Constipation: what is it, what causes it and the solution.

Constipation is known to many to mean many things. Some people feel it is a state of stomach disorder especially when they don’t seem to have an explanation for their bowel movement. To some it is straining, while to others, it means hard, pellet-like stools or an inability to defecate when desired, or infrequent defecation.

Some people also think they have constipation if they don’t have a bowel movement every day neglecting the fact that bowel movements are different for everyone, and as well that, the food you eat, how much you exercise, and other factors can affect your bowel habits.

What exactly is Constipation, and what causes Constipation?

Constipation is a symptom and not a disease. Clinically, there is constipation if patients who do not take laxatives report at least two of the following in any 12-week period during the previous 12 months. (This is usually known as Rome Criteria:

• Fewer than three bowel movements (BMs) per week.    
• Hard stool in more than 25% of bowel movements (BMs).
• A sense of incomplete evacuation in more than 25% of bowel movements (BMs).
• Excessive straining in more than 25% of bowel movements (BMs).
• A need for digital manipulation to facilitate evacuation.

Constipation makes people lack energy and feel full or floated. You may have constipation if you have three or fewer bowel movements in a week.

What causes constipation?

At one time or another, almost everyone gets constipated. In most cases, it lasts for only a short time and is not serious. There are many causes of constipation, and mostly they are poorly understood. The literature provides many overlapping and sometimes conflicting lists of causes. When you understand what causes constipation, you can take steps to prevent it.

Though this is by no means the exhaustive list, nonetheless, this goes a long way to list some identified causes.

• Insufficient Nutrition  

              - Inadequate Fiber intake.  

              - Dehydration caused by low fluid intake.

• Psychiatric factors

-                  - Depression

-                  - Sexual abuse

-                  - Unusual attitude to food and bowel functions

Constipation occurs in both children and old people. Constipation in older people however, is not a result of aging, as research has shown but is instead related to an increase in constipation-promoting factors such as chronic illnesses, immobility, neurologic and psychiatric conditions, and medicines used. 

In infancy and childhood, most constipation is functional rather than organic. Constipation in children can also be associated with very specific causes such as coercive toilet training, sexual abuse, excessive parental interventions, and toilet phobia. 

There are also some lifestyle habits that may cause constipation.

Some lifestyle habits that may cause constipation include:

• Changing your normal diet, exercise, or travel habits.
•  Ignoring the urge to have a bowel movement. 
•  Feeling a lot of stress.
• Taking calcium or iron supplements.
• Taking medicines such as painkillers with codeine; diuretics, also known as water pills; medicine for depression; and some antacids.

Some medical conditions that may cause constipation include:

• Pregnancy or having given birth
• Problems with the muscles and nerves in the intestine, rectum, or anus
• Irritable bowel syndrome, a condition in which the nerves that control the muscles in the intestine don't function correctly; the intestine becomes sensitive to food, stool, gas, and stress.
• Diabetes, a condition in which a person has high blood sugar, also called hyperglycemia because the body cannot use blood glucose, or blood sugar, for energy.
• Hypothyroidism, a condition in which the thyroid gland does not produce enough hormone to meet the body's needs and many of the body's functions slow down.

How to treat Constipation.

Treatment of constipation is symptomatic. The treatment depends on its duration and severity. Available studies have concentrated on therapies with fiber and different laxatives. Whilst therapy with fiber and with laxatives has some benefit in improving the quantity and quality of BMs, there is no clear evidence regarding which laxative is superior.

Treatment should be graded and should start with lifestyle and diet changes. Any medication that can cause constipation should be stopped if possible. Further steps include the use of bulk-forming agents, osmotic laxatives, and possibly pelvic floor physiotherapy. If these fail, a next step can be the use of contact laxatives, enemas, and prokinetics. Surgery—for example in Ogilvie syndrome—is only indicated in exceptional circumstances when all other conservative treatments have proved ineffective, or when there is a risk of perforation of the cecum. 

