Constipation (constipation) is defined as less than three bowel movements per week and severe constipation means less than one bowel movement per week. 
Constipation and bowel irregularity are things we do not usually or often talk about.
Those who have suffered from this problem know that it can be painful and frustrating.

Almost everyone has an episode of constipation during their lives.
Women and older people are the most affected compared to men.

The normal frequency of bowel movements varies greatly from person to person. Some people go to the bathroom three times a day, while others go only once or twice a week.




Constipation is divided into two types:

  • Acute or occasional constipation when the patient suffers from constipation only at this time but usually does not suffer from constipation, for example, it can be caused by a trip, it can be a post-surgery immobility effect or occurs in the post- (normal or cesarean section ).
  • The chronic constipation occurs if the symptoms are constant over time.



Causes of Constipation

To understand constipation, you need to know how the colon works. When food passes through the colon, it absorbs water from the food and creates solid waste products or feces.
Muscle contractions in the colon push the stool into the rectum.
Constipation occurs when the colon absorbs too much water or if the colon is lazy and the muscle contractions are slow. This way the feces move very slowly along the colon.
As a result, the stool can become hard and dry.

There is not enough fiber in the diet
People who eat a high fiber diet are less likely to get constipated.
The most common causes of constipation are a diet low in fiber or high in fat, such as meat, eggs and cheese.

Soluble and insoluble fiber is the part of fruits, vegetables and grains that the body can not digest.
Soluble fiber dissolves easily in water and has a soft, gelatinous texture in the intestine.
The insoluble fiber passes through the intestine almost unchanged.
The volume and smooth texture of the fiber helps prevent hard, dry stools and difficult to evacuate.
The American Dietetic Association recommends 20 to 35 grams of fiber per day.
Often children and adults eat lots of refined and processed foods from which the natural fiber has been removed.
Those who choose ready-to-eat or ready-made foods, for example for fast food, have a low-fiber diet.

Not drinking enough liquids
Research shows that even those who drink more do not always improve constipation, many people report a bit of relief if they drink liquids, such as water and lemon juice (it’s better in the morning).
Fluids add fluid to the colon and stool volume, so evacuation becomes more fluid.
People who have constipation problems should try to drink fluids every day. However, drinks that contain caffeine such as coffee and coke aggravate the symptoms, causing dehydration .
Alcohol is a drink that causes dehydration. It is important to drink fluids that moisturize the body, especially when taking caffeine.


Prolapse, intestinal intussusception or rectocele
The rectum may undergo anatomical changes to weaken the supporting musculature.
The possible causes are: surgery, childbirth, aging, overweight, etc.
A portion of the rectum can slide:

  • In the vagina , in this case, we speak of retocele, the prolapsed part down towards the vaginal opening. A woman may need to insert a finger into the vagina to push the rectum posteriorly when she is evacuating.
  • In itself , this disorder is called intussusception, or intestinal invagination, is the entry of one segment of the rectum over another.
  • Outside the anus , is the descent or prolapse of the rectum beyond the anal canal, does not affect the vagina.

In these cases, you may need surgery to place the rectum in its anatomical position.

Dolichos colon and megacolon
The term ” Dolichocolon ” means excessive length of the colon, mainly affects the
There are different opinions on the development of this disease, some people think it exists from birth, others believe it is the consequence of a disease.
This bowel anomaly favors the formation of fecal impaction (hard stools), constipation, pain in the belly on the left side, intestinal obstruction and, in severe cases can cause the volvo, ie, the twisting or rolling of the small intestine on itself.

The term ” megacolon ” means an increase in the internal diameter of the end portion of the large intestine, usually in the sigmoid colon or rectum.
The cause is the narrowing of a part of the colon where there is the absence of peristalsis (intestinal movement to advance the garbage to the anus).
The result is a dilation of the anterior portion of the colon because it decreases the progression of feces that accumulate by pressing the intestinal walls.


Constipation may be associated with serotonin reuptake inhibitor antidepressants such as Prozac (fluoxetine).

Lack of physical activity Lack of physical
activity can cause constipation, especially in the elderly, although doctors do not know why.
For example, constipation often occurs after an accident or during an illness when we need to stay in bed and can not work.

Some people become constipated by consuming milk and dairy products.

