Constipation

What is Constipation?
If you've ever exchanged tips about eating prunes or drinking lots of water to stay regular, then you've probably had personal experience with constipation. Although constipation is common in all age groups, people over age 65 suffer from it the most. Constipation is a problem for less than 2 percent of people who aren't elderly, but it affects as many as a quarter of men and a third of women over age 65.

Constipation is generally thought to be less of a problem of digestion than motility, a technical word for the muscle contractions that move faeces through the gut. The main factors that put you at risk for constipation are thought to be the same as in younger people... a low-fibre diet and low fluid intake. (A recent US study disputes this, however, asserting that among older people lack of calories is the most likely cause.) You may also find yourself constipated if you're lactose intolerant or if you don't, or can't, exercise; metabolic disorders or weak muscle tone can also contribute to irregularity. You may also be taking a medication that's constipating, such as, aluminium antacids, narcotics, diuretics, antipsychotics or tricyclic antidepressants, calcium channel blockers, iron supplements, nonsteroidal anti-inflammatory agents, and some anticonvulsants.

The problem usually originates in your colon, since that's where the fluid is removed from the stool in the bowel. Constipation occurs when contractions in the colon are irregular or there's not enough water in your intestines to move the stool into the lower bowel and out of the system. At that point, you may find yourself unable to defecate. Whatever the cause, constipation can be more than an annoyance. Gastroenterologists, who often deal with the most stubborn cases of irregularity, point out that although it's seldom life threatening, chronic constipation can erode a person's quality of life.

Just because you don't have a bowel movement every day doesn't mean you're constipated. Some people have a bowel movement two to three times a day, others every three days. If you go for more than three days without one, however, your stool may harden, making it more difficult to eliminate.

In rare cases, new or progressively worse constipation may be a symptom of another, more serious problem, such as colorectal cancer or medication toxicity. Bloating, gas, cramps, abdominal pain, alternating diarrhoea and constipation, and rectal bleeding are symptoms that should prompt concern, especially if this is a new bowel pattern.

Causes
Everything from the kind of food you eat to how physically active you are... even whether you go to the toilet as soon as you feel the urge... affects how regular you are. People who get plenty of fluid and a variety of fruits, vegetables, and whole grains during the day tend not to suffer from constipation: fibre and fluid keep stools from becoming hard and dry, and promote motility of the gastrointestinal tract.

Conversely, you're more likely to be constipated if...

• Your diet is low in fibre
• You don't get enough fluids (6 to 8 glasses a day)
• You get less than 30 minutes of exercise a day
• You are immobile or bedridden due to illness or disability
• You often ignore the urge to move your bowels
• You overuse laxatives or enemas
• You have Irritable Bowel Syndrome, also known as spastic colon, an annoying but usually harmless condition that can cause alternating bouts of diarrhoea and constipation
• You have scarring, tumours or another condition in your digestive tract that prevents it from functioning properly
• You have a disease such as multiple sclerosis, lupus, scleroderma, underactive or overactive thyroid, or diabetes, all of which can affect a broad range of body functions
• You take certain medications such as antihistamines, iron supplements, diuretics, certain high blood pressure medicines, and antacids that contain aluminium and calcium

Symptoms
Try to be aware of changes in your bowel movements. Symptoms of constipation include...

• Bowel movements that feel incomplete
• Strain or feelings of pain when you try to eliminate
• Gas pains or a bloated abdomen
• Fissures, or tiny cracks, in your anus, usually from straining
• Haemorrhoids or swollen tissue around your anus; othese symptoms usually result from "hard" stools or straining to produce stool rather than from pure constipation
• Blood streaks in your stool from tiny fissures or haemorrhoids
• Anorexia or loss of appetite
• In people with dementia, signs of constipation may include increased confusion or somnolence

Treatment
Minor constipation in older people usually responds well to a change in diet. According to the Medical Sciences Bulletin, fibre is the treatment of choice for constipation, accompanied by exercise, if possible, and at least 1500 millilitres (50 ounces) of fluid a day. (Temporary side effects from increasing your fibre intake can include bloating and flatulence, so adding fibre gradually is a good idea.)

If your constipation isn't the result of disease, simply altering your diet or adding extra fibre may get your bowels back in order. Here are a few suggestions...

• Add high-fibre foods to your menu: whole grains, vegetables, nuts, and fresh or dried fruits such as figs, berries, apricots, or prunes. If chewing or swallowing raw vegetables is a problem, then eat them cooked. Whole-grain cereals and high-fibre bran flakes sprinkled on casseroles and other dishes is another option.
• Cut down on high-fat foods such as meat and cheese and refined sugars
• Drink at least eight 8-ounce (250 ml) glasses of water daily, and perhaps a glass of juice as well. (Prune juice really does work as a mild laxative.) Be careful about drinking too much milk, though, because it can lead to constipation.
• Limit caffeinated drinks (such as colas, coffee, alcoholic drinks and tea) that tend to be dehydrating.
• Try to get regular exercise, such as 30 or 45 minute daily walks, because increased activity often relieves constipation.
• Heed your body's warning signs when you need to go to the bathroom, but don't strain or rush.

• < Prev
• Next >