Stress is a very common cause of constipation. Stress affects the body in many different ways, including activating the sympathetic nervous system (fight or flight response). Certain body types will react to stress by decreasing the movement of the bowels (peristalsis). In stressful situations, people sometimes will eat unhealthy diets, decrease the amount of exercise they perform, and drink less water, which often lead to constipation. Aside from taking laxatives when stressed, people should consider taking long walks, and doing deep breathing, meditation, taking a break, exercising and massage therapy These are safe and healthy forms of stress management, and wil likely improve the symptoms of constipation. Other causes behind constipation are a regime of certain medications, dehydration, anda poor diet. To prevent constipation, evaluate your diet and if necessary, consider increasing the amount of fibre in the diet by eating more leafy greens, fruits and vegetables high in fibre, and decrease your intake of cheeses, high fat foods, and simple sugars. If these measures do not improve constipation, and your symptoms persist or worsen, it is advisable that you visit a primary care physician because there may be other underlying causes for constipation that can only be evaluated by a professional. A thorough evaluation of a patient’s history and a medical examination are essential to make a diagnosis.
The patient may complain of hard, painful stools when the stool consistency has changed (e.g., caused by poor diet or lack of hydration) or difficult, strained passage of soft stool when suffering from altered defecatory behaviour (e.g., anatomical obstruction, motility disorder). In the absence of organic disease, constipation may resolve itself with regular exercise, better hydration, and fiber supplementation. Osmotic or secretary laxatives may be considered in patients with unrelenting constipation. Long-term use of laxatives may result in dependency and paradoxical constipation, which can only be relieved with adequate lifestyle changes. In addition to a general physical exam and a digital rectal exam, doctors use the following tests and procedures to diagnose chronic constipation and try to find the cause:
Blood tests: Your doctor will look for a systemic condition such as low thyroid (hypothyroidism).
Examination of the rectum and lower, or sigmoid, colon (sigmoidoscopy): In this procedure, your doctor inserts a lighted, flexible tube into your anus to examine your rectum and the lower portion af your colon.
Examination of the rectum and entire colon (colonoscopy): This diagnostic procedure allows your doctor to examine the entire colon with a flexible, camera-equipped tube.
Evaluation of anal sphincter muscle function (anorectal manometry): In this procedure, your doctor inserts a narrow, flexible tube into your anus and rectum and then inflates a small balloon at the tip of the tube. The device is then pulled back through the sphincter muscle. This procedure allows your doctor to measure the coordination of the muscles you use to move your bowels
Evaluation of anal sphincter muscle speed (balloon expulsion test): Often used along with anorectal manometry, this test measures the amount of time it takes for you to push out a balloon that has been filled with water and placed in your rectum.
Evaluation of how well food moves through the colon (colonic transit study): In this procedure, you may swallow a capsule that contains either a radiopaque marker or a wireless recording device. The progress of the capsule through your colon will be recorded over several days and be visible on X-rays.
In some cases, you may eat radiocarbon-activated food and a special camera will record its progress (scintigraphy): Your doctor will look for signs of intestinal muscle dysfunction and how well food moves through your colon.
An X-ray of the rectum during defecation (defecography): During this procedure, your doctor inserts a soft paste made of barium into your rectum. You then pass the barium paste as you would stool. The barium shows up on X-rays and may reveal a prolapse or problems with muscle function and muscle coordination.
MRI defecography: During this procedure, as in barium defecography, a doctor will insert contrast gel into your rectum. You then pass the gel. The MRI scanner can visualize and assess the function of the defecation muscles. This test also can diagnose problems that can cause constipation, such as rectocele or rectal prolapse.
LIFESTYLE AND HOME REMEDIES
Increase your fiber intake: Adding fiber to your diet increases the weight of your stool and speeds its passage through your intestines. Slowly begin to eat more fresh fruits and vegetables each day. Choose whole-grain breads and cereals. Your doctor may recommend a specific number of grams of fiber to consume each day. In general, aim for 14 grams of fiber for every 1,000 calories in your daily diet. A sudden increase in the amount of fiber you eat can cause bloating and gas, so start slowly and work your way up to your goal over a few weeks.
Exercise most days of the week: Physical activity increases muscle activity in your intestines. Try to fit in exercise most days of the week. If you do not already exercise, talk to your doctor about whether you are healthy enough to start an exercise program.
Don’t ignore the urge to have a bowel movement: Take your time in the bathroom, allowing yourself enough time to have a bowel movement without distractions and without feeling rushed
Dr. Parameshwara C M, Chief Colorectal Surgeon and Founder, Smiles IICP (Bengaluru Smiles) Super-Speciality Hospital for Piles & all Colo-Rectal Disorders
City Today News