Irritable bowel syndrome (IBS)
People with irritable bowel syndrome suffer more often from constipation, in this case can be alternated with diarrhea , the patient may complain of pain in the spine .

A change in habits, such as when we travel. 
When we travel, our daily habits change.
This can have an effect on the digestive system and sometimes causes sudden constipation. The meals we eat at different times, wake up and go to bed at different times etc.

House Exchange
Women are often unable to evacuate for a week or two if they are going to live in another home.
The same happens if they sleep in the house of their fianc2ee, for some time do not feel at ease and are unable to defecate.
I noticed these things in several girls, unlike when they were 20, but 25-35 years old.
It is a psychosomatic effect that always happens, after a few days had to go to the doctor to take a laxative.
After the first time, she is accustomed to the new home and the new bathroom, then the old intestinal habits are restored.


Diseases that cause constipation

Diseases that can slow the movement of stool through the colon are as follows:

Neurological diseases
MS ( multiple sclerosis ), Parkinson’s disease , stroke , spinal cord injury, chronic idiopathic intestinal pseudo- obstruction .

Endocrine and metabolic disorders
Uremia, diabetes , hypercalcemia, high blood glucose, hypothyroidism .

Systemic diseases (diseases that affect different tissues and organs)
Lupus, scleroderma and amyloidosis.

Mostly due to chemotherapy and pain medications. A colon cancer also blocks or compresses the digestive system.

Other causes of constipation include:


Constipation during pregnancy

Constipation is a common problem during pregnancy. More than half of pregnant women are constipated.
One culprit is the increase in the hormone progesterone that relaxes smooth muscles throughout the body, including the digestive system.
This means that food passes more slowly through the intestines.
The problem can be aggravated later in pregnancy by the pressure of the uterus that is growing against the rectum.
Iron supplements, especially in high doses, can worsen constipation.


Constipation in children

In addition to irregular bowel movements, a child with constipation may also have the following signs and symptoms:

  • Loss of appetite ,
  • Lack of energy or fatigue ,
  • Being irritable, angry or sad,
  • Flatulence and stench in the stool,
  • Discomfort and abdominal pain,
  • A general feeling of malaise.


Symptoms associated with constipation

In addition to causing a change in normal bowel habits, constipation can also cause the following symptoms:

  • Cramps and stomach pain .
  • Constipation does not gain weight, but the patient has a swelling sensation ( swollen belly )
  • Defecation more difficult, serves an effort
  • Incomplete evacuation or feeling of not having emptied the bowel
  • Useless enemas and laxatives
  • Need for manual maneuver to remove feces
  • It can be accompanied by hemorrhoids ,
  • Loss of appetite.


When should we be concerned about the arrest of a soldier?

If you stay 6/7 consecutive days without evacuating the situation can become dangerous then you have to go to the doctor for a visit, especially if you are suffering from other diseases that affect peristalsis.
People who used to go to the bathroom every day should worry already after 3 days because the reason may not be food.


Are there chronic complications of constipation?

Sometimes an anal skin laceration (anal fissure) can occur if the stool is very bulky and hard.
There is a lot of pain and we can see the fresh red blood on the toilet paper.
The anal fissure treatment is laxatives and lifestyle changes to keep the stool soft.
The doctor may prescribe anesthetic creams or oils such as glyceryl trinitrate (nitroglycerin) to relieve pain.
Chronic constipation and prolonged use of laxatives can cause the lazy bowel, meaning it no longer works well without medication.
Constipation then becomes a vicious cycle and even more chronic.
Severe chronic constipation can cause an intestinal blockage.
This is most likely in the elderly and infirm. A large mass of hard stools (or faecal impaction ) blocks the rectum. The mass is too large to pass so the intestinal muscles can not push the stool out.


Do children need to do some exams?

Usually do not need exams to diagnose idiopathic constipation (no apparent cause).
The doctor should check your medical history and should visit the child to hear if there are feces in the gut. This may indicate if a lock exists.
If an obstruction is suspected, the doctor sends the child to the pediatrician or hospital for the exams.


Natural and Home Remedies for Constipation in Adults

Adults should drink a lot and exercise daily or at least 3 times a week for a proper bowel function.

