Constipation: Symptoms, Causes and Effective Treatments

Many people may experience constipation at some point in life. For example, you may experience constipation if you do not consume enough dietary fibre and drink adequate amounts of fluids. It can also occur due to irregular or unusual defecation habits. Not having bowel movements for several days will cause abdominal discomfort and harm your health.

Although constipation is quite common, chronic constipation can be a concern. It may occur due to distinct reasons such as stool passing through the colon slowly, dehydration, food moving slowly through the digestive tract, and more. This article will detail the causes, symptoms, and treatments for constipation.

Various home remedies can assist in easing constipation, such as consuming apple cider vinegar. However, if the home remedies aren’t helpful and the constipation is chronic, it is advisable to seek professional help.

What is Constipation?

Constipation is a gastrointestinal tract disorder or problem that leads to infrequent stools (less than three stools a week) or pain and stiffness in the stool passage. Chronic constipation may lead to the impaction of the intestine, which may even require surgery.

Aspects that may result in the emergence of constipation in an individual include changes in diet, colonic motility, daily behaviours, biological and other pharmaceutical factors. Studies show that around an average of 16% of adults worldwide have constipation. Furthermore, constipation is prevalent among 33.5% of adults (aged 60-110 years).

Symptoms

Merely the bowel movement cannot determine whether you have constipation or not. It is because each individual has different bowel habits. Some of the significant symptoms of constipation are:

• Passing stools less than three times a week.
• Having stools that are hard, dry, or lumpy.
• Going through pain or strain while stooling.
• Feeling full even after stools.
• Not being able to pass stool completely.

Other symptoms of constipation that require seeking medical advice include:

• Presence of blood in the stool.
• Persistent pain in the lower back.
• Cramping and pain in the abdomen.
• Sudden changes in bowel movements.
• Vomiting or fever.
• Sudden weight loss.
• Feeling bloated

The Causes of Constipation

The person’s colon absorbs water from the food consumed. The left over material after the water and nutrients are absorbed is called stool or feces. This gets stored in the rectum which is a dilated sac like structure of the intestines, before it gets excreted from the body. However, if it doesn’t get excreted from the colon for a longer time, you may have bowel difficulties.

You may also face difficulties if the colon absorbs too much water from the stool, making it dry. In this case, the stool becomes too hard and painful to pass. Constipation may also occur when the waste material (stool) slowly moves through your digestive system. The slower it moves, the harder it’ll become to pass stools.

Let’s discuss the causes of constipation in detail below:

Diet

One of the leading causes of constipation is a lack of fiber in your diet. If you do not consume adequate amounts of fiber-containing foods such as vegetables, fruits and drink less water, you may have more chances of experiencing constipation. 

The reason is simple; a high fiber diet results in increased stool weight, leading to a decreased time of colon transiting. On the other hand, a low fibre diet does the opposite and results in constipation. Studies have shown that a high fiber diet only helps individuals who have normal colonic functions and transit time. Those who show a delayed colonic transit time, do not benefit from a high fiber diet. However, it won’t benefit patients with constipation and delayed colonic transit.

Diseases

Some of the medical conditions or diseases that lead to constipation include:

• Mechanically, you may experience constipation due to the rectal, colon and anal stricture. Additionally, it may also be due to intestinal pseudo-obstruction and megacolon rectocele. Furthermore, diverticulosis, injured tissues.
• Metabolic or endocrine conditions like porphyria, pregnancy, hypothyroidism, hypercalcemia, diabetes mellitus, and hyperthyroidism
• Depression, eating disorders, anxiety, and other related psychological conditions
• Myopathic disorders like amyloidosis and scleroderma
• Neurological disorders include Parkinson’s disease, paraplegia, spinal cord injury, spina bifida, stroke, and autonomic neuropathy
• Anal conditions such as haemorrhoids, anal strictures, and anal fissures may delay the stool removal process resulting in chronic constipation. It results from the pain that you may go through during faecal excretion.
• Internal stenosis may result from cancer or causes related to it. For example, tumours, intestinal radiation, colorectal cancer, etc., may lead to constipation. It may also occur due to intestinal masses, sigmoid or cecal volvulus, inflammatory, and ischemic or surgical stenosis.
• Connective tissue disorders like lupus
• People having the Hirschsprung disease may also get constipation as they are more susceptible to it.

Medications

Different types of medications may also lead to constipation. Hence, ensure that you don’t use these medications above the safe limit.

