter one or more of the following:
Infrequent Bowel Movements
Reduction in the frequency of regular bowel movements is one of the main indicators of constipation. Generally speaking, constipation is defined as less than three bowel motions per week.
Hard Stools
People who are constipated frequently pass firm, dry, and challenging-to-pass faeces. It might hurt to pass these stools and need straining.
Straining
Constipation frequently manifests as the inability to stretch during bowel motions. It can be painful to pass a stool, and over time, it may even cause haemorrhoids or anal fissures.
Incomplete Emptying
A constipated person may experience a lingering sense of fullness even after having a bowel movement because they may believe that their rectum is not completely empty.
Abdominal Discomfort
Pain and discomfort in the abdomen can be caused by constipation. Many people report this pain as cramping or as feeling bloated in the abdomen.
Rectal Pain
Constipation and firm stools can cause pain in the lower abdomen. This may occasionally be quite bad and continue even after having a bowel movement.
Bloody Stools
Constipation can, while less frequently, occasionally result in little quantities of bright red blood in the stool or on the toilet paper because of the strain and discomfort.
Changes in Bowel Habits
Some persons who are constipated notice alterations in their regular bowel patterns. For instance, they could experience alternating constipation and diarrhoea, which is characterised by diarrhoea followed by constipation.
Nausea and Loss of Appetite
A generalised sensation of malaise, nausea, and appetite loss might be brought on by severe constipation.
Rectal Prolapse
Rectal prolapse is a disorder when a piece of the rectum protrudes through the anus and can happen in extreme situations of persistent constipation.
Causes of Constipation
What your colon does best is absorb water from any leftover food that makes its way through your digestive tract. It efficiently produces stool during this process, which is a waste product of digestion.
Together, the colon's muscles eventually force this waste product through the rectum and into the elimination process. Stool, on the other hand, hardens and becomes difficult to evacuate if it stays in the colon for too long.
A diet that is not at its best is one of the common causes of constipation. You should drink enough water and include dietary fibre in your diet to keep your stools soft and readily digestible.
Dietary fibre comes in two main forms: soluble and insoluble, and it mostly comes from plant-based sources. The capacity to dissolve in water allows soluble fibre to pass through the digestive system as a soft, gel-like material.
On the other hand, when insoluble fibre passes through the digestive system, it mostly keeps its structural integrity. Both types of fibre combine with faeces to increase its size and bulk while also making it more flexible. This transforming action makes the rectum easier to travel through.
Constipation can be caused by a number of different variables in addition to food. Potential causes include stress, changes in daily schedules, and illnesses that prevent the colon's muscles from contracting or interfere with the regular need to urinate.
Common instigators of constipation encompass:
- A diet low in fiber, especially diets rich in meat, dairy products, or cheese.
- Dehydration.
- Insufficient physical activity.
- Delaying the natural urge to have a bowel movement.
- Travel or disruptions in daily routines.
- The use of certain medications, including specific antacids, pain relievers, diuretics, and certain treatments for Parkinson's disease.
- Pregnancy.
- Advancing age, as constipation affects approximately one-third of individuals aged 60 and above.
Diagnosis of Constipation
Examining medical records, performing a physical examination, and occasionally ordering further tests or investigations are all used to diagnose constipation. An official diagnosis of constipation is made as follows:
Medical History Review
Your symptoms will be the first question the doctor asks. They will want to know how long you have been constipated, how often and how well you are able to go to the toilet, and whether you are having any accompanying symptoms such as bloating, stomach discomfort, or blood in the stool.
Inquiries concerning your food, exercise routine, and any recent prescription or lifestyle changes will also be made. It is crucial to be truthful and to include as much information as you can.
Physical Examination
During a physical examination, your abdomen may be examined for any lumps or sore spots. Using a gloved finger to probe your rectum for obstructions, anomalies, or indications of impaction, your doctor may do a digital rectal examination (DRE).
Review of Medications
Your doctor will examine your medications to determine whether any may be aggravating your constipation. Constipation is a side effect of several pharmaceuticals, including certain anticholinergic medications, antacids, and opioids.
Lifestyle and Dietary Assessment
To find out whether any aspects of your lifestyle are causing your constipation, your doctor could inquire about your food, water consumption, and exercise routine. They could propose changing one's diet, consuming more water and fibre, and so on.
