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The uncomfortable truth about constipation



Do you always go when you get the urge? Did you know that holding it in and ignoring your need to go to the bathroom can lead to constipation? Constipation is when bowel movements become less frequent and difficult to pass stools. In most cases, it is treated as a symptom, not a disease and it is most often temporary and not serious. It is important to understand its causes, prevention, and treatment will help most people find relief.



Symptoms and Common Causes of Constipation


Who gets constipation?


Almost everyone at any age can experience constipation at some point in their life. It is generally triggered by poor diet, stress, lack of exercise, and underlying health conditions. are typically the causes. Older people are more likely than younger ones to experience this condition. In fact, about one-third of older adults have occasional symptoms of constipation.


Babies / Infants


Causes of constipation in babies/infants

A baby’s wee and poop change a lot from birth, one of the main causes of constipation in babies is a change in diet. A change in diet may include:

  • changing from being formula-fed to consuming soft foods

  • changing from being breastfed to consuming soft foods

  • exposure to new foods and flavors

  • not drinking enough liquids (breastmilk, formula, or water)


Some babies poop after every feed, and others will only poop once every few days. It is normal unless your baby doesn’t poop for up to 7 days. If your baby seems to be in pain or discomfort while pooping or if your baby has very hard and dry poop it is best to consult a pediatrician for advice.



Children


Constipation is a common problem in children, in fact, 1 in every 20 children's visits to the doctor is because of constipation.

Causes of constipation in children

Among the common causes of constipation in children are:

  • not eating enough high-fiber foods like fruit and vegetables.

  • not drinking enough fluids

  • feeling pressured or being regularly interrupted while in the toilet or during potty training.

  • feeling worried or anxious about something – such as moving house, the arrival of a new baby, or starting nursery or school.


Pregnant women


Up to 38% of pregnant women get constipated at some point during pregnancy. You're most likely to get constipated in the third trimester, though constipation can happen anytime between your 1st to the 3rd trimester as well.


Causes of constipation in pregnant women

​Here are some reasons why you could be constipated:

  • As the fetus grows and gets heavy it will put pressure on your bowel

  • An increase in the progesterone hormone during pregnancy causes the relaxation of your body's muscles. This includes your intestines, and a slower-moving intestine means slower digestion which leads to constipation

  • Worry, anxiety, minimal physical exercise, and a low-fiber diet can also cause constipation

  • Dehydration is another reason why pregnant women suffer from constipation

It’s always best to speak to a gynecologist if you experience prolonged bouts of constipation or pain, cramping, bloating, or gassiness.




Adults


Causes of constipation in adults

​Adult men and women may suffer from constipation for different reasons, such as;

  • Eating foods low in fiber like fruits, vegetables, and whole grain

  • Not drinking enough water which may cause dehydration

  • Not getting enough exercise, especially if the person lives a sedentary lifestyle or is wheelchair bound

  • Changes in your regular routine, such as traveling, going to be at different times, or eating at odd hours

  • Stress too is a major contributor to constipation in this group



Elderly


As people age, the prevalence of constipation tends to increase. For elderly living outside of the home or away from family surroundings, it is reported that 40% of older people live in communities or nursing homes and up to 60% of those in medical institutions suffer from mild to severe forms of constipation.


Fearing constipation is common among the elderly and this sometimes leads older people to depend heavily on stimulant laxatives. These are habit-forming and the bowel movements begin to depend on laxatives over time, when the natural mechanisms fail to work without the help of drugs, this can lead to a loss of normal bowel movements.


Causes of constipation in the elderly

​Here are other reasons why older people get constipation. :

  • Loss of teeth and wearing dentures can make it hard to chew and break down food particles into smaller pieces, these bigger particles then travel down the digestive tract and are expelled as waste.

  • The loss of a spouse or living in a care center or nursing home may cause them to lose interest in eating

  • Constant worrying about bowel movements may trigger psychological issues in elderly

  • The limited or complete lack of movement due to prolonged periods of bed rest or being bedridden can also cause constipation

  • Drugs prescribed for several medical conditions may lead to constipation among the elderly

  • If suffering from urinary incontinence, they may consume lesser fluids which can increase the chance of constipation

  • Eating softer foods like porridge and having limited sources of fiber from fruits and vegetables also a cause

  • Suffering from dementia, Alzheimer's or other conditions that affect the memory


How to know the cause of your constipation?


There are plenty of reasons why you may be suffering from constipation. A full body examination is needed to identify the root cause of the problem to provide the best possible chance of recovery. There are a few ways doctors use to make this assessment:

  • Anorectal manometry to asses fecal incontinence and chronic constipation

  • Colonic transit marker study is a motility (movement) study of your colon

  • Dynamic MRI defecography is an imaging exam that doctors use to look at problems in the structure of the pelvic floor or problems with how these muscles are working when you move your bowels.

  • Colonoscopy to examine causes of signs and symptoms of intestinal or digestive conditions, including constipation

  • X-rays can help your doctor determine whether our intestines are blocked and whether there is stool present throughout the colon

  • Health screening to determine if other health conditions or diseases are causing your constipation

  • The Bristol stool chart is used as a tool to diagnose constipation, diarrhea, and irritable bowel syndrome. You could use this assessment at home too to identify your own stool consistency.

Bristol stool chart - Know how your poop should look


How to treat constipation?


Depending on the circumstances and the severity of your constipation, the doctor may recommend:

  • A change in your diet, to include more fruits, vegetables, and whole grains to increase your fiber intake

  • To limit high-fat, and low-fiber food

  • Increasing your fluid intake

  • Checking your medications to see if they are causing your constipation

  • Over-the-counter fiber supplements or stool softeners

  • A laxative or enema

  • Therapy or exercises to help release clenching your muscles when trying to poop

  • Adjusting your toilet posture

  • Medication

  • Surgery


When to Call the Doctor?

  • if your baby is irritable and seems to be having stomach pain

  • if you see blood in your stool or in your child's stool

  • when your baby has constipation and develops vomiting, and its belly looks like it is bloated or filled with gas.

  • when constipation does not get better with treatment.

  • when you are experiencing abdominal pain, nausea, or vomiting

  • If you have lost your appetite

  • If you have sudden weight loss


Although simple lifestyle changes can eliminate some cases of constipation, it isn’t always enough to get permanent relief. Sometimes, constipation is a symptom of a serious condition. Avoid making self-diagnosis, it is best to get a professional consultation to understand your condition and get advice on the best course of treatment. Download the Doctor Anywhere App to speak to a GP or specialist from the comfort of your home before deciding on the type of treatment needed.

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