You should as well consult your Doctor or a specialist who can help diagnose you better.

1.  Eat more fiber. 

Fiber helps form soft, bulky stools and is found in many vegetables, fruits, and grains. Make

sure to add fiber to your diet a little at a time so your body gets used to it. Limit foods that have little or no fiber such as pizza, ice cream, cheese, meat, snacks like chips, and processed foods such as instant mashed potatoes or frozen dinners. Just take a look at the table below. I got it somewhere.

High-fiber Foods

Fruits	Vegetables	Breads, Cereals, and Beans
Apples      Peaches      Raspberries      Tangerines    Oranges         Pears         Prunes	Acorn squash       Broccoli      Brussels sprouts                    Cabbage      Carrots       Cauliflower       Spinach       Zucchini	Black-eyed peas      Kidney beans      Lima beans   Cold whole-grain cereal (all-bran, total, bran flakes)   Hot whole-grain cereal (oatmeal,  wheatena)       Wheat or 7-grain bread

Your doctor may suggest you take fiber pills or powder to help soften and bulk up the stool. You can buy fiber products in a pharmacy or grocery store without a prescription. Some fiber products are flavored while others are not. Be sure and take the fiber with plenty of water as directed.

Some people have gas and bloating at first when taking extra fiber. Let your doctor know if you are having problems that do not go away after a few days.

2. Drink plenty of water and other liquids such as fruit and vegetable juices and clear soups.

Liquids have little effect on stool form; however, drinking enough fluids is important because dehydration can cause constipation. Try not to drink liquids that contain caffeine or alcohol if you feel thirsty or dehydrated.

3. Get enough exercise.

Regular exercise helps your digestive system stay active and healthy. Exercising 20 to 30 minutes every day may help.

4. Visit the restroom when you feel the urge to have a bowel movement. Allow yourself enough time to relax.

Sometimes people feel so hurried that they don't pay attention to their body's needs. Make sure you visit the restroom when you feel the urge to have a bowel movement. If you usually have a bowel movement at a certain time of day, visit the restroom around that time. Reading a book or magazine in the restroom can help you relax. If you cannot have a bowel movement within 10 minutes, get up and return the next time you get the urge.

5. Use laxatives only if a doctor says you should.

Laxatives are medicines that help you pass stool. Most people who are mildly constipated do not need laxatives. However, if you are doing all the right things and you are still constipated, your doctor may recommend a laxative for a limited time. Your doctor will tell you what type is best for you. Laxatives come in many forms including liquid, chewing gum, and pills.

6. Check with your doctor about any medicines you take.

Some medicines can cause constipation. Be sure to ask your doctor if any medicines you are taking could cause constipation.

7. Follow any special treatments your doctor recommends.

If you have problems with the muscles and nerves that control bowel movements, your doctor may suggest biofeedback. Biofeedback is a painless process that uses sensors in the rectal area to help you feel the stool and move it out of the rectum. Doing biofeedback with a trained therapist has been shown to help some people with constipation.

Key Points to Remember.

The key to preventing and treating constipation is eating enough high-fiber foods and drinking enough fluids. Together, these work to make your stools softer and bulkier, making it easier to move through your intestines. Dietary fiber (fibre) is one of the main tools in the prevention and treatment of constipation. Fiber absorbs water and makes stools easier to eliminate.

You can add fiber to your diet by eating more fruits, vegetables, beans and grains every day. The goal should be to have 2-4 servings of fruits and 3-5 servings of vegetables every day. This will provide enough roughage to help your digestive system function smoothly. Make sure to add fiber to your diet gradually, to avoid gas and bloating and to allow your body to get used to it. At the same time, limit your intake of foods with little or no fiber, such as meat, cheese and ice cream. 

It is also important to drink additional liquids to enable the fiber to work properly. Fiber doesn't work immediately; allow some time to see a change in your bowel movements. If you cannot get enough fiber by consuming fruits and vegetables, you could add fiber supplements. Water is one of the best natural remedies for constipation.