The position can facilitate evacuation and make it more effective, the “Turkish” bathroom is ideal, alternatively you can put your feet on a stool or a headrest to increase abdominal compression.

The shiatsu can be very effective to have a complete evacuation, when you go to the bathroom you have to press a point on the back of the hand between the thumb and forefinger just below the second metacarpal. This favors evacuation and proper functioning of the large intestine.
Foods to eat for constipation are:

  • Plums
  • Flax Seed
  • Kiwi
  • Almonds
  • Pumpkin
  • Zucchini
  • Ginger
  • Walnuts
  • Blackberries


Over-the-counter laxatives for severe constipation

Use only these laxatives as a last resort.
There are several types of laxatives:

  • Stimulants – help to rhythmically contract the muscles of the intestine, for example Dulcolax
  • Lubricants – help the stool to fall more easily, for example mineral oil
  • Stool softeners – these moisturize (moisten) the stool
  • Fiber Supplements – are perhaps safer, laxatives such as Duefibra. You need to drink plenty of water when you take them.
  • Osmotic – facilitates fluid circulation throughout the colon, for example, Molaxole®
  • Saline laxatives – draw water into the colon, such as magnesium milk

Lactic bacteria
Probiotics and lactic ferments are used to regulate the intestinal bacterial flora and improve digestion, especially after taking antibiotics . In particular we recommend products that also contain Lactobacillus acidophilus and Bifidobacterium.

Pregnancy or breastfeeding
Pregnant women should change their diet by increasing fiber and drinking more.
If home remedies do not work, a laxative may be prescribed to pass stools more regularly.
There are several safe laxatives for pregnant women because they are not absorbed by the digestive system, so it does not affect pregnancy.
Laxatives that can be taken during pregnancy are those osmotic: lactulose, sorbitol.


Natural Remedies for Constipation in Infants and Children

Often, some simple changes in diet and lifestyle can relieve constipation in children:

What to eat? A diet high in fiber.
A high fiber diet can help your baby’s body form soft stools. The recommended intake of dietary fiber (dietary fiber) is 14 grams per 1,000 calories in the child’s diet.
For children, this results in an intake of about 20 grams of dietary fiber per day. For teenage girls and young women, it is 30 grams per day, while for teenagers it is about 40 grams per day.
You need to give your child foods high in fiber, such as beans, grains, fruits and vegetables.
A tablespoon of olive oil is one of the most effective remedies for constipation.

What are the foods to avoid? 
Among the foods that favor constipation are: milk, dairy products, meat, biscuits and sweets.

Enough fluids. 
Water and other fluids help soften the stool. Do not give too much milk to the baby because it contributes to constipation.
Encourage your child to sit in the restroom for 5/10 minutes after each meal. Keep this habit even on vacation during the summer.
Reward your child’s efforts, not the results.
Give children small prizes when they will evacuate.
Possible rewards include stickers, a special book or a game.
Do not punish a child because they have soiled their panties or underwear.

Children who drink only milk (newborn)
If your child is constipated but has not yet started eating solid foods, the first therapy to be done is to give water to drink more than the normal amount of breast milk.
If using milk powder, prepare the food as recommended by the manufacturer and do not dilute the mixture.
We recommend moving the child’s legs gently, as if he were riding a bike, and massaging his abdomen (belly) to stimulate the abdominal organs.

Children who are able to eat solid foods (after weaning)
If your child is at least 1-2 years old (or when he stops drinking milk) you should drink plenty of water or fruit juice.
Give the child lots of fruit, puree, fruit juice, depending on the ability to chew.
The best fruit for children is:

  • Apples,
  • Apricots,
  • Grapes,
  • Peaches,
  • Pears,
  • Plums,
  • Prunes,
  • Raspberries,
  • Strawberries.

Never force your child to eat food if she does not want it. If you insist, you can turn meals into a battle and the child can associate the meal with a negative and stressful experience.
In addition to eating fruit, children should have a well-balanced diet that includes vegetables and whole foods such as bread and pasta.
If your child is still constipated after changing the diet, the doctor may prescribe a laxative.
Mass builders are not suitable for children, it is usually advisable to have an osmotic laxative.
However, if this does not work, your doctor may prescribe a stimulant laxative.

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