Constipation is a common functional gastrointestinal disorder, with a prevalence of approximately 20% in the general population. In the elderly population, the occurrence of constipation is higher in comparison to the younger population. Moreover, the elderly females suffer more often from severe constipation. Constipation is straining during stools, passing stools once every two to three days, or passing hard stools by rectal or vaginal digitisation to facilitate stools.
In an exclusive interaction with OnlyMyHealth editorial team, Dr BS Ravindra, Director, Department of Gastroenterology & Hepatology, Fortis Hospitals, Bengaluru explains the symptoms, causes, and treatment of constipation. Here is what he shared with us.
What are the causes of constipation and associated diseases?
Lifestyle issues, lower fibre intake, less water intake, and lack of exercise are the common reasons for constipation. Some diseases associated with itare diabetes, thyroid problems, kidney diseases, heart disease, parkinsonism, stroke, and spinal cord problems. Medicines also add to it, especially antacids, iron supplements, some BP medicines, and antidepressants. Consider constipation as dangerous if there is bleeding, weight loss, or a lump in the abdomen, as these are ominous signs that can be colonic or rectal tumours.
Importance of a proper routine and diet
Tests needed: sugars, thyroid, calcium, phosphorus, haemoglobin, and a stool examination if these are negative. A colonoscopy and anal sphincter assessment by manometry are done too. Drink a litre to 1,250 ml of warm water once you get up in the morning if you don’t have water restrictions, as in heart and kidney diseases. Another 2 litres of water must be consumed throughout the day.
Fix a breakfast time of 8 or 8:30 a.m., allow six to seven hours between meals, and have a light dinner withvegetables and fruits before 7 p.m. Avoid drinking water when you have food. Have water half an hour early or an hour later. If you are eating food in less than 20 minutes, you are bound to have constipation as you are not chewing the food well. Everybody should walk or run for 30 minutes a day. Every meal should have 30 to 40 percent salad, either raw or cooked for less than five minutes.
When to see a doctor? What are the treatments?
If you have constipation, consult a doctor; if symptoms persist, consult a gastroenterologist, who is an expert in anorectal manometry, colonic transit, and constipation biofeedback. Constipation medications are classified into three categories: stool softener fibres, laxatives, and medications that increase colonic movements. Some people require biofeedback treatment. The role of surgery to shorten their colon is extremely small. Laxative abuse is something people should be aware of; one should not get addicted to laxatives beyond three to four months. Discuss with your gastroenterologists that you are getting addicted to laxatives and need to taper these medications.
Untreated constipation causes bleeding piles and painful fissures, as well as psychological issues such as depression, sleep disorders, indifference, and an inactive mind. Constipation is a common condition that is likely to reoccur, but it can be avoided with proper care and attention. It is best to get medical advice if you have constipation-related underlying symptoms that have persisted for longer than three weeks to prevent any complications down the road.