Constipation

Constipation is a functional disorder of the gastrointestinal tract. It can mean different things to different people, but common manifestations include:

• Reduced frequency of bowel motions.
• Increased stool consistency and volume.
• Delayed stool transit through the gastrointestinal tract.
• Increased effort required to evacuate stools.

It is important to recognize that bowel habits are unique to each individual. While some people may have daily bowel movements, others might go every few days. When this regular pattern is disrupted, it is essential to seek urgent medical attention to rule out serious causes of constipation.

When stools become hard, excessive straining may be necessary for evacuation, which can lead to other anorectal problems, including:

• Anal fissures.
• Haemorrhoid disease.
• Abdominal discomfort or pain.
• Hernia development.

Laxatives can help treat constipation; however, long-term use may lead to dependency and a "lazy bowel." Therefore, medical advice should be sought to address potential underlying causes.

Benign Causes of Constipation

• Insufficient water intake.
• Low-fiber, high-fat diet.
• Stress.
• Inactive lifestyle.
• Pregnancy.
• Use of opioid medications.

Fibre and Constipation

Fibre plays a crucial role in managing constipation and maintaining overall gut health. It absorbs water into the stool, providing bulk and facilitating easier, more consistent bowel movements. However, excessive fibre intake can cause bloating and loose stools.

Fibre is categorized into two types:

• Soluble     Fibre:
   
  • Made of low-molecular-weight polysaccharides with a high capacity to retain water.
   
  • Found in oat bran, barley, nuts, seeds, beans, lentils, peas, and some fruits and vegetables. Psyllium, a common fibre supplement, is also a good source.
 
• Insoluble     Fibre:
   
  • Composed of high-molecular-weight polysaccharides.
   
  • Found in wheat bran, vegetables, and whole grains.

Recommendations:

• Adults should consume up to 25g of fibre daily (2/3 soluble, 1/3 insoluble).
• Water intake of up to 2L per day is equally important to maintain stool consistency and bulk. However, individuals with conditions requiring fluid restrictions should consult their healthcare provider.

Tests and Examination

A thorough history is crucial to evaluate the onset of constipation and identify potential triggers. During your consultation, an examination of the rectum (back passage) may be performed to rule out blockages.

Dr. Petrushnko may recommend the following diagnostic tests:

• Colonoscopy: To assess the colon and exclude structural or pathological causes.
• Imaging Studies: Such as an abdominal X-ray or CT scan for further evaluation.

Treatment

The cornerstone of constipation management is adopting a balanced lifestyle and diet, which includes:

• Increasing fluid consumption.
• Following a high-fibre, low-fat diet.
• Engaging in regular physical activity.
• Using  fibre supplements as needed.

Laxative use should be carefully discussed with your general practitioner or your surgeon, Dr. Petrushnko, to ensure appropriate management tailored to your needs.