Constipation

Definition

Constipation (constipation) is characterized by the very rare emission of stools, which are often hard.

Doctors speak of constipation if the frequency of bowel movements is less than 3 times a week for several months.

Other signs of constipation are: hard, dry or hard to pass bowel movements (in the intestinal tract). Pain during bowel movements is also possible.

Epidemiology

– Constipation (constipation) is a very frequent condition among the population, about 20% of the population would suffer from this disease.

– Women are more affected by constipation than men, 80% of cases of constipation concern women.

– In the United States, in 2017 it was estimated that 12 to 19% of the population was constipated.

Causes

Constipation (constipation) can be caused by:

– a poor diet (too much fat, too sweet) and low fiber consumption (lack of vegetables, salad and fruit)

– a lying position for many days (as is the case in hospitals). Incidentally, it is for this reason that people who remain in bed (because of an illness, for example) are often given a small laxative syrup

– lack of water and fluids

– lack of physical exercise (sedentary lifestyle)

– the stress

– a change of diet (in case of travel, for example)

– psychological problems

– the use of certain medicines (see below)

– regular use of laxatives (paradox that can generate a vicious circle)

– hypothyroidism

– at menopause

– the pregnancy

– a serious illness (cancer, bowel obstruction)

– a very long intestine.

– certain diseases that affect the nerves, such as: Parkinson’s disease or multiple sclerosis .

Medications and Constipation

– Certain medications can cause constipation, such as opiates (used against pain or cough), anticholinergics (against spasms,…), antidepressants (tricyclics), neuroleptics.

– If you are taking a medication that could cause constipation, talk to your doctor or pharmacist about taking a laxative or finding an alternative to your treatment.

Groups of risk

Women, in addition to the elderly and children, are the people who are particularly affected by constipation.

Symptoms

Constipation is characterized by the infrequency of bowel movements. Doctors speak of constipation if, in general, there are fewer than three bowel movements per week for several months. However, there are no fixed rules as to frequency, so if you experience discomfort associated with defecation despite having frequent bowel movements, talk to your doctor, as this could also be constipation.

Associated symptoms can be: abdominal pain, stomach pain , swelling, flatulence , hemorrhoids , spasms, hard stools, or even a feeling of incomplete evacuation.

We remind you that if you are experiencing discomfort at the gastrointestinal level: swelling, hemorrhoids, pain, etc. And that if you have doubts about your condition, do not hesitate to consult a doctor. In fact, in rare cases, constipation can hide serious illnesses (cancer,…), which is why an appointment in case of suspected constipation is always recommended.

Diagnosis

The diagnosis of constipation can be identified through anamnesis and/or supplementary tests (colonoscopy, blood culture,…) depending on the symptoms described by the patient. Only a doctor can make an accurate diagnosis.

Complications

Constipation rarely leads to complications. Most of the time, it is a benign disease. However, in rare cases, constipation can be a symptom of a serious condition such as intestinal cancer.

Furthermore, in the case of intestinal cancer, constipation must be absolutely well treated to avoid intestinal obstruction (ileus). In elderly people suffering from chronic constipation, an intestinal obstruction may occur (treatment which may require surgery).

When to consult?

It is absolutely necessary to consult a doctor in case of blood in the stool and severe abdominal pain, as this could be bowel cancer.

Make an appointment with your doctor if you notice constipation from medication.

Heads up! Non-exhaustive list, for every suspicious symptom, please consult a doctor.

I have constipation, what should I do?

1. If you are constipated, the first step is to try to change your lifestyle:

– Eat more fiber -rich fruits and vegetables (prunes, figs,…);

– Practice more exercises or sports;

– Drink more fluids (about a liter and a half a day), especially water rich in magnesium (it favors liquid stools);

2. Then, if lifestyle changes don’t work, you can take laxatives (medicines that cure constipation). However, as there are different types and causes of constipation, only a doctor can choose the best remedy among the different laxatives available, so don’t hesitate to consult a doctor and let him advise you.

However, we can suggest the use of bulk-forming laxatives in case of chronic constipation. They are medicines rich in fiber (psyllium grains, sterculia,…), which are not very irritating and good to be used over a long period of time.

Treatments

Note: The first treatment (before taking laxatives) is to change your lifestyle, ie adopt a fiber-based diet and exercise more. More information in the “Good Advice” section below.

If you are still constipated even after changing your lifestyle, here are the most commonly used laxative medications:

Medications to be administered orally (syrup, extracts, tablets)

Bulk-forming laxatives

What is it about?

Bulk-forming laxatives are usually based on dietary fiber or mucilage and are available in powder or granule form.

How it works ?

It is a mechanical action that increases the volume of feces, the bolus will inflate and come out more easily.

Can we use it over a long period of time?

Yes, these laxatives can be used for a longer period.

Is there any danger?

Take care not to obstruct the digestive system (risk of obstruction), read the medicine leaflet and ask your pharmacist for advice.

Tips

– Drink plenty of water with the powders and granules, dilute and drink immediately.

– Also use food supplements based on wheat bran, to be diluted in yogurt, for example.

the lubricating laxatives

What is it about ?

Lubricating laxatives are based on mineral oils, i.e. based on paraffin or vaseline.

How it works ?

Lubricants delay the absorption of water, which favors the passage of the food bolus, by effect, as the name implies, of lubrication, and also create a lipossoluble film that reduces the absorption of water.

Can we use it for a long period of time?

No, it is not recommended to use it for a long time.

