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Constipation common causes & treatment explained by best Gastroenterologist

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What is constipation & when does it become chronic?

When your regular bowel movement is restricted to less than thrice a week, you are having constipation. This is common and often tends to interfere with your ability to go about your day-to-day tasks. However, when this stretches out for over several weeks or more, it turns into chronic constipation. Chronic constipation causes people to strain excessively in order to force a bowel movement. But in most cases, constipation is the symptom of an underlying cause, most of which do not reveal any clear answers.

What are the symptoms of chronic constipation?

Constipation changes your bowel habits and messes with your daily routine. When constipation is prolonged, it becomes chronic. But how to tell whether matters are getting worse? Look for the following signs:

  • You are passing stools for less than thrice a week and inconsistently.
  • Notice if the stools you pass are lumpy or hard.
  • You will experience that you need to strain harder to pass your bowels.
  • You will consistently feel there is some sort of a blockage in your rectum.
  • Even after passing stools, you might feel that you didn’t empty your rectum.
  • You might start using your hands to either press on your abdomen or use a finger to remove residue stool from your rectum.

When any of these symptoms keep happening for a prolonged period of time, it is advisable to seek medical help.

What causes Constipation?

The intestines in our body are the organs responsible for bowel movements. Constipation commonly occurs when the excretory waste or stool moves very sluggishly through the digestive tract. So much that it cannot be eliminated effectively from the rectum. This leads to the stool becoming hard and dry. To get a better understanding let us first explain the digestion to excretion path, step by step:

  • Step 1: Food moves down the digestive tract which absorbs nutrients.
  • Step 2: Partially digested food moves to the large intestine and colon.
  • Step 3: Your colon absorbs the water from waste.
  • Step 4: The body excretes the stool as it pushes out.

During constipation, the stool stays in the colon for much longer, giving it time to absorb water to a bigger extent leading to dry and hardened consistency of stools that are difficult to push out.

Chronic constipation follows the same internal mechanism where it seems that the stool is stuck and refuses to budge.

The main cause of chronic constipation, therefore, is a blockage in the rectum. This slow or restricted stool movement can be due to the following reasons:

  • Anal fissures: These are tiny tears in the skin, especially around the anus.
  • Bowel obstruction: This means that there is blockage or restriction in the large intestines.
  • Colon cancer: When cancer manifests in the colon, it closes up the passage narrowing the colon and causing bowel stricture.
  • Abdominal cancer: When cancer manifests in the abdominal region, it starts pressing down on the colon area, narrowing the passage and restricting the flow.
  • Rectal cancer: Patients diagnosed with rectum cancer show a bulge through the dorsal wall of the vaginal area, called the rectocele. This triggers the same response of narrowed colon passage leading to constipation.
  • Neurological problems: If there is any nerve-related problem around the rectum, it will contract the colon and rectum, making it stressful to pass the bowels. While most cancer patients start experiencing bowel stricture, neurological problems leading to constipation can be primarily isolated to these causes:
    • Autonomic neuropathy: This happens when the nerves that control bodily functions are damaged or affected.
    • Multiple sclerosis: Here also it is difficult to maintain normal bodily functions.
    • Parkinson’s disease: It affects the neural pathways so much that the person loses grip on various motor functions including passing stools.
    • Spinal cord injury: When spinal cord injury takes place, the nerves around the spine might be affected. This will lead to a loss of control over motor functions and passing stools.
    • Stroke: With a stroke, there is a high chance of paralysis and that makes it nearly impossible to control other bodily functions.
  • Weak pelvic muscles: If the pelvic muscles involved in ensuring bowel movement are affected by trauma or injury, it will also cause chronic constipation. These will be linked to the following:
    • Anismus: This happens when the pelvic muscles do not seem to relax, to allow bowel movement.
    • Dyssynergia: This occurs when our pelvic muscles don’t coordinate the relaxation and contraction reflexes correctly.
  • Hormonal causes: The hormones secreted by our body help balance fluids in our body. Conditions that are caused due to hormonal imbalance lead to constipation. These are:
  • Lifestyle causes: Leading an unhealthy lifestyle can lead to multiple body disorders. Such as:
    • Eating low-fibre foods does not build roughage to push out stools.
    • Dehydration by inadequate intake of water will harden stools.
    • Lack of exercise will not help mobilise the stools.
    • Consuming large amounts of milk, milk products or cheese.
    • Stress

Treatment & Prevention of Constipation

While constipation on its own is nothing major, a few lifestyle changes can make the problem non-recurring.

  • Include plenty of high-fibre foods in your diet, this will build roughage for your intestines.
  • Eat less processed foods, and avoid dairy and meat products.
  • Drink plenty of water and fluids.
  • Exercise and stay active.
  • Manage stress levels.
  • Don’t suppress the urge to pass stool.

In conclusion, it is essential that you pay attention to your diet and lifestyle to avoid constipation. Patients undergoing treatments that lead to constipation should get a proper diet chart and follow the same to help their recovery and avoid further complications from chronic constipation. Those who are undergoing nerve-related issues or diabetes need to get a proper diagnosis from their physicians and follow up with the proper medication to avoid constipation. If things look bad, always reach out to a doctor for proper medical support to relieve this constipation. Our team of experts are ready to help. book an appointment with Dr Anukalp Prakash for any symptoms listed above.

FAQ:

How long is too constipated?

If you don’t pass stools regularly, find problems in pushing it out of your rectum, or have passed stools less than 3 times a week for over 2 weeks you need help getting your intestines cleared out. When you experience discomfort, drink water and healthy fluids except dairy products to assist your intestines to push out the stools.

Should I keep eating if I’m constipated?

When the digested food residue lies in the large intestine for longer than it is supposed to then the stool starts getting hard and it becomes difficult to excrete it. So the problem does not lie in eating the food but the kind of food you eat will decide how long your body will take to push it out of your system.

Food which is not fibre or roughage rich like vegetables, beans, bran, etc. takes longer to leave the system. Roughage from fibre acts like a lubricant for your intestines to help smooth out the blockage. So eat fibre-rich food and hydrate with ample fluid intake to relieve constipation.

Can you still pass gas if constipated?

When your poop is stuck in the rectum for too long it starts developing gas and you will pass gas even when you’re constipated. If you don’t hydrate enough then the gas will build up causing abdominal pain too.

Do bananas help you poop?

Bananas have a medium glycemic index and are high in fibre which helps prevent and relieve constipation. But this applies to normal constipation and might not help with chronic constipation. Bananas when ripe have soft soluble fibre that absorbs water, helping the stools stay large and soft. Also, the enzymes in bananas act as a lubricant to improve the movement of stool through your digestive tract.

Will constipation go away on its own?

Constipation is largely caused due to lack of water in your stools. So it will not go away on its own unless you do something.

  • Avoid alcohol as it dehydrates you. Drink a few extra glasses of water instead.
  • Eat juicy fruits, fibre-rich vegetables and whole grains.
  • Avoid meat, eggs and cheese until constipation clears up.
  • Move your body and exercise.

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