• Anticholinergic drugs such as Hyoscine
• Antipyretic drugs like codeine and morphine
• Antipsychotics such as clozapine and haloperidol
• Antidepressants like fluoxetine and imipramine
• Food supplements with calcium and iron
• Drugs used for lipid-lowering and blood pressure-lowering
• Antioxidants, antihistamines, muscle relaxants, and anti-ulcer drugs

3. Other common causes 

• Older age: Research shows that senior adults with cognitive impairment, less dietary fibre intake, and reduced mobility are more at risk of constipation.
• Dehydration: Loss of fluid or inadequate fluid consumption may lead to constipation, as per studies.
• Less frequent exercises.
• Travel or similar routine changes

Relief And Treatment

Some ways may help ease constipation. The best way would be to change your diet and physical activities. It may help you to treat and even get relief from constipation. Try out the following methods for positive results:

• Limiting or avoiding alcohol/caffeine consumption as these beverages lead to dehydration.
• Drinking an increased amount of fluids for hydrating yourself prevents stool from drying.
• Increasing fibre-rich food intake by eating raw vegetables, fruits, beans, whole grain, bran cereal, and prunes may help. Hence, you should make your daily fibre intake between 20-25 grams.
• Increasing your exercise levels to around 150 minutes of moderate exercise per week.
• Passing stool as soon as you have the urge to have bowel movements.
• Cutting down on low fibre foods like milk, cheese, meat, and other processed food
• Get used to having bowel movements around 15-45 minutes before breakfast through bowel training (You may take help from a doctor).
• Ask your medical healthcare professional and take laxatives as per their suggestions. However, don’t use them more than twice a week without instructions from a physician.
• Take prescribed treatment and medications from a medical healthcare professional for easing constipation. 

Medications for Constipation

You can also try out certain medications recommended by your physician (such as laxatives) and the aforementioned treatments if they alone don’t show fruitful results.

• Take stool softeners like Surfak and Colace.
• Consume fibre supplements.
• Use lubricants like mineral oil.
• Take help from stimulants like Senokot.
• Use osmotic agents like Milk of Magnesia.

Prescription Drugs for Constipation

Several medicinal drugs may help you with your constipation issues. Such prescription drugs include:

• Prucalopride: It assists in increasing bowel movements by working on the colon walls, which leads to increased stooling.
• Lubiprostone: It allows your stool to pass effortlessly by increasing the fluid levels in your bowels.
• Linaclotide or Plecanatide makes bowel movements more frequent by speeding up food passage through the gastrointestinal tract and increasing fluid levels in your intestines.

Other treatments

• Surgical removal of the hardened stools: It occurs in long-term constipation. (chronic cases)
• Biofeedback therapy for retraining your muscles
• Manual removal of faeces for increased relief
• An enema.
• Long term treatments such as IBS (for chronic conditions)

How To Prevent Constipation Efficiently?

You can also prevent constipation through specific practices. These are similar to the techniques that you use for relieving constipation.

• Research suggests that drinking approximately 1.5-2 litres of water per day is beneficial. Drinking more water is a great way to relieve and prevent constipation.
• Consume more high-fibre foods as suggested by your healthcare professional (approx. 25 grams as per research)
• Exercise regularly and stay active.
• Eat more vegetables, fruits, and whole grains.
• Adapt yourself to the habit of using the restroom every day at the same time.
• Avoid caffeine and alcohol to prevent dehydration.
• Try to manage your stress levels.
• Do not try to control the urge to defecate. Instead, attend to nature’s calls immediately.

Studies show that fibre-rich food can improve intestinal peristalsis and increase faecal weight. In addition, all these foods act as natural laxatives that prevent constipation.

Helpful Indian Home Remedies For Constipation

If the usual remedies aren’t working out for you, you can try out Indian ayurvedic remedies for constipation. The traditional herbal ingredients and other cures that you can try include:

1. Ginger

Ginger is a great digestive aid, as per a research review. It can help in reducing the pressure on your lower intestines. During constipation, this reduced pressure can help you have a bowel movement. Ginger is safe for all, whether pregnant, nursing, or child.

Way to use 

Slice the root of the ginger into small pieces and slowly chew it. If it isn’t good for your tastebuds, then you may brew ginger tea or just boil it a bit and drink the ginger water.

2. Triphala 

Another Indian herbal remedy you can try for constipation is Triphala. It’s the combination of Belleric myrobalan (Bibhitaki), Indian gooseberry (Amalaki), and Black myrobalan (Haritaki). It acts as a mild laxative along with its antioxidant and anti-inflammatory properties.

