Facts on Constipation
Constipation is the infrequent passage of bowel motion, less than what is usually normal for that individual. This is often accompanied by passage of hard stool.
Stools are supposed to be solid, but moist and easy to pass out. It is a very common problem. It is a symptom, and not a disease in it self.
The total absence of bowel movement or opening is called Obstipation. It needs to be differentiated from passage of hard infrequent stools.
Generally, if one starts passing hard stools less than three times in a week, then one can be said to be constipated.
It is an indicator (symptom) that some thing is not right about the function of the large bowel like in people with irritable bowel syndrome, or low thyroid function.
Other problems that can present as infrequent passage of hard stool could include crohn's disease.
Some Causes of Constipation
The causes of constipation are many. To understand how constipation is caused, it would be useful to briefly discuss the function of the large bowel which is responsible for constipation occurring or not. The large bowel does not help in digestion of food. What it does is to absorb water from the remnant of the digested food material as it passes down towards the anus or back passage. To put this in perspective, about 1500mL of fluid is passed down to the large bowel daily. Only less than 100mL is passed in faeces. The rest is absorbed by the large bowel. This is what makes stool hard. Once water is sufficiently withdrawn from the faeces as it passes down the gut, the remnant of digested food is now called faeces. If too much time is taken for the remnant of digested food to pass down the gut, there will be lots of time for more water than usual to be drawn from the faeces, making the stool hard and thus difficult to pass. Normally, it takes between 24 to 100 hours for digested food remnant to pass from the beginning of the large intestine (Caecum) to reach the end (rectum).Any thing that interferes with either the speed of passage of faeces down the large bowel, or absorption of water from the faeces, will thus cause constipation.
The common causes of constipation not surprisingly include:
Low fibre diet: Fibre is the part of a vegetable, fruit, or food generally that the body can not digest. They are also called roughages. They help to provide bulk to the faeces and facilitate movement of faeces down the gut. The remnant of digested food will therefore not have too much time to loiter behind in the gut and for so much water to be with drawn from it and become hard stool. Most Western diet tends to be lacking in high fibre diet. It is recommended that at least 30 grams of fibre should be taken by adults per day. Foods that are rich in fibre include Vegetables, Fruits, Jacket potatoes, Brown rice, Breakfast cereals, Wholemeal (brown) bread, Wholemeal pasta and nuts.
Including any of these in your diet may help overcome constipation.
Insufficient drinking water: Not drinking enough water means the body must squeeze every drop of water it can get from the remnant of digested food as it passes down the gut to salvage water for the body’s use. This leaves the partially digested food material going down the gut concentrated and "strong", setting the pace for constipation. Drinking a lot of water or fluid is important in preventing constipation. It is suggested that at least 2 litres or eight to ten glass of fluid be drank per day as drinks.
Lack of exercise: Inactivity or lack of exercises will mean the gut will be very slow. This will give more than enough time for transit of faeces and absorption of water, thus hardening the stool.
Certain Medications: Medications are other causes of constipation. Medications can affect the bowel in so many different ways.
Examples of medications such as codeine phosphate or Cocodamol, morphine or MST contain opiates. They slow down the speed of movement of the gut, thus causing constipation. Often, doctors do advise that when one must take these medications while you have constipation then, take them with a laxative or high fibre diet and loads of fluids.
Always read the information leaflets on prescriptions and drugs for guidance on the possible complications it causes. Your pharmacist will be an invaluable help in guiding you on medications and their side effects.
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