Constipation can seriously impair the quality of life of the affected people: defecation is difficult and painful. The stool is usually hard and can be expelled in small quantities only by straining hard. The cause of constipation is usually harmless (eg stress, shift work). Sometimes there are diseases such as diabetes behind it. You can read everything you need to know about constipation below.
What is constipation?
In the case of constipation , those affected empty their bowels less than usual. You almost always have other symptoms, such as difficult bowel movements, hard stools, or a feeling that you can’t completely empty your bowels. On average, at least one in five people complain of constipation from time to time.
Constipation is not a disease, it is a symptom that can have many different causes. Acute constipation is often caused by poor lifestyle habits such as a low-fiber diet, too little exercise, and lack of fluids. For example, constipation during a trip may be due to unusual foods and meal times.
Constipation can also occur in many diseases. These include diabetes , multiple sclerosis , and underactive hypothyroidism ( thyroid disease ). In addition, opiates, water medications (diuretics), some medications for heartburn , high blood pressure and sleep disorders ( such as sleep apnea ) medications can also cause constipation.
Constipation treatment and resolution consists of correcting the causes or weakening its effects as much as possible. Often it is enough to change one’s lifestyle. Exercises, supplements, and various laxatives may also be helpful. In the case of chronic diseases or the side effects of drugs, it is sometimes possible to improve or change the treatment.
This type of constipation comes on suddenly. Even if the cause is not serious most of the time, it can sometimes be serious diseases such as intestinal obstruction that require urgent surgical intervention. It is also possible that unusual living conditions triggered it. But unusual living conditions are more likely to cause the occasional constipation, described below.
Constipation is usually considered chronic if people are able to empty their bowels less than three times a week for at least three months and have other typical symptoms. Chronic diseases or long-term medications are often responsible for chronic constipation. Negative lifestyle habits also play an important role.
This type of constipation, as the name suggests, is between acute constipation and chronic constipation. Symptoms develop and worsen over hours or days. They appear in certain situations or certain events and disappear again after a few days. Common triggers are changes in the rhythm of life, such as travel and shift work. It is also possible to be caused by infectious diseases or short-term medications.
What is the incidence of constipation?
Constipation is a common problem that many people face at some point in their lives. Experts estimate that one in five people are constipated from time to time, and about one in seven people have chronic constipation. Women are affected three times more often than men at a younger age. The frequency increases with age.
Constipation in the elderly
Constipation is more common with age. In older people, the causes are often insufficient fluid intake and lack of exercise. Since the sense of thirst diminishes with age, it’s important to always have something to drink on the table or in sight. If an elderly person suffers from heart or kidney disease, the doctor will determine the appropriate amount to drink.
However, some medications can also cause constipation. It is best to discuss it with the doctor who treats it. It is possible to take another active ingredient that often does not cause constipation. Among the things that are good for constipation in the elderly are a proper diet with plenty of fiber, and consuming fresh fruits and vegetables daily.
Constipation during pregnancy
Constipation during pregnancy is not uncommon. This is due to higher hormone levels that help slow intestinal motility. It also puts pressure on the intestines as the child grows. Food supplements such as iron, which are taken frequently, also increase constipation.
It is beneficial to take a daily walk in the fresh air, drink plenty of fluids (water, herbal teas), eat high-fiber foods (whole grain products, fruits, vegetables) and, above all, chew food well. Because digestion begins in the mouth.
Foods that are difficult to digest and that interfere with breathing should be avoided. These include cabbage vegetables and onions. White flour products and chocolate are also objectionable. If possible, laxatives should be avoided during pregnancy.
What causes constipation?
The digestive system is a delicate organ system that can be easily affected. Things that can cause constipation by impairing bowel function include:
- shift work
- lack of exercise
- insufficient fluid intake
- low fiber diet
Although many of these can cause constipation, not every person who experiences them will be constipated.
Also, although not always, the following can be counted among the causes of constipation:
- Changing hormonal balance in women: Women are about twice as likely to suffer from constipation than men. Changing female hormone balance before menstruation, pregnancy, breastfeeding or menopause can cause constipation.
- Age: The frequency of constipation generally increases with age. This is due to the changing gut. It becomes more elastic, and this increases the likelihood that stool will stay in the intestine longer and more fluid be withdrawn. Factors such as muscle deterioration from lack of exercise, medications that are more likely to be prescribed for the elderly, a low-fiber diet and insufficient fluid intake can also cause constipation.
