What are the symptoms of constipation. How can constipation be prevented. What causes chronic constipation. When should you see a doctor for constipation. How is constipation diagnosed and treated. Can constipation lead to complications. What are the best home remedies for constipation.

Understanding Constipation: More Than Just Infrequent Bowel Movements

Constipation is a common gastrointestinal issue that affects millions of people worldwide. While it’s often defined as having fewer than three bowel movements per week, the reality is more complex. Every individual has a unique bowel pattern, and what’s normal for one person may not be for another.

The key characteristics of constipation include:

• Dry and hard stools
• Painful and difficult bowel movements
• A feeling of incomplete evacuation

Is constipation always a cause for concern? Not necessarily. Occasional constipation is common and often resolves on its own. However, chronic constipation can lead to discomfort and potential complications if left untreated.

The Physiology Behind Constipation: Why Does It Happen?

To understand constipation, we need to delve into the digestive process. As food moves through the digestive tract, nutrients are absorbed in the small intestine. The remaining waste then enters the large intestine, or colon, where water is absorbed to form solid stool.

Constipation occurs when:

1. Food moves too slowly through the digestive tract
2. The colon absorbs too much water from the waste
3. The resulting stool becomes dry, hard, and difficult to pass

This slow transit time can be influenced by various factors, including diet, lifestyle, medications, and underlying health conditions.

Recognizing the Signs: Symptoms of Constipation

How can you tell if you’re constipated? While individual experiences may vary, common symptoms include:

• Infrequent bowel movements (less than three times a week)
• Straining during bowel movements
• Hard or lumpy stools
• Feeling of blockage in the rectum
• Need for manual maneuvers to facilitate bowel movements
• Abdominal discomfort or bloating

Do these symptoms always indicate constipation? Not necessarily. It’s essential to consider your normal bowel habits and any recent changes in diet or lifestyle.

Unraveling the Causes: Why Am I Constipated?

Constipation can stem from various factors, often interacting in complex ways. Understanding these causes is crucial for effective prevention and treatment.

Lifestyle Factors Contributing to Constipation

• Low-fiber diet
• Inadequate fluid intake
• Lack of physical activity
• Ignoring the urge to have a bowel movement
• Stress and anxiety
• Changes in routine (e.g., travel, altered sleep patterns)

Medical Conditions Associated with Constipation

Can underlying health issues cause constipation? Absolutely. Several medical conditions can contribute to or exacerbate constipation:

• Irritable Bowel Syndrome (IBS)
• Hypothyroidism
• Diabetes
• Parkinson’s disease
• Multiple sclerosis
• Spinal cord injuries
• Diverticulosis
• Colon cancer

Medications That May Cause Constipation

Certain medications can slow bowel movements or lead to constipation as a side effect. These include:

• Opioid pain relievers
• Antidepressants
• Anticonvulsants
• Calcium channel blockers
• Iron supplements
• Antacids containing aluminum or calcium

Are you taking any of these medications and experiencing constipation? It’s crucial to consult your healthcare provider before making any changes to your medication regimen.

The Impact of Age and Gender on Constipation Risk

Constipation doesn’t affect everyone equally. Certain demographic factors can increase the likelihood of experiencing this condition:

Age-Related Constipation

Why does constipation become more common as we age? Several factors contribute:

• Decreased muscle tone in the digestive tract
• Reduced physical activity
• Slower metabolism
• Increased use of medications that may cause constipation
• Chronic health conditions that affect bowel function

Gender Differences in Constipation Prevalence

Studies show that women are more likely to experience constipation than men. This gender disparity can be attributed to:

• Hormonal fluctuations during menstrual cycles
• Pregnancy and postpartum changes
• Higher rates of certain gastrointestinal disorders in women
• Pelvic floor disorders affecting bowel function

Does this mean men are immune to constipation? Not at all. While less common, men can still experience constipation and should be aware of its symptoms and causes.

Diagnosing Constipation: When to Seek Medical Attention

While occasional constipation is common, chronic or severe cases may require medical evaluation. When should you consult a healthcare provider?

• Constipation lasting more than three weeks
• Severe abdominal pain
• Blood in the stool
• Unexplained weight loss
• Persistent changes in bowel habits
• Constipation alternating with diarrhea

During a medical evaluation for constipation, your healthcare provider may:

1. Review your medical history and symptoms
2. Perform a physical examination, including a digital rectal exam
3. Order blood tests to check for underlying conditions
4. Recommend imaging studies like X-rays or colonoscopy in certain cases

Is a colonoscopy always necessary for constipation? Not typically. However, your doctor may recommend one if they suspect a more serious underlying condition or if you’re due for routine colon cancer screening.

Treatment Approaches: Alleviating Constipation

The treatment of constipation often involves a multi-faceted approach, combining lifestyle changes, dietary modifications, and sometimes medications.

Lifestyle and Dietary Changes

• Increasing fiber intake (aim for 25-30 grams per day)
• Staying well-hydrated
• Engaging in regular physical activity
• Establishing a regular toilet routine
• Avoiding prolonged toilet sitting
• Managing stress through relaxation techniques

Over-the-Counter Remedies

Several OTC options are available for occasional constipation relief:

• Bulk-forming laxatives (e.g., psyllium)
• Osmotic laxatives (e.g., polyethylene glycol)
• Stimulant laxatives (e.g., bisacodyl)
• Stool softeners (e.g., docusate sodium)

Are these medications safe for long-term use? While generally safe for short-term relief, prolonged use of certain laxatives can lead to dependence or electrolyte imbalances. Always consult your healthcare provider before starting any new treatment regimen.

