Constipation

The frequency of moving stool varies from individual to individual, ranging from three times a day to twice a week. Constipation happens when this function is unduly delayed from the normal pattern. Occasional constipation is not serious but a long-standing disruption of this pattern, and changes in the appearance and consistency of the stool may be signs of a more serious disorder (eg intestinal cancer, hypothyroidism).

Symptoms

• Delay or difficulty in bowel movement.
• Pellet-like stool (small, dry, and hard).
• Pain, which may come and go in waves.
• Flatulence (excessive gas in the bowels) and frequent passing of air.
• Abdominal distension and discomfort.

Common causes

• Change of diet.
• Insufficient fluid and fibre in the diet.
• Too little exercise, causing the colon contractions that push the stool down to weaken.
• Ignoring the urge to pass stool when busy.
• Haemorrhoids (piles) or anal tissues (tears in the skin arround the anus), which cause pain when passing stool. (See PILES page 452).
• Certain drugs and minerals (eg painkillers, iron tablets) and cough mixture with codeine.
• Pregnancy, in which the fetus pushes down on the bowel.
• Illness which causes loss of fluids, alters the diet, or hinders a person's mobility (eg paralysis).
• In bottle-fed infants, feeding formulas that are too strong.
• Aging process. The abdominal muscles gradually weaken with age.

What you can do

• Eat plenty of fibre daily (eg four servings of cereals, fruits, and vegetables).
• Drink 6-8 glasses of fluids a day.
• Eat at regular hours.
• Exercise everyday. Walk briskly for at least half an hour.
• Consult a doctor if the measures listed above fail.

What your doctor can do for you

• Rule out haemorrhoids, anal tissues, and the more serious causes of constipation (eg colon or rectal cancer).
• Emphasize exercise and dietary strategy.
• Prescribe a laxative.
• Prescribe suppositories or an enema (passing fluid into the rectum through a tube inserted into the anus to induce bowel movement).
• Treat the complications.

Prevention tips

• Take plenty of fluids and fresh fruits and vegetables daily.
• Exercise regularly.
• Keep regular hours for your meals.
• Follow a regular pattern for bowel movement. Do not ignore the urge to pass stool.

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 280-281.