Constipation is the most common problem faced by millions of people across the word. Passing hard stools, having pain and difficulty in the bowel movements are the main symptoms of constipation. It can happen due to many factors like drinking very less fluids or not eating fiber rich foods and sometimes due to side effect of the intake of certain medications. Long term constipation can lead to fissures and other complications. Laxatives can be taken for short periods for getting relief from constipation but that cannot be the right solution for constipation.
The stool gets hard and dry in the intestine and it faces difficulty while passing out of small hole of the rectum. For some people following the wrong pattern of bowel habit and visiting the toilet 2-3 times a week makes the problem worse than before. If there is any change in the usual pattern of passing stool it may cause constipation.
Causes Of Constipation :
1. Fiber – Not eating the required volumes of fiber can cause constipation. An adult with good health condition should take about 14-18g of fiber each day. Fiber particle adds quantity to the feces thus helping in its movement through the gut. Fresh fruits, vegetables, and cereals are high in fiber content.
2. Fluids – Not taking the required quantity of water and other fluids can make constipation problem worse.
3. Side Effects Of Medication – Antidepressant drugs, iron tablets and certain painkillers can lead to constipation. You need to discuss with your doctor about the possible side effects of these drugs. Tell your doctor if you suspect that particular medication is causing constipation so that he may give suitable alternate medication for your problem. Drugs that are taken for reducing weight can cause constipation with difficulty and pain in passing feces.
4. Medical Condition – Various medical conditions like irritable bowel syndrome, intestinal problems and underactive thyroid can cause constipation due to poor mobility of the feces inside.
5. Without Any Apparent Cause – There are some people who have constipation without any known medical cause, though they drink plenty of fluids and eat fiber daily.
Pain With Constipation :
1. Stretching Of Walls Of Abdomen – Constipation will be accompanied with pain due to stretching of walls of the colon. When plenty of stools get build up in the lower colon, the walls of the abdomen get stretched excessively causing pain. Lower abdominal pain can be felt during movement of stool. Very often the pain starts on the left lower abdomen where the colon is descending. For some people pain is felt in the middle of pelvic region and on the back also.
2. Rectal Tears – As the hardened stool pushes through the opening of the rectum it can injure and tear the soft membrane of the rectum. Inflammation of the rectum can occur during the process of straining while passing stool. This can lead to hemorrhoids commonly known as “piles”, affecting millions of people with chronic constipation. Rectal pain can occur due to constipation and after using the toilet.
3. Anal Fissure – Lining of rectum or anus can get torn causing inflammation and injury. Small blood vessels can get damaged heavily leading to bleeding of rectum. Tiny tears occurring on the anus is the condition of anal fissure and is extremely painful. Every visit to the toilet can cause significant pain due to anal fissure for people suffering from long term constipation.
4. Compression Of Nerve – Hardened fecal particles can strain all the way through the colon and rectum causing tiny tears. Fecal impaction can occur when hard stool blocks the way of other stool particles. This can exert considerable pressure on the neighborhood nerves like sacral nerves. Nerve compression can occur in such cases during constipation causing pain on the lower back.
No tests are needed to identify constipation since it is self explanatory. However your doctor may order for few tests like liver function test and colonoscopy to diagnose any medical condition within.
Some of the common signs of constipation are :
- Hard lengthy stool
- Bowel movement with or without pain
- Difficulty in passing stool
- Spending more time in the toilet for passing stool
- Visiting toilet 2-3 times a week or less frequent visit to the toilet
- Mild to moderate pain in the lower right abdomen and on the pelvic region and on the lower back
Read more on Home Remedies For Constipation
1. Fiber – Occasional constipation needs no treatment except changing your lifestyle and diet. Eating fiber rich foods like fruits, vegetables, cereals, whole-wheat, and flour can help in reducing constipation. Fiber is nothing but plant food which can stay for extended hours in the gut adding more volumes to the stool thus making it to move fast. Including wholegrain cereals daily in your breakfast can make lot of difference. Add brown rice or wholemeal pasta in your diet 3-4 times a week. If you have constipation try adding fiber to your diet gradually and not all of sudden since it can cause bloated feeling and fullness of stomach for several days.
