Constipation — When Your Gut Goes Slow-Mo

Your digestive system can, at times, behave like that stubborn teammate who refuses to move, even with a little push.  Rightly so, constipation ends with long hours in the toilet and lots of pushing, huffing and puffing.  It can be a test of patience and perseverance for many. After battling years of constipation, many people lose hope and accept it as a part of their lifestyle. With that as the core, let us discuss constipation causes, related symptoms, and constipation treatment. 

Constipation is a gastrointestinal (GI) issue that causes three or fewer bowel movements per week. It may be associated with straining while passing stools, the passage of hard or lumpy stools, a feeling of incomplete evacuation of stools, a sensation of anorectal blockage, and the use of manual manoeuvres to facilitate stool evacuation. The passage of stools may be painful in some cases. Constipation can affect all ages, from children to adults, and can be transient at times.

Constipation usually progresses in stages — each with a specific cause. The primary issue is the gradual slowing down of the excreta — the residues from the digested food — as it passes through the colon.

Functional constipation affects children and young adults. Bowel movements are infrequent, and passing stools is difficult; however, this is not accompanied by structural changes in the gut and could be caused by external factors such as fever, dehydration, changes in diet, psychological concerns, prolonged episodes of pain, poor toilet training, certain meds and a family history of constipation.

Chronic constipation lasts for years and usually doesn't have any apparent reasons but may have clear physiological and anatomical reasons.

The secondary subtype has specific constipation causes and can be attributed to medicines, certain diseases, dietary concerns or structural abnormalities in the GI tract. 

The slow passage of stools and erratic bowel movements may not happen overnight. That said, constipation has many risk factors that you need to look out for:

• Poor water intake: A dehydrated body produces hard, dry stools that are difficult to pass.
• Low-fibre diet: Less fibre reduces the bulk of the stools, making their movement difficult. 
• Inactive, sedentary lifestyle: Prolonged hours of inactivity and lying down, slowing digestion and initiating constipation.
• Medicines: Certain medications cause constipation as a side effect.
• Underlying gut problems: IBS (irritable bowel syndrome), hypothyroidism, diabetes, etc., may be associated with constipation.

To sum it up, here are the typical constipation symptoms:

• Infrequent bowel movements (fewer than three times per week)
• Having difficulty passing faeces
• Abdominal bloating or pain
• Feeling full and uncomfortable - like that of incomplete evacuation of bowel motions
• Difficulty in passing flatus (farting) 

In severe cases, there can be bleeding near the anus, blood in the stools, severe abdominal pain and weight loss that warrants a colonoscopic evaluation.

Eventually, chronic constipation affects psychological and overall health and may manifest in the following ways:

• Perpetually feeling low on energy
• Skin issues
• Hairfall and poor scalp health
• Unexpected mood swings

Constipation symptoms must raise a red flag, especially when there is new onset constipation in an elderly person. It is best to act early and reverse it while in its early stages to avoid complications.

It is not rocket science — to avoid constipation, avoid the causative factors unless you have an underlying gut issue that causes constipation and demands professional treatment. Poor gut health and related discomfort from constipation affect more than your physical self — they affect your happiness and the freedom to enjoy meals. Some of the best ways to prevent constipation can begin at home.

It’s best to wake up and hydrate yourself with warm water; 2-3 glasses will fight the dehydration from the 8 hours of zero water. Stay hydrated throughout the day and eat fibre-rich meals on time. This includes vegetarian protein sources such as chickpeas, pulses with skin and fresh green veggies.

Choose an activity that you will not hate — it could be sports like cycling and swimming, walking, or free-hand exercises.

Above all, remember to work closely with your physician and dietician if you notice prolonged constipation-related issues.

Constipation, though common, is fairly neglected. Remember that sudden onset of constipation can be the sign of an underlying issue, so it is always best practice to reach out to a physician before shit hits the fan.  Avoid OTC laxatives and random constipation-friendly diets off the internet if you do not want to deal with side effects. 

The common symptoms of constipation include erratic bowel movements (less than three times per week), difficulty passing stools, related abdominal bloating or pain and feeling bloated and uncomfortable — like that of incomplete discharge of bowels.

The typical causes of constipation include dehydration, a low-fibre diet, a sedentary lifestyle, poor sleep, erratic meal times or certain meds.

The best way to treat constipation is to consult a physician and evaluate your gut health. Working closely with the doctor and a dietitian, routine meals, water intake, and fibre-rich meals can relieve constipation.

Lifestyle changes that can help relieve constipation include staying active, drinking plenty of water, eating fibre-rich meals, sleeping well, and managing stress. 

Fibre-rich diets and vegetarian protein sources like chickpeas, pulses with skin, fresh green veggies, etc. with good hydration, can alleviate constipation.

Yes, certain medications cause or worsen constipation, like opioids, antidepressants, antacids, etc.