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
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
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
Changes to your diet and lifestyle
Use alternative medicines (if available) to control associated conditions
Have a healthy toilet routine
Try simple laxatives such as Fybogel, Senna
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
Drink plenty fluids
Increase fibre in diet – such as whole bread, wheat, oats, brown rice, and vegetables - see figure 1
Unless there is no place to have a bowel motion, do not delay going once you feel the urge to have a poo
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)
Seek a consultation for your constipation if the following is/are present:
If simple laxatives do not improve the constipation
Your constipation is new onset, after the age of 45 years, lasting beyond a month
Presence of blood in your poo
Unexplained weight loss, as evidenced by the need to change clothes size, actual weight measurements and or comments from your family or loved ones
There is extreme tiredness and fatigue
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
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