2. Fluids – Drink at least 8 glasses of water daily split in regular intervals. You can drink any fruit juices without sugar each day. Fluids help in good movement of stool in the gut and in easy expulsion of stool from the rectum. If you are not drinking required quantity of water start adding 3-4 glasses each day until you reach the 2 liter level.
3. Go For Regular Walk – Constipation occurs largely on people with less physical movement and leading sedentary life. So go for daily walking and keep your body active which in turn increases gut movement thus reducing constipation.
4. Influence Of Medication – If you are taking treatment for depression and psychotic drugs that triggers constipation, consult your doctor who may prescribe alternate drugs. Avoid taking painkillers regularly since it may affect your stomach and liver. Always know about the side effects of any medication before taking it.
5. Sitz Bath – You can get great relief from constipation and anal fissure by relaxing yourself in a sitz bath. Add some baking soda to the bathtub and immerse your body in this water for 15-20 minutes. Repeat this process daily which can help in curing the injured muscles of the rectum and healing of miniscule tears in the anus.
6. Warm Water Application – Place a hot water bottle wrapped in a towel, in the lower abdomen for few minutes. Let it sit for 10 minutes. This simple home remedy can help in reliving back pain and facilitates easy movement of stool in the colon.
7. Follow The Routine – Nothing is more important than your health. Do not suppress the feeling of visiting toilet even if you are busy. Once the stool gets harder it may not be able to come out of rectum as before. Follow a routine in using the toilet and make sure that you are emptying the bowel by spending time in the toilet. Make it a point to pass stool as soon as you wake up in the morning since after quality sleep stools get accumulated in the lower part of large intestine. This makes it easy for expulsion of stools. Some people follow the habit of visiting the toilet 30 minutes after having lunch. Avoid using phones in the toilet since it can add stress and your mind become occupied with the talk failing to pass stool fully.
8. Laxative – If there is no improvement even after following fiber rich diet and drinking plenty of water, you can consider taking laxatives. But always consult your doctor and do not use laxatives for longer period. You can stop using laxatives once the stool gets soft and easy. Laxative can be of immense use for people for whom hard stooling blocks the leftover stool due to fecal impaction. Such medications help in right movement of bowels thus controlling constipation.
- Laxative Types and Uses
Bulk forming laxatives are those that help in adding bulk to the stools and they are nothing but fiber supplements. Fiber actually adds volume to the existing stool thus making it easy to move towards the rectum ready to get emptied. Unprocessed bran is a type of bulk forming laxative and beginning with lower amounts of bran can be of help. You can expect good results within a day or two after taking bran. Bran can be added to your breakfast or juices or even a glass of milk. Fiber supplements like psyllium powder, methylcellulose or wheat dextrin can also be obtained for your pharmacist. But remember to drink plenty of water while taking brain or other fiber supplement since bulk forming laxatives works well in water content. Flatulence and feeling of fullness in stomach can be observed for few days after using bran. But this would get settled once your stomach gets used to it.
- Stimulant laxatives like bisacodyl or glycerol or sodium picosulfate helps in stimulating the nerves of the colon thus facilitating easy bowel movement. Stimulation of nerves pushes the stools in fast pace thus getting relief from constipation. Taking a dose during bedtime will help in expulsion of feces within 12 hours. But stimulant laxatives can cause mild to moderate stomach cramps in some people.
- Osmotic laxatives help in the retention of fluid volumes in the large intestine. It includes lactulose and macrogols and also the phosphate enemas given before the surgical procedure.
- Fecal softeners belong to the group of laxatives that helps in softening the fecal particles, thus reducing the hard texture. Liquid paraffin is a natural source of fecal softener but it can cause skin irritation and urinary incontinence.
Laxatives : Good or Bad ?
Laxatives are meant for short term use only for softening the stool and clearing off the backlog. If you are new to laxative it is better to start with bulk forming laxative. Always consult your doctor if you find it difficult to pass stool easily after using the laxative for 2 or 3 days. Laxatives are well tolerated orally but in some cases it is given through the anus. Laxatives are given in the form of suppositories and act as a good stimulant triggering passage of stools. Glycerol trinitrate is available in the form of ointment which helps in relaxing the muscles of the anus helping in easy passage of stool.