Is there any danger?

Long-term use may reduce the absorption of fat-soluble vitamins (A, D, E, K), and there may be a respiratory risk, including in the elderly. Mineral oils can travel up the esophagus and into the lungs (paraffinome).

osmotic laxatives

What is it about ?

These are salt or sugar based laxatives. They are the most used.

How it works ?

Osmotic laxatives act, as the name implies, by osmosis, that is, they attract water and, as we have seen, facilitate the flow better. The effect can be quick, about one to two hours to take effect, but this depends a lot on the way of preparation, so talk to your pharmacist or read the medicine leaflet.

Can we use it for a long period of time?

Yes and no, it depends on the preparation. In general, we advise you not to use a laxative for a long time, as this can create a vicious circle, so consult your doctor or a pharmacist. Simple measures, such as physical activity, diet, among others, can almost always improve constipation.

Is there any danger?

Respect the dosage according to the preparation, as side effects such as flatulence, colic, among others, may appear, but we are not aware of a real danger.

the stimulant laxatives

What is it about ?

These are laxatives that quickly stimulate the flow. They are often indicated before a surgical intervention.

How it works ?

Stimulant laxatives increase water and electrolyte secretion by pharmacologic mechanisms. The effect is usually pretty quick.

Can we use it for a long period of time?

No, it is a laxative to be used on rare occasions and should not be used for a long time.

Is there any danger?

This type of laxative is contraindicated for pregnant women, as well as for people with intestinal obstruction. Sometimes these preparations may contain Senna, a substance responsible for undesirable effects.

the irritating laxatives

What is it about ?

In general, these are plant-based medicines (Sene/Cassia, Aloe Vera/Aloe Vera, Castor Bean, Frangula,… >> see under plants) rich in anthraquinone..

How do they work?

Decreased peristalsis.

Can we use it for a long period of time?

No, it is not recommended to use it for a long time.

Medications given rectally (suppositories)

What is it about ?

In general, these are suppositories or washing liquids, to be introduced into the anus, based respectively on glycerin or osmotic laxatives.

How do they work?

Glycerin-based suppositories act by emollient effect. Washes in general act by osmotic effect.

Can we use it for a long period of time?

Talk to your doctor, as always, it is not advisable to use a laxative for a long time, the ideal is to look for the cause of constipation.

Recent medications and other treatments for constipation

– There are specific medicines on the market for constipation in general sold with a prescription. They are especially indicated if over-the-counter (OTC) medications have limited effectiveness. Among these drugs are the following molecules: linaclotide, lubiprostone and plecanatide.

– Sometimes the doctor may also prescribe antidepressants, especially serotonin reuptake inhibitors. These medications work primarily as an analgesic, particularly during constipation in patients with irritable bowel syndrome.

– In some severe and particular cases of constipation, surgery may be performed to remove a part of the colon.

natural treatments

Several plants exert a laxative effect, here are the most used ones:

Plants without irritating effect

Bulk-forming laxative, with possible use for a longer period of time.

– Psyllium , a plant in the form of grains, very effective against chronic constipation.

– The fig , quite effective as a laxative. We can usually find it in syrups, sold in pharmacies. Consult your pharmacist to indicate a fig-based product.

– Flaxseeds , effective against chronic constipation.

Plants with an irritating effect

To be used for a short period of time). These plants are usually rich in anthraquinone.

– Frangula is very effective as a laxative, it is usually prepared as a mixture with other preparations.

– Castor or castor oil , an effective laxative plant to treat short-term constipation (not suitable for treating chronic constipation).

– Senna , useful for treating occasional constipation, in adults (pay attention to contraindications), ask your specialist for advice.

– Rhubarb , useful for treating occasional constipation.

– Aloe vera ( Aloe vera ), a plant rich in anthroquinone, to be used in cases of occasional constipation.

Another plant:

Essential oil (oe) of peppermint ( Mentha x piperita ) taken in capsule form (200mg oe of peppermint) 15 to 30 minutes before a meal, helps prevent muscle spasms in the gastrointestinal tract. Peppermint does not act directly against constipation, but it does help reduce associated symptoms such as abdominal pain. Choose capsules with gastric protection to prevent the contents of the capsule from being released into the stomach and causing heartburn.

Tips

– Drink plenty of water (from 1 liter to 1 and a half liters a day), as this allows you to soften your stools.

– Have a fiber-rich diet based on vegetables, fresh fruit or dried fruit.

– Do not forget to try, if possible, treatments with medicinal plants.

– Take laxatives for a short time, as taking too much laxative can favor constipation.

– An interesting trick to promote defecation is to raise your legs to horizontal when you are on the toilet. You can also place a footstool to place your feet. This position increases defecation and reduces the use of laxatives.

– In young children, a warm sitz bath can promote transit.

– Check your medications, it is possible that a medication you already take promotes constipation. Ask your doctor or pharmacist if a medicine can have this constipating effect.

Prevention

– Drink plenty of water (from 1 L to 1 L and a half per day), as this allows you to soften your stools.

– Have a diet rich in fiber, based on vegetables, fresh or dried fruits.

– Play sports or exercise. Lying down or standing still for a long time does not favor the flow.

– As soon as you feel like going to the bathroom to evacuate, go and don’t hold back.

– Have your meals at fixed times, it is a fact that regularity in food reduces constipation.

The use of probiotics can help prevent constipation, probiotics mainly favor bowel movements. One effective species of bacteria is Bifidobacterium lactis .

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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