- Diseases: “Secondary constipation” is the name given to constipation triggered by disease or medication. These diseases include intestinal diseases such as irritable bowel syndrome or polyps, nerve or muscle diseases, hormonal disorders such as diabetes, autoimmune diseases or anal diseases such as hemorrhoids .
- Medications: The use of some medications can have unwanted side effects. Medications that can cause constipation include pain relievers, high blood pressure reducers, antidepressants, sedatives or iron supplements.
So if you need to take medication, you should check for side effects and talk to your doctor if necessary. Under no circumstances should prescription drugs be discontinued independently, without consulting a doctor!
What are the symptoms of constipation?
There are three things you should ask yourself about symptoms:
- Do you go to the toilet less often to defecate?
- Is it difficult to remove stool or do you have pain?
- Is your stool often hard and only in small quantities?
These signs indicate constipation. Constipation is mainly manifested by the decrease in the number of toilet needs and the emergence of complaints. Symptoms are generally:
- Hard stool that is tried to be done by pushing
- pain during defecation
- Often hard and sometimes lumpy stools
- Small amount of stool
- A feeling that the bowel is not completely emptied
- feeling full
- Stomach ache
- Abdominal bloating
It is difficult to say exactly when constipation begins. The frequency of bowel evacuation varies greatly from person to person, but most people empty the bowel every day. Experts speak of constipation only if there are significant deviations and additional symptoms appear, such as those mentioned.
When should you see a doctor?
A professional evaluation is highly recommended if the constipation comes on suddenly and is accompanied by symptoms such as very severe pain, swollen stomach, fever, vomiting and signs of shock. In case of chronic constipation that is not clearly caused by a negative lifestyle, a doctor should be consulted to investigate the cause.
Which doctor treats constipation?
In most cases, it will be sufficient to see a family doctor for constipation. Sometimes, however, it may be necessary to consult physicians from a variety of disciplines, from gastrointestinal medicine, proctology or urology to gynecology and neurology. Your family doctor will make the necessary referrals.
How is constipation and its cause diagnosed?
The examination begins with an examination of the complaints. One of the most important questions is how long you have been constipated. Additionally, the doctor will want to learn about the variable stool composition and frequency.
E.g; It deals with alternating diarrhea and constipation, stool color changes, mucus or blood deposits, pain during defecation, and other possible abnormalities such as blood in the anus . In such cases, sometimes keeping a stool diary for a while may be beneficial for the patient.
The doctor also needs to know if you are currently experiencing abdominal pain, severe bloating, or anything else that is bothering you.
Did you have a fever, contagious disease, did you lose or gain significant weight? How’s your appetite? Are there other illnesses or complaints such as back pain or spine problems? Is there a disease in other upper abdominal organs such as the gallbladder, liver or pancreas? All these questions and information about intestinal diseases in the family are also important for the doctor.
Diagnostic methods for constipation may include laboratory analysis on a smaller or larger scale, ultrasound examination of the abdominal organs, X-ray , and colonoscopy.
Imaging procedures such as computed tomography and magnetic resonance imaging (emar-MRI) may also be necessary. In some cases, they can determine the transit time of stool in the upper digestive tract, namely the stomach, esophagus, and small intestine or intestine.
Using anorectal manometry, defecography, balloon testing, and electromyographic examination, the functionality of the rectum, sphincter structure in the anus, and interaction with the pelvic floor can be checked.
How is constipation treated?
The solution and treatment for constipation, as always, depends on the cause. Many people can self-help once the cause of constipation is clear.
In the case of temporary or travel constipation, providing adequate fluids and exercise along with a healthy diet is usually sufficient. Laxatives may also be beneficial temporarily. You should ask your pharmacist or doctor about the advantages and disadvantages of the various methods before use.
If more severe symptoms occur, there is no stool for a while, or there is chronic constipation, the doctor should clarify the cause. Diagnosis begins with questions about lifestyle, bowel movements, medical conditions, and substance use. Physical examinations, blood, urine, stool tests, ultrasound examinations, colonoscopies, x-rays may be necessary.
