Constipation is medically defined as passing infrequent bowel motions (stools), fewer than 3 per week. However, people may also experience the passage of hard or dry stools as constipation. In this article, we will discover the Best Treatments for Constipation.
Contact of table
- About constipation
- Explanation of the stools
- Symptoms of constipation
- Lifestyle-related causes of constipation
- Medical causes of constipation
- Complications of chronic constipation
- Diagnosis of constipation
- Treatment for constipation
About constipation
Constipation is medically defined by the passage of infrequent bowel movements (stools), less than 3 per week. However, people may also experience passing hard or dry stools as constipation.
Occasional constipation is extremely common and may be due to a change in routine (such as travel), a change in diet, a brief illness such as a respiratory infection, or medications such as antibiotics or pain relievers.
Chronic constipation, present for more than a few weeks, is rarely due to a life-threatening condition. However, if it does not respond to simple measures, consult your doctor.
Explanation of the stools
Food nutrients are absorbed in the small intestine.
Waste is massaged along the large intestine by waves of muscle contractions (peristalsis). Once the excess water is removed, the waste is temporarily stored in the rectum. The anus is a muscular ring (sphincter) that can be opened at will to allow the evacuation of feces.
Water makes up about three-quarters of fecal contents, while the rest is made up of solids, including undigested fiber, intestinal bacteria, and dietary fat.
Symptoms of constipation
Symptoms of constipation include:
- need to open the bowel less often than usual
- hard, dry stools that can be painful to pass
- endeavoring to pass the motion
- having to sit on the toilet much longer than usual
- the subsequent sensation that the intestine has not been completely emptied
- swollen abdomen
- abdominal cramps.
- In some cases, constipation is caused by more serious illnesses and events, including tumors and systemic diseases.
Lifestyle-related causes of constipation
Constipation can be caused by many different lifestyle factors that often work in combination, including:
A change in routine: Normal bowel movements depend on the regular and rhythmic contraction of the intestine. It is part of the body’s internal “clock” and is often upset by changes in routine. This type of constipation is often seen in shift workers and travelers.
Low-fiber diet: Because fiber is indigestible, it adds bulk to stool, making it easier to push along the digestive tract. There are 2 broad types of fiber; soluble and insoluble. Soluble fiber helps soften stool. Good sources of soluble fiber include legumes, fruits, and vegetables. Insoluble fiber adds bulk to stool, helping it move more quickly through the intestines.
- Good sources of insoluble fiber are wheat bran, wholemeal bread, and cereals.
Insufficient water: The fibers in the stool swell only with water. Constipation can occur from a high-fiber diet if you consume too little water.
Lack of regular exercise: Living a sedentary lifestyle or having limited movement due to a disability are common causes of constipation.
- A tendency to “postpone” going to the bathroom: ignoring the urge to go means that more water will be extracted from the stool, making it difficult to pass. Regularly ignoring this urge can make your body less sensitive to normal toilet cues.
- Some medications, such as narcotics (especially codeine), antidepressants, iron supplements, calcium channel blockers (antihypertensives, especially verapamil), and non-magnesium-containing antacids, are known to slow bowel movements.
Pregnancy – the action of hormones, reduced activity, and pressure of the growing uterus against the intestines means constipation is common during pregnancy.
Older age: Constipation is more common in older adults. This is due to several factors, including reduced contractions of the intestinal muscles and dependence on regular medications.
Illness: A period of illness, especially an illness that involves hospitalization and bed rest, typically causes constipation. Factors include change in routine, shyness, reduced food intake, pain (especially after abdominal surgery), and pain medications such as morphine. Short-term treatment with laxatives is often necessary.
Medical causes of constipation
Constipation is sometimes symptomatic of underlying medical problems, such as:
Disordered defecation – this condition is an important cause of chronic constipation and is caused by insufficient forward contractions of the lower bowel (anorectum), or by increased resistance in the lower bowel. Straining is a very common symptom and individuals with disordered defecation may need to push on or trigger the anal canal to generate defecation.
Slow transit – some people naturally pass motions less often than most people. It seems their bowel ‘pacemaker’ may be less active. These individuals are more likely to become constipated with minor changes in their routine.
Irritable bowel syndrome – characterized by abdominal pain, bloating, and either constipation or diarrhea or alternating constipation and diarrhea. People with irritable bowel syndrome may have features of slow transit, disordered defecation, or both.
Anal fissure – a tear in the lining of the anus (anal mucosa). The person may resist going to the toilet for fear of pain.
Obstruction – the rectum or anus may be partially obstructed by, for example, hemorrhoids (piles) or rectal prolapse.
Rectocele – the rectum pushes through the weakened rear wall of the vagina when the woman bears down or strains.
Hernia – an abdominal hernia can reduce intra-abdominal pressure, which makes it more difficult to pass a motion.
