CONSTIPATION (Difficulty in defecation)

Constipation: Difficulty/Pain when passing out faeces

Did you know that passing out faeces and gases freely is a luxury? If you doubt it, ask someone who has had constipation

This is a very common disorder also known as Costiveness, Dyschezia or Irregularity.

Constipation is a condition of the digestive system in which bowel movements become infrequent, incomplete, or difficult to pass. The faeces usually appear as dry, hard, small lumps.

[Bowel movements simply means defecation, to pass out faeces]

Constipation can be so severe that defecation becomes very painful and obstipation could occur. Obstipation is the blockage of stool and gas evacuation

This condition mainly happens when the colon (the ending of large intestine which helps absorb water from faeces) re-absorbs too much water from the faeces or if the muscles of the colon do not contract effectively making the stool move too slowly and loses more water.

Common causes of constipation include:

Inadequate intake of water: Water enables effective digestion and makes the resulting faeces softer. Absence of water makes the faeces harder, thus difficult to pass

Inadequate quantities of dietary fibre in the diet: Dietary fibre, or sometimes referred to as roughage, is the indigestible portion of food. It facilitates bowel movements. Examples of foods low in dietary fibre are high fat foods such as cheese, milk, meat, egg etc. While foods high in dietary fibre are fruits, vegetables etc

Physical inactivity and immobility: Long period of immobility makes our rate of metabolism and food movement slow, resulting in more re-absorption of water from faeces. Thus, sick people and elderly people are at a higher risk of constipation compared to physically active people

Excessive intake of milk and dairy products

Medication: Many medications have constipation as a side effect. These include: Opioids, diuretics, antidepressants, antihistamines, antispasmodics, anticonvulsants, aluminium antacids etc

Aging: As we get older, our intestinal muscles tend to weaken, resulting in slowing down of our metabolism

Pregnancy: This causes hormonal changes in a woman, making her more predisposed to constipation. The womb may also press on her intestines, slowing down the movement of the food

Resisting the urge to defecate: This is usually caused by the fear of pain (Agliophobia), fear of public restrooms, not wanting to defecate at our place of work or school or sheer laziness. But whichever way, the longer the faeces remain in the colon; the more water is re-absorbed from it, making it harder and drier

Over-use of laxatives: Most people think that bowel movement should be done at least once a day. So to make sure this happens, they induce defecation by taking laxatives. Laxatives are actually effective in bowel movements, but overusing them will make the body dependent on them, so that constipation occurs when we stop using them

Certain diseases: Some underlying diseases have constipation as one of their symptoms. These diseases include: Diabetes, stroke, hypothyroidism, uremia etc

A disruption of regular diet or routine, such as when travelling, could also cause constipation

Constipation is usually easier to prevent than to treat. Following relief from a bout of constipation, maintenance with high fluid intake, adequate exercises, and high fibre diet is recommended.

In most cases, constipation resolves on its own without any treatment or risk to health. Treatment options are as follows:

·        Adequate intake of water

·        Adequate intake of high dietary fibre foods

·        Exercise and physical activity

·        Prompt expulsion of faceces as soon as you feel the urge

·        Treating any underlying disease

·        Use of laxatives: This is not often encouraged except in severe cases of which it should be the last resort. This is because, its frequent usage may cause bowel movement to become dependent on it

·        Enema: This option only evacuates the faeces in the rectum and not those in the colon. It involves introducing liquid into the rectum through the anus, this causes the rectum to expand rapidly resulting in a feeling of extreme urgency to defecate

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