By Dr Ananya Mandal, MD
Constipation is a condition characterized by inability to pass stools that become hard and more difficult to pass.
Bowel habits are unique to all individuals. For some passing stools once in two or three days may be normal while for others passing stools every day is normal.
Symptoms of constipation
Constipation affects all individuals at any age or at least once in their lifetime. Inability to empty the bowels completely also may lead to constipation.
Constipation can lead to hard, lumpy, large or small stools passage as well. Severity of the condition may vary from person to person.
While constipation may be resolved in a short duration in some individuals, with others it may take longer with pain and discomfort.
Prolonged periods of on and off constipation severely affects the quality of life of individuals.
Causes of constipation
The cause of constipation is difficult to identify but there are several risk factors that raise the likelihood of constipation. Some of the risk factors of constipation include:-
- Lack or inadequacy of fibres and fluids in diet. Fibres are included in fruit, vegetables and cereals
- Avoiding or delaying urge to pass stools
- Certain medications may lead to constipation as a side effect
- Mental ailments like anxiety disorders and depression
- Elderly over the age of 55. Older people are five times more likely than younger adults to get constipated. This is due to slow bowel movements, use of multiple medications as well as a relatively sedentary life.
- Infants and children
- Pregnant women - Approximately 40% of pregnant women experience constipation during their pregnancy
- Sedentary life and lack of exercise
- Recent abdominal or pelvic surgery
- Terminally ill patients
Diagnosis and treatment of constipation
Diagnosis of constipation is based mainly on history of the condition. Criteria for constipation are included in the ROME criteria. This includes:-
- Less than three bowel movements a week
- Passage of hard stools in more than 25% of bowel motions
- Sense of incomplete bowel movements in more than 25% of bowel motions
- Excess straining in more than 25% of bowel motions
- Necessitating digital manipulation to facilitate passage of stools
Laxatives are medications that are prescribed to help empty the bowels. Treatment for constipation is effective but it may take weeks before there is a regular bowel pattern.
Prevention of constipation
Prevention of constipation involves making diet and lifestyle changes. This includes eating high-fibre foods, drinking plenty of fluids and regularly exercising.
Good toilet habits and giving time and privacy to pass stools comfortably without ignoring the urge to go to the toilet also helps in preventing constipation.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)
Last Updated: Oct 8, 2014