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Constipation

What is constipation?

Constipation is defined as the combination of:

  • Less than 3 bowel motions a week

  • Straining required for defecation

  • Firm small pebble like stools

 

What are the causes of constipation?

There are several factors that contribute to constipation:

  • Sedentary lifestyle

  • Low fluid intake

  • Low fibre intake

  • Stress and anxiety

  • Changes in daily routine

  • Medical Conditions

  • Pregnancy

  • Medications

  • Advanced age

  • Others

 

What are the complications of constipation?

  • Faecal impaction

  • Faecal incontinence

  • Haemorrhoids

  • Rectal prolapse

  • Urinary retention or incontinence

 

When should I see my doctor?

Constipation becomes an abnormal symptom requiring review with your Doctor when it is associated with:

  • Change in bowel habits

  • Bleeding

  • Abdominal pain

  • Weight loss

  • Loss of appetite

  • Straining to defecate

  • Feeling of something blocking the bowels from emptying

  • Unable to pass any motion or wind

  • It is causing you concern

 

What tests may I need to have?

  • medical history & physical examination

  • colonoscopy

  • radiology (for rarer causes of constipation)

    • colonic transit studies

      • performed either by you taking a tablet containing markers, then having a series of x-rays or having a nuclear medicine scan after taking combined liquid and solid meal (containing radio isotope).  These tests require x-rays or scans over a period of 5-6 days.

    • anorectal mamometry

      • test the anal sphincter muscle by placing a catheter in the anus

How is Constipation treated?

General

  • high fibre diet

    • adds bulk to the stools assisting with transit of stools

    • recommended intake is at least 30 grams per day

    • foods high in fibre: cereal, fruit, vegetables, nuts, seeds, legumes (lentils/beans)

  • regular fluid intake

    • healthy adults recommended at least 2L of water per day

  • regular exercise

    • at least 20 minutes on three occasions each week

  • regular toileting regime

  • exclude medical causes

  • discuss medications causing constipation with your doctor

Medication

  • fibre supplements

  • aperients