Effective Proven ways to Confidently Manage your Constipation

What is constipation?

Constipation is simply defined as:

• Inability to open bowels (poo) at least 3 episodes within a one-week period

• The bowels are large, dry, lumpy or appear like rabbit pellets

• There is straining, pain or sometimes, people cry during poo’ing

Fig 1: Foods for Constipation

What are the causes of constipation?

Constipation is caused by non-sinister and sinister issues. The most common are not due to cancer or masses. Among the commonest causes are:

• Ignoring the urge to visit the toilet – this leads to increased absorption of water by the large bowel, thus leading to excessive dryness of stools

• Inactivity and lack of exercise

• Depression

• Anxiety

• Stress

• Change in diet or daily routine

• Not eating enough high fibre foods such as vegetables, cereals, and fruits

• Staying dehydrated and not drinking enough water (note that some fluids can dehydrate one -eg alcohol)

• Side effect of some medications, eg pain killers such as cocodamol, codeine

Strategies to handle constipation

1. Changes to your diet and lifestyle

2. Use alternative medicines (if available) to control associated conditions

3. Have a healthy toilet routine

4. Try simple laxatives such as Fybogel, Senna

5. See medical attention if you are not getting better and or having “red flag” symptoms

Next, we shall elaborate on some of the aspects listed above.

• Change in diet

1. Avoid alcohol

2. Drink plenty fluids

3. Increase fibre in diet – such as whole bread, wheat, oats, brown rice, and vegetables - see figure 1

• Lifestyle

1. Keep moving

2. Run

3. Targeted exercise

Figure 2: Toliet (Water closet system)

• Toilet routine

1. Unless there is no place to have a bowel motion, do not delay going once you feel the urge to have a poo

2. Rest your feet on a low stool while on the toilet seat (presupposes you use the WC) and raise your knees above your hips – this is the anatomical convenient position that ensures a straight rectum (last bowel sac before the anus)

Red flags

Seek a consultation for your constipation if the following is/are present:

1. If simple laxatives do not improve the constipation

2. Your constipation is new onset, after the age of 45 years, lasting beyond a month

3. Presence of blood in your poo

4. Unexplained weight loss, as evidenced by the need to change clothes size, actual weight measurements and or comments from your family or loved ones

5. There is extreme tiredness and fatigue

6. You suspect that some of the medications you are taking may be responsible for the constipation

What will happen if your constipation is left untreated?

• Faecal impaction – this is defined as inability to open bowels without the need to manually evacuate the rectum of faeces | sometimes aggressive laxatives may work

• Haemorrhoids – bulging of blood vessels, located at the junction of the rectum and anus, which may then bleed, become thrombosed (blood clot), infected or painful

• Overflow diarrhoea – in which “loose stools” will seep around hard bowel motions, which may then present as diarrhoea. Unfortunately, some have inadvertently taken Imodium (anti-diarrhoeal agents) for this complication, thus worsening the original complication

Find a slide show version of the post below (best viewed on a laptop or PC) - which you can share for educational use.

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