Constipation, although not a disease but a symptom, has a significant impact on the daily lives of many people. According to a survey by the Hellenic Foundation of Gastroenterology and Nutrition, it affects 16% of the adult population, while one in five Greeks has been confronted with this annoying problem at least once in the past. Among the elderly, the percentage is 33% and 70% of cases involve women.
These data make it clear that constipation is a problem that we cannot afford to ignore.
What is constipation?
Constipation is defined as a reduction in stools to less than 3 per week or the need to apply significantly increased pressure to achieve defecation.
According to experts, a person is classified as constipated when they have at least two of the following symptoms for 3 months in the last six months.
- Hard stools
- Feeling of incomplete bowel movements (1 in 4 bowel movements)
- Difficulty in emptying and abdominal pain
- 1-2 stools per week
- Feeling of rectal obstruction
What are the causes of constipation?
Constipation is usually related to diet and lifestyle, but it can also be caused by diseases or medicines.
The most common causes are:
- A diet low in fibre i.e. low in fruit, vegetables and legumes and high in animal fats
- Reduced fluid intake
- Sedentary life
- Changes in daily habits such as travelling, change of job, slimming diets
- Involuntary inhibition of the desire to defecate, which some people do either because they do not want to use foreign toilets or because they are busy. This often happens in children, who postpone bowel movements because they do not want to interrupt their play.
Other causes that can lead to constipation are:
- Hormonal changes in pregnancy and menopause
- Age progression due to slowing of the metabolism, often accompanied by reduced physical activity and changes in diet
- Irritable bowel syndrome (spastic colitis)
- Use of medicines that have constipation as a side effect, such as iron preparations, antacids containing aluminium and calcium, certain antihypertensive (calcium antagonists, diuretics), certain painkillers or antiparkinsonian drugs.
- Increased and chronic use of laxatives because the bowel becomes dependent on them for motility
- Various pathological conditions such as neurological and psychological disorders (Parkinson’s disease, multiple sclerosis, depression, etc.), various systemic diseases (diabetes mellitus, hypothyroidism, etc.) and anatomical or functional disorders of the rectal region (intestinal obstructions, strictures, etc.).
What experts suggest for the treatment of constipation
In most cases, changes in diet and daily habits can help prevent constipation and relieve symptoms.
- Follow a balanced diet rich in fibre.
The fibre dissolves in water forming a gel which causes the intestinal contents to increase in weight and volume and soften. This leads to an increase in bowel motility and improved passage of stool.
The daily needs of the body are met by the intake of 25-35 g of fibre per day. Foods rich in fibre are fresh fruit and vegetables, bread and wholemeal pasta, legumes, especially lentils, and all bran cereals.
You can accompany your main meal with a large salad with a variety of vegetables and include fruit such as orange, kiwi or apple in your daily diet.
An alternative is psyllium, which comes from the plantago plant, belongs to the soluble fibre family and is known for its mild laxative action.
Although fibre helps the bowel function, it is advisable to increase the intake gradually in order to avoid bloating and flatulence.
- Consume about 2 litres of fluids per day.
Fluids are important because they soften the intestinal contents and help the action of fibre. You can alternate water with other liquids such as soups, fruit juices and tea. Prefer mineral water because it contains magnesium which has a mild laxative effect.
- Increase physical activity by putting exercise in your life. It is advisable to follow an exercise program 3-4 times a week of about 30 minutes duration. But even short walks or simple exercises help to maintain the mobility of the bowel muscles.
- Maintain proper functioning of the intestinal flora by consuming foods rich in probiotics such as yogurt, sour milk, kefir, and dark chocolate.
- Educate your gut.
The gut is an organ that loves good habits. Get in the habit of going to the bathroom at the same time every time, even if you don’t have the stimulus. Never suppress your need to go to the toilet because if you ignore the stimulus to defecate you may over time stop feeling it.
- Allow yourself small relaxation interludes during the day. Relaxation affects proper bowel activity while stress inhibits it.
If changes in daily habits do not relieve your constipation symptoms, seek medical help. The doctor will diagnose the cause and recommend the appropriate treatment.
- Mogan Trottier et al, Treating constipation during pregnancy, Canadian Family Physicians, Vol 58, August 2012