Abdominal or gynecological surgery – a combination of change in routine, strange surroundings, post-operative pain, and codeine-containing analgesics is a potent cause of constipation and often needs preventive care.
Problems of the endocrine system – such as hypothyroidism, diabetes, or hypopituitarism.
Tumor – pain while trying to pass a stool could be a symptom of rectal cancer.
Diseases of the central nervous system – such as multiple sclerosis, Parkinson’s disease, or stroke are associated with an increased susceptibility to constipation.
Complications of chronic constipation
Some of the complications of chronic constipation include:
- Fecal impaction – the lower bowel and rectum become so packed with feces that the muscles of the bowels can’t push any of them out.
- Stercoral ulcer – the presence of impacted stool can erode the lining of the lower bowel. These ulcers can cause significant bleeding or bowel perforation.
- Fecal incontinence – an overfull bowel can result in involuntary ‘dribbling’ of diarrhea.
- Hemorrhoids – constant straining to open the bowel can damage the blood vessels of the rectum.
- Rectal prolapse – the constant straining pushes a section of rectal lining out of the anus.
- Urinary incontinence – the constant straining weakens pelvic floor muscles. This makes the involuntary passing of urine more likely, especially when coughing, laughing, or sneezing.
Diagnosis of constipation
The underlying reason for the constipation must be found. Diagnosis may include:
- a careful medical history, to determine the type of disorder
- detailed questioning about medications, diet, exercise, and lifestyle habits
- physical examination, including an examination of the anal canal and rectum
- a trial of simple laxatives is usually done, as the outcome of this helps with an accurate diagnosis of the cause
- referral to a specialist in disorders of defecation, who may perform simple tests of anorectal function, or anorectal manometry (pressure measurements of the rectum and anus)
colonoscopy in those with alarm symptoms or aged over 50 with a new onset of constipation.
Best Treatments for Constipation
Treatment depends on the cause but could include:
- Stopping or changing medications – that can cause constipation.
- Removal of the impacted feces – which may involve enemas, stool softeners, and a short-term course of laxatives.
- Dietary changes – such as increasing the amount of fiber in the daily diet. Dietitians generally recommend about 30g of fiber every day. Good sources of fiber include wholegrain cereals, fruits, vegetables, and legumes. The intake of foods such as milk, cheese, white rice, white flour, and red meat should be restricted, because they tend to contribute to constipation.
- More fluids – liquids help to plump out feces. However, it is important to restrict the intake of diuretic drinks such as tea, coffee, and alcohol.
- Fiber supplements – these may be helpful if the person is reluctant or unable to include more wholegrain foods, fresh fruits, or vegetables in their daily diet. As fiber supplements can aggravate or cause constipation, always check with your doctor or dietitian when using them.
- Exercise – one of the many benefits of regular exercise is improved bowel motility. Ideally, exercise should be taken every day for about 30 minutes. People with a condition that affects mobility need to be as active as possible each day, as every little bit of regular exercise helps.
- Treatment for underlying disorder – such as surgery to repair an abdominal hernia, hormone replacement therapy for hypothyroidism, or anesthetic cream and sitz (salt water) baths for an anal fissure.
- Laxatives – there are 2 main types: bulk forming and osmotic agents that increase the water content of the stool. Agents that increase the water content may interfere with the absorption of water from the bowel, or swell or bulk up the stool with fluid. Chronic constipation that has not responded to a trial of fiber supplementation can be safely treated long-term with laxatives and avoid further medical interventions. There is little evidence that chronic use of laxatives at appropriate doses will lead to a ‘lazy’ or ‘twisted’ bowel.
Disordered defecation not responding promptly to fiber supplementation and laxative use may require the use of suppositories or enemas and pelvic floor ‘retraining’ by biofeedback therapy, which is offered by centers specializing in anorectal disorders.
Slow transit constipation that has not responded to simple laxatives may be treated with medications that increase the speed of stool transit.
What eliminates constipation fastest?
Taking laxatives can provide quick relief from constipation. Examples include stool softeners, bulking agents, stimulant laxatives, and osmotic laxatives. A doctor or pharmacist can advise which type of laxative to recommend.
What is the best medicine for constipation?
Lactulose (Cephulac, Constulose, Duphalac, Enulose, Kristalose). This medication is an osmotic that draws water into the intestines to soften and loosen stool. Side effects include gas, diarrhea, stomach upset, and stomach cramps. Linaclotide (Linzess).
How to relieve constipation in 30 minutes?
First, try drinking a cup of warm water, wait 30 minutes, then gently massage your lower abdomen to try to stimulate the area. If this doesn’t seem to help, take a warm shower, with the water concentrated on your lower back.
What is the best stool softener for daily use?
We highly recommend Colace Clear Stool Softener for daily use, as it is a doctor-recommended gentle and effective solution for occasional constipation. Colace Clear is a dye-free, low-strength stool softener, making it a safe and gentle option for those looking for occasional relief from constipation.