Bowel Health - Constipation

Nobody likes to talk about bowel health, and especially constipation, but bowel health is very important to our overall health. Constipation is a digestive problem in which you pass hard bowel movements. People who are constipated may empty their bowels infrequently. They often have to strain to have a BM.

How often should I move my bowels?

It is different for everyone. What is normal bowel habits for you, may not be what is normal for someone else. Some people "go" 3 times a day, while others go once a day or as infrequently as 3 times a week. If this is normal for you, there is not a problem. Generally speaking, though, if you have infrequent bowel moments that are hard and uncomfortable to pass you probably have a problem with constipation.

What causes constipation?

Your intestines are designed to move ingested food along your digestive tract. Your colon, which is another name for your large intestine, is designed to absorb the water and salt out of your fecal material, where it is filtered back into your blood stream to be used for your other bodily functions, before the water is finally eliminated through the urinary tract as urine.

You may become constipated if too much water is absorbed. Some people have a problem with muscle coordination of the colon, which is called animus. With this problem, your fecal material gets hung up in the rectal vault, and as a result the stool stays locked in the rectum, losing water to absorption, causing a hard blockage.

The factors that influence bowel health are age, level of activity, diet and lifestyle, inattention to bowel habits, illness, medications and pregnancy. Medications are notorious for causing constipation because they slow down the frequency of the natural peristaltic contractions.

Older people are more likely to be bothered by constipation because they may not drink enough water, and they may be living a more sedentary lifestyle. People who have serious illnesses and injuries, such as fractures, and had endured corrective surgery, may be on varying degrees of bed rest, which adds to the risk of constipation due to immobility.

When should I seek medical help?

You should go to your doctor when and if your bowel habits do not improve, even after you have taken corrective measures, through exercise, diet and fluid intake. If you have alternating episodes of constipation and diarrhea, this could be a sign of irritable bowl syndrome, or some other problem that your doctor should know about. If you discover that you have blood in your stool, have abdominal pain, pain in the rectum you should report this to your doctor. Also, if you have an unexplained weight loss, you should let your doctor know. He may want to do an examination to see if you have a potential problem.

How is constipation diagnosed?

If you have a problem with constipation that does not resolve itself through lifestyle changes you may need to see your physician. Your doctor may want to do a digital exam of your rectum to check for the presence of a fecal impaction. Most impactions are easily removed via an enema, followed by a mild laxative. If constipation persists, your doctor may ask you to submit to some diagnostic tests, which include:

1.
Stool analysis-to check for the presence of occult blood, which may be an indicator of other problems within the colon or rectum.
2.
Sigmoidoscopy-the examination is performed through a lighted flexible tube that is inserted into the rectum and lower portion of the colon. This can be done in the doctor's office.
3.
Barium enema-an enema containing a contrast medium is instilled into the rectum and colon so that it is visible in an X-ray.
4.
Colonoscopy-an examination of the entire colon with a flexible tube equipped with a camera. The doctor can examine the colon via a computer monitor. For this procedure, the patient is usually admitted to the hospital as an outpatient.
5.
Anorectal manometry-for this procedure the doctor inserts a narrow tube equipped with an inflatable balloon, which measures the coordination of the muscles that move the bowel. This test is done when the doctor suspects a dysfunction of the pelvic floor.

Are there complications associated with constipation?

Constipation usually isn't serious, but chronic constipation and straining to have a BM can cause you to develop hemorrhoids or rectal fissures, which are cracks and tears that develop in the anal tissue. Hemorrhoids, cracks and fishers can be very painful. Patients have reported the pain is such that it feels like they are trying to pass razor blades through the rectum.

Another complication was hinted at earlier in this article. Fecal impactions are a very real problem with chronic constipation. A few years ago my daughter had to go to the emergency room. I thought she was having an attack of appendicitis. I was embarrassed to know that she had not had a bowel movement in three weeks! That is all that was wrong with her! An enema and 2 bottles of citrate of magnesia later, she was fine. For some people even a load of dynamite wouldn't relieve them, and surgery is needed to remove a fecal obstruction.

The safest way to relieve constipation is to make lifestyle changes that include drinking 8 to 10 glasses of water a day. Your doctor may suggest fiber supplements to be taken in conjunction with a fiber enriched diet. Exercise is very important! Walking just 10 to 15 minutes a day can help regulate the bowel. Your doctor may suggest you take a stool softener such as colace, or mineral oil, or a mild laxative like milk of magnesia. If you take mineral oil, be very careful. Do not take it at bedtime or before lying down any time, due to the risk of aspirating mineral oil into the respiratory tract, which can cause a very serious form of pneumonia.

Remember, to prevent constipation, you should make lifestyle changes. This means to eat lots of fruits and vegetables, drink lots of water. Drink even when you are not thirsty, because we don't always get enough water when we depend on our thirst to tell us when to drink. Drinking 8 to 10 glasses of water a day is sufficient, unless otherwise stated by your physician.

If you are easily constipated, you should limit foods that are high in fat and sugar. Cheese is known to be a constipating food because it is loaded with fat. When you feel the urge to "go" don't put it off. The longer you wait to evacuate the harder your stool will become, because your fecal material loses water through absorption.

Before using laxatives and fiber supplements, be sure to consult with your doctor. It is important not to rely on laxatives because they cause dependency. When the bowel becomes dependent on laxatives to move, the bowel becomes lazy and will not move easily without them. It should never be embarrassing to talk to your doctor about your bowel health.

Source: The Mayo Clinic web page