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Constipation is a problem associated with the digestive system where the patients evacuate less than three bowel movements in a week. Mostly, the stool would be rigid or very dry. However, the severity and symptoms of constipation vary between individuals. Generally, it is described as discomfort or difficulty in bowel movement. Constipation invariantly affects the individual quality of life both physically and mentally.
Constipation is very common and may be treated by simple home remedies, supplements or medications. But for some cases, they may progress to chronic constipation. Signs and symptoms of chronic constipation includes:
It is a tool that categorizes the appearance of stools. It describes the size, shape, color, and consistency. The scale was developed in 1997 by a team of doctors at the British Royal Infirmary in Bristol, England. Since then it has been used as a tool in many gastrointestinal disorders.
The seven types of stool are:
| Stool Type | Description | |
| Type 1 | Separate hard lumps like nuts, difficult to pass | Observed during constipation |
| Type 2 | Sausage-shaped, similar to type 1 | Observed during constipation |
| Type 3 | Sausage-shaped but with cracks on the surface | Ideal stools and they are easily passed out |
| Type 4 | Like a sausage or snake, smooth and soft | Ideal stools and they are easily passed out |
| Type 5 | Soft blobs and smooth with clear-cut edges | Tending towards diarrhea |
| Type 6 | Mushy stool, fluffy pieces with ragged edges | Indicates diarrhea |
| Type 7 | Watery, no solid pieces, entirely liquid | Indicates diarrhea |
Factors that may increase the risk of chronic constipation includes:
Constipation occurs when the large intestine absorbs too much water from the stool, resulting in dry and hard stools. It may also be due to inadequate contraction of bowel walls to expel the waste product. There also several other factors which may lead to or worsen constipation:
Hormones in our body is crucial in maintaining the balance of fluids. Diseases such as diabetes, hyper- and hypo-parathyroidism cause imbalance of the hormones which may lead to constipation.
Some drugs that may cause constipation:
Diagnosis is done to find out the cause of constipation by asking the patients about symptoms, family and medical history and their regular habits. Based on the answers, physical examinations and tests are then carried out by healthcare professionals. Some key questions include:
Physicians may also find out more about your medical history, such as:
Questions about daily routine include:
From the above information, healthcare professionals will then recommend the appropriate treatment or lifestyle changes. If the problem persists, further tests would be required such as blood test, urine test, stool test or imaging tests. Endoscopy may also be performed to find out the underlying reason for constipation.
Here are some ways to prevent constipation:
Constipation is not a life-threatening disease or disorder. However, chronic constipation may have serious complications which include:
Most often, acute or short-term constipation does not require much medical interventions. But in some cases, it may develop into a chronic condition where it may require medical intervention and greater lifestyle modifications. Some medications that healthcare professionals may provide are laxatives to encourage bowel movement, or steroid-containing ointment for treating hemorrhoids that arise from constipation.
However, medications should not be relied on in the long term. Drinking enough liquids and ensuring sufficient fiber in the diet are some ways to promote bowel movement.
In addition, a high fiber diet, not only benefits the bowel, it may promote healthy cholesterol levels, among many other health benefits. A change in lifestyle like allocating a specific time for bowel movement may be helpful. In severe cases, surgical intervention may be needed to treat constipation.
Laxatives
Most of the time, laxatives are commonly prescribed for the treatment of constipation to promote bowel movement. However, overuse of laxatives may result in the bowel's dependency on the medications and result in decreased bowel movement when the medication is stopped. Laxatives are also not recommended in certain groups of people such as pregnant mothers.
Topical Steroids
Steroidal ointments are prescribed for relief of itching, swelling and inflammation caused by anal fissure and hemorrhoids. Steroids may cause changes to the skin such as thinning when used for long term.