If the cause is due to a disease or a drug, it is sometimes possible to optimize the treatment of the underlying disease or switch to other drugs on the doctor’s instruction.
Changes in lifestyle and possibly additional laxatives often help in cases of temporary constipation, but a doctor should still be consulted. For some types of constipation, surgery may be considered a last resort.
Constipation remedies (stool softeners)
There are several types of laxatives (stool softeners). Each works a little differently to facilitate stool evacuation. Examples are given below:
- Fiber supplements: Fiber supplements add bulk to your stool. Bulky stools are softer and easier to pass. Fiber supplements include psyllium, calcium polycarbophil, and methylcellulose.
- Stimulants: Stimulants , including bisacodyl and sennocytes, cause your intestines to contract.
- Osmotics: Osmotic laxatives help stool pass through the colon by increasing fluid secretion from the intestines and helping to stimulate bowel movements. Examples include oral magnesium hydroxide, magnesium citrate, lactulose, polyethylene glycol.
- Lubricants: Lubricants such as mineral oil help stool move more easily through your colon.
- Stool softeners: Stool softeners such as docusate sodium and docusate calcium draw water from the intestines and moisten the stool.
- Enemas and suppositories: Tap water enemas, with or without soap, can be helpful to soften stools and induce a bowel movement. Glycerin or bisacodyl suppositories also provide lubrication and stimulation, helping to push stool out of the body and relieve constipation.
Remember, your doctor will decide which medicine to take and how.
If the above stool softeners don’t help with your chronic constipation, your doctor may recommend a prescription medication such as:
- Medications that draw water into your intestines: A number of prescription medications are available to treat chronic constipation. Lubiprostone, linaclotide, and plecanatide work by drawing water into your intestines and speeding up stool movement.
- Serotonin 5-hydroxytryptamine 4 receptors: Prucalopride helps move stool through the colon.
- Environmentally-acting mu-opioid receptor antagonists: If constipation is caused by opioid pain medications, drugs such as naloxegol and methylnaltrexone reverse the effect of opioids on the gut to keep the gut moving.
Remember, your doctor will decide which medicine to take and how.
What is good for constipation?
1- What is good for constipation in adults?
Things that are good for constipation in adults include:
- Drink more water: Being dehydrated regularly can cause a person to experience constipation. To prevent this, it is important to drink enough water and not become dehydrated.
- Eat more fiber, especially soluble, non-fermentable fiber: To treat constipation, doctors often tell people to increase their fiber intake in their meals. This is because increased fiber intake increases the volume and consistency of bowel movements, making them easier to pass.
- Get more exercise: Several research studies have reported that exercise can help improve symptoms of constipation. Studies have linked sedentary lifestyles with an increased risk of constipation.
- Drink coffee, especially caffeinated coffee: For some people, drinking coffee can increase the urge to go to the bathroom. This is because coffee stimulates the muscles in the digestive system.
- Eat prunes: People often use prunes and prune juice as natural remedies for constipation. Prunes are one of the most accessible natural remedies available.
- Be wary of milk and dairy products: In some people with sensitivity, consuming milk and dairy products can cause constipation due to its effect on bowel movements.
2- What is good for constipation in children?
Constipation in children is often triggered by a low-fiber diet and a sedentary lifestyle. Too much sugar and too little fluid intake are also inconvenient.
The following will help a constipated child:
- drinking enough water
- Adding lots of fruit and vegetables to the menu
- Choosing whole-grain products like whole-wheat bread or whole-wheat pasta
- Consuming dried fruit, sauerkraut, or flaxseed soaked in plenty of fluids
- Apple or pear puree and whole grain food for toddlers and babies
- Yogurt, kefir or buttermilk
- moving frequently and regularly
- If necessary, gently massage the child’s abdomen clockwise with the palm of the hand.
- Placing the hot water bottle on the tummy of the child or baby
- Taking care of the hygiene and care of the anus and buttocks
Children with constipation should avoid:
- White bread, muffins, white rice, red meat, fast food
- Sweets and cocoa
- sedentary lifestyle
- consuming very little fluids
In rare cases, Hirschsprung’s disease , an inherited bowel disease, triggers chronic constipation.
Constipation in children can also be caused by antibiotics, lactose intolerance, and changes in daily rhythm. Babies often react with constipation when switching from breast milk to solid foods.