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The ABC's of Constipation

"Constipation is having fewer than three (3) bowel movements in a week"
By: Gwen Y. Reyes-Amurao, M.D.The ABC's of Constipation

The Mayo Clinic describes constipation as having fewer than three (3) bowel movements in a week. Although the bowel habits of one person may greatly vary from another, and occasional constipation can be normal or expected, a more serious condition known as chronic constipation can be alarming and must be addressed immediately. Unlike constipation, chronic constipation is described as having infrequent bowel movements or difficult passage of stools that persists for several weeks or longer. Aside from this, other signs and symptoms may also be present and can be observed for several weeks or months at a time.

If you think you are experiencing constipation, or have experienced this in the past, read on to find out more about this condition.

Signs and Symptoms

  • Having hard, dry and small stools
  • Having difficulty in passing stools, often accompanied by straining or forceful exertion
  • Feeling that you can’t completely empty the stool in your rectum
  • Feeling of bloatedness, or having a heavy and full abdomen
  • Abdominal pain and/or vomiting

Diagnosing Constipation

  • How often do you experience constipation?
  • How long have you experienced the signs and symptoms?
  • What do your stools look like? (Your doctor may show you the Bristol Stool Scale)
  • What does your diet consist of? Or What are your eating habits?
  • What type of lifestyle do you have? Do you have any type of physical activity?
  • What medications are you taking?

According to the National Institute of Diabetes and Digestive and Kidney Diseases, tests may vary depending on the severity of constipation and even the patient’s age. All factors included, the following tests are available:

  • Colonoscopy - This procedure is used to view your rectum and entire column through video imaging
  • Colorectal Transit Studies - These are tests that show how well stool moves through your colon through the use of radiopaque markers or scintigraphy.
  • Anorectal Function Tests - These studies would show problems in your anus or rectum, the most common type of which is anal manometry. This measures the pressure in within the anorectal area and can detect the presence of nerve and/or muscle problems that prevent normal transit of stools.
  • Lower GI Series or Radiography - This makes use of barium that is allowed to travel through the entire colon. A radiographic picture of your entire digestive tract is taken to determine the presence of blockages or anatomical problems that prevent normal defecation.
  • Imaging Studies (like Magnetic Resonance Imaging or Computerized Tomography scan) - This will help determine the presence of medical conditions that may be causing constipation.

Causes of Constipation

Just like any condition, constipation can have several causes, and can be because of something as simple as a change in one’s diet or as complicated hypothyroidism or Parkinson’s Disease. Common causes include:

  • Diet low in fiber
  • Poor fluid or water intake
  • Sudden shift to a sedentary lifestyle from an active one; lack in exercise
  • Ignoring the urge to pass stools
  • Pregnancy
  • Intake of medications that cause constipation (antacids, anti-depressants, calcium and iron supplements)
  • Presence of medical conditions such as diabetes, hypothyroidism, muscular dystrophy, Multiple Sclerosis, Parkinson’s Disease, Spinal Cord Injury, Irritable Bowel Syndrome or Disorder

Complications of Chronic Constipation

Complications often arise in the later, more advanced stage of constipation. Because of the inability to relieve signs and symptoms early on, you may experience greater difficulty in passing stools, which are often very hard and try. Often due to straining, complications like the following may arise:

  • Hemorrhoids or swelling of the veins around the anus
  • Fecal Impaction or accumulation of hardened stools that is difficult to pass out
  • Rectal Prolapse or protrusion of a certain part of the anus due to difficulty in passing stools or straining
  • Anal Fissure or tiny tears in the anus

Addressing Constipation

In simple cases, laxatives often address the problem and can relieve you immediately. Because there are different types of laxatives, and different over-the-counter medications available to almost any individual, and it is important to determine the cause of the constipation so that the appropriate medication can be given. Consult your doctor prior to taking any medication. For your information, some of the more commonly used agents include:

  • Bulk-forming agents
  • Osmotic agents
  • Stool softeners
  • Lubricants
  • Stimulants

Preventing Constipation

Knowing the causes of constipation is the first step in preventing this condition from developing. Problems in regular bowel movement can arise in as early as childhood, so it is best to practice good toilet habits while you or your children are young. The following tips are helpful in preventing constipation:

  • Eat a well-balanced diet with lots of fruits and vegetables and include a variety of fiber-rich food
  • Load up on water daily, 2-3 liters for women, 3-4 liters for men depending on the amount of physical activity in a day
  • Exercise regularly or do a little walking from time to time. This increases motility in your digestive tract.
  • Do bowel training. Set a specific time each day, usually best during the least busy part of your day. Sit in the toilet bowl until you feel the urge. Do this daily and your digestive tract will be trained like clock-work.
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