Additional Tests (if necessary)
To determine the reason behind your constipation, your doctor could occasionally prescribe further testing. These tests might consist of:
- Blood tests: These can be used to find underlying medical issues such as electrolyte imbalances or thyroid problems.
- Imaging studies: To look for structural irregularities in the intestines, X-rays or other imaging procedures such as abdominal ultrasounds or CT scans may be conducted.
- Colonoscopy or sigmoidoscopy: During these procedures, the inside of your colon and rectum are examined using a flexible tube equipped with a camera. They can be useful in locating tumours, polyps, and other anomalies.
- Anorectal manometry or defecography: These examinations assess the rectum and anus's muscle and nerve functions to see if there are any problems with sensation or muscular coordination.
Your doctor can diagnose you and suggest a course of therapy after gathering all relevant data and, if required, ordering additional tests. Treatment options for constipation could include dietary adjustments, medication, lifestyle adjustments, or taking care of any underlying medical disorders that may be causing the issue. To properly treat and track your disease, you must adhere to your doctor's instructions and show up for follow-up visits.
Medical Nutrition Therapy for Constipation
Making dietary and lifestyle adjustments is part of Medical Nutrition Therapy (MNT) for constipation, which aims to both prevent and treat this common digestive problem. Hard, dry stools, irregular bowel motions, and trouble passing stool are the hallmarks of constipation. A healthy diet is essential for encouraging regular bowel motions and gut health in general. The following food and lifestyle suggestions will help you manage constipation with MNT:
1. Increase Dietary Fiber Intake
Stools with more volume from fibre are simpler to pass. Try to consume at least 25–30 grammes of fibre per day. Legumes (beans, lentils), fruits (particularly those with skin), vegetables (broccoli, carrots), whole grains (oats, whole wheat, brown rice), and legumes (beans, lentils) are good sources of fibre.
2. Stay Hydrated
Constipation may be exacerbated by dehydration. Make sure you stay hydrated throughout the day; an adult should consume 8 to 10 glasses (or around 2 to 2.5 litres) of water. Natural fruit juices and herbal teas can also help you meet your recommended fluid consumption.
3. Prunes and Prune Juice
Prunes are renowned for having laxative properties. Their fibre and sorbitol content can aid in softening stools and encouraging regular bowel motions. It might be advantageous to consume prune juice or a few prunes each day.
4. Probiotics
Yogurt and fermented foods like kefir and sauerkraut include probiotics, which can help balance gut flora and improve digestion.
5. Limit Highly Processed Foods
Foods that have been processed, particularly those with lots of sugar and little fibre, might make you constipated. Limit the amount of processed meats, sugary snacks, and fast meals you eat.
6. Moderate Your Dairy Intake
Constipation can occur in certain persons due to lactose intolerance. Try dairy substitutes like soy or almond milk, or lactose-free dairy products, if you think this is the case.
7. Incorporate Healthy Fats
Good fats, including those in nuts, avocados, and olive oil, can lubricate the digestive system and encourage regular bowel motions.
8. Regular Meal Schedule
Reducing constipation may be possible by eating meals at regular intervals throughout the day to aid your body's normal digestive patterns.
9. Physical Activity
Frequent physical activity can help avoid constipation by stimulating the digestive tract. Make an effort to engage in moderate exercise for at least half an hour every day of the week.
10. Consider Individual Factors
Certain people may have constipation due to particular food intolerances or diseases, such as irritable bowel syndrome (IBS) or gluten intolerance. To create a customised MNT plan in these situations, consulting with a medical professional or certified dietitian is crucial.
11. Gradual Changes
Increase your fibre consumption gradually to give your digestive system time to adjust. Periodically, abrupt, significant dietary adjustments might exacerbate constipation.
It is noteworthy that dietary modifications may not be the only solution for constipation in all circumstances. It's critical to see a healthcare provider for a complete assessment and suitable therapy if constipation continues or is accompanied by excruciating pain, bleeding, or other worrisome symptoms.
For constipation, a certified dietitian can offer tailored advice on using MNT according to your needs and preferences.
The Takeaway
Constipation is a common problem that typically appears in people who are older, use certain medications, or follow a low-fiber diet.
The vast majority of cases of constipation are minor and easily resolved with dietary changes and increased exercise.
For those who are suffering from chronic constipation or who are also experiencing concurrent changes in their bowel habits, speaking with a healthcare professional is crucial.
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