Haritaki helps in loosening stools. Amalaki contains cooling properties that reduce inflammation and cool down your stomach’s inner lining. Bibhitaki contains dietary fibres that ease constipation as they are digestive agents.

Ways to use

You can purchase the herbal mixture of Triphala that comes in powder, liquid, or pill form.

3. Lemon Water

As lemon is a citrus fruit, it contains high fibre and vitamin C levels, which may stimulate your bowel movement. Hence, people use it as a way to fight against constipation. It’s safe, and anyone can use this homemade remedy.

Ways to use

Mix freshly-squeezed lemon juice with some warm water and slowly sip on it (in the morning). You should stay hydrated by consuming water regularly throughout the day.

4. Senna Tea

Senna Tea is another option. It’s a herbal mixture made up of flowers of plants within the legume family. Although these plants are globally present, a particular type is cultivated in India. It has incredible health benefits.

These leaves help in fighting constipation as they contain Sennosides. These compounds help in triggering your digestive tract, which stimulates bowel movement. However, if you are nursing, pregnant, taking steroids, or having blood thinners, you should avoid this remedy. If you use Senna tea extensively, it may lead to damages to your digestive tract.

Ways to use

You can purchase the senna tea bags or leaves and brew them like regular tea. 

Constipation: Diagnosis

If you have chronic constipation or usual treatments are not helping ease your problems, it’s time to go for professional treatment. When you go to a doctor, they diagnose your constipation based on different factors. For example, they will ask questions regarding your medical history. Then, they will physically examine you, ask about family medical history and may even write down some tests for a complete diagnosis.

In the beginning, your doctor or healthcare professional will do the following:

• Ask about your health history, for example, if you had surgery in the digestive tract.
• Ask whether you had alterations in your weight.
• Will ask about different health conditions like medications (including supplements, alternative, and complementary medicines) you’re going through, symptoms, or any underlying conditions.
• They will ask about your eating habits and physical activity levels.
• May perform a blood test to test your electrolytes, blood count, and thyroid function.
• Perform a physical exam along with a rectal examination.

Apart from this, there are specific other tests to identify constipation that include:

1. Colorectal Transit Study

Colorectal transit studies are bowel function tests that professionals perform to understand your bowel movements. This test helps understand how the food moves through the colon of a body.

To go through this test, you will have to take a pill that contains markers. The markers will be visible on the x-ray. Then the professional will perform several abdominal X-rays for 3-7 days. It will allow them to visualise how the food movement takes place in your colon and whether your intestinal muscles work adequately or not. You may also have to eat high-fibre food during the tests.

2. Barium Enema X-ray

The healthcare professional may also examine your colon through a barium enema X-ray. It is a test for diagnosing constipation. This test requires you to drink a specific liquid. You have to drink it a night before the test as it will help clean out your bowel.

The professional will insert barium (a dye) in your rectum through a lubricated tube during the test. The barium will make the colon and the rectum area more visible during an X-ray.

3. Anorectal Manometry

You may have to take the anorectal manometry test. It allows the healthcare professional to evaluate the function of your anal sphincter muscle. During this test, the medical healthcare professional will insert a catheter (a small flexible tube) having a balloon at its end inside the anal opening. Then, the professional will insert it till it reaches the rectum.

After that, the healthcare professional will inflate the balloon. Later, the professional will pull it out to understand the muscle strength of your anal sphincter. It will even help you understand whether your muscles contract properly or not.

4. Colonoscopy

Another test beneficial for diagnosing constipation is colonoscopy. The healthcare professional will use a colonoscope to examine your colon in this test. This tube also has a camera and light source.

The healthcare professional will give you a sedative and pain medicine to avoid pain during the test. You will also have to stay on a liquid-only diet (for 1-3 days) to prepare for the test. Furthermore, you may also have to clear out your bowel either through a laxative or enema.

Conclusion

Constipation is a common health issue that may occur due to certain conditions like changes in diet, medical conditions, dehydration, and many other factors.

The most efficient way to solve the issue of constipation is to try out home remedies which include increased fibre intake, regular exercise, staying hydrated, etc. However, if these methods don’t work, you can also try out Indian home remedies for constipation as they are ayurvedic and herbal cures.

However, constipation may not resolve by these methods, and symptoms may worsen. For example, this may cause pain in the rectum or anal openings or the absence of bowel movements for longer. In that case, you should talk to a medical professional. They can help you with specific medical treatments after diagnosis and provide you with appropriate medication.