Prescription Medications for Chronic Constipation

In cases of severe or chronic constipation, your doctor may prescribe medications such as:

• Lubiprostone (Amitiza)
• Linaclotide (Linzess)
• Plecanatide (Trulance)
• Prucalopride (Motegrity)

These medications work by increasing fluid secretion in the intestines or enhancing muscle contractions to promote bowel movements.

Preventing Constipation: Proactive Measures for Digestive Health

Prevention is often the best approach when it comes to constipation. By adopting healthy habits, you can reduce your risk of experiencing this uncomfortable condition.

Dietary Strategies for Constipation Prevention

A fiber-rich diet is crucial for maintaining regular bowel movements. Include the following in your daily meals:

• Whole grains (e.g., oats, quinoa, brown rice)
• Fruits (e.g., apples, pears, berries)
• Vegetables (e.g., broccoli, carrots, leafy greens)
• Legumes (e.g., beans, lentils, chickpeas)
• Nuts and seeds

How much fiber do you need? The recommended daily intake is 25-30 grams for adults. Increase your fiber intake gradually to avoid bloating and gas.

Hydration and Its Role in Preventing Constipation

Adequate fluid intake is essential for preventing constipation. Water helps soften stool and promotes regular bowel movements. Aim for:

• 8-10 glasses of water per day
• Herbal teas and clear broths
• Water-rich fruits and vegetables

Should you avoid caffeine and alcohol? While these beverages can have a mild diuretic effect, moderate consumption is generally not a concern for constipation. However, they should not replace water as your primary source of hydration.

Exercise and Physical Activity

Regular physical activity can stimulate bowel function and reduce the risk of constipation. Consider incorporating:

• 30 minutes of moderate exercise most days of the week
• Walking, swimming, or cycling
• Yoga or stretching exercises

How does exercise help prevent constipation? Physical activity stimulates the muscles in your intestines, promoting regular bowel movements and reducing transit time.

Complications of Chronic Constipation: Understanding the Risks

While occasional constipation is usually harmless, chronic constipation can lead to several complications if left untreated:

• Hemorrhoids: Swollen veins in the rectum caused by straining
• Anal fissures: Tears in the lining of the anus
• Fecal impaction: A large, hard mass of stool that becomes stuck in the colon
• Rectal prolapse: When part of the rectum protrudes from the anus
• Diverticular disease: Formation of small pouches in the colon wall

Can chronic constipation lead to more serious conditions? In rare cases, severe chronic constipation may increase the risk of colorectal cancer. However, this link is not fully understood and requires further research.

Special Considerations: Constipation in Pregnancy and Childhood

Certain life stages can present unique challenges when it comes to constipation.

Pregnancy and Constipation

Why is constipation common during pregnancy? Several factors contribute:

• Hormonal changes that slow digestion
• The growing uterus putting pressure on the intestines
• Iron supplements often prescribed during pregnancy
• Reduced physical activity in some cases

Managing constipation during pregnancy often involves dietary changes, increased fluid intake, and safe exercise. Always consult your healthcare provider before using any medications or supplements during pregnancy.

Childhood Constipation

Constipation in children can be caused by:

• Dietary factors (e.g., low fiber intake, excessive dairy consumption)
• Toilet training issues
• Withholding stool due to pain or fear
• Medications
• Underlying medical conditions

Treatment for childhood constipation may include dietary changes, behavioral modifications, and in some cases, medications prescribed by a pediatrician.

Emerging Research and Future Directions in Constipation Management

The field of gastroenterology continues to evolve, with ongoing research into new treatments and management strategies for constipation.

Microbiome and Constipation

Recent studies have explored the role of gut bacteria in constipation. Can probiotics help? While some research suggests potential benefits, more studies are needed to determine the most effective strains and dosages for constipation relief.

Biofeedback Therapy

This technique helps patients learn to relax and coordinate the muscles involved in bowel movements. It shows promise for treating certain types of constipation, particularly those related to pelvic floor dysfunction.

Novel Pharmacological Approaches

Researchers are investigating new medications that target specific receptors in the digestive system to promote motility and ease constipation.

As our understanding of constipation continues to grow, we can expect more targeted and effective treatment options in the future. However, for most people, a combination of lifestyle changes, proper diet, and appropriate medical care when needed remains the cornerstone of constipation management.

Remember, while constipation is a common issue, chronic or severe symptoms should always be evaluated by a healthcare professional. By understanding the causes, symptoms, and management strategies for constipation, you can take proactive steps to maintain your digestive health and overall well-being.

Constipation; Symptoms, Causes, Treatment & Prevention

Overview

What is constipation?

Having fewer than three bowel movements a week is, technically, the definition of constipation. However, how often you “go” varies widely from person to person. Some people have bowel movements several times a day while others have them only one to two times a week. Whatever your bowel movement pattern is, it’s unique and normal for you – as long as you don’t stray too far from your pattern.

Regardless of your bowel pattern, one fact is certain: the longer you go before you “go,” the more difficult it becomes for stool/poop to pass. Other key features that usually define constipation include:

• Your stools are dry and hard.
• Your bowel movement is painful and stools are difficult to pass.
• You have a feeling that you have not fully emptied your bowels.

How common is constipation?

You are not alone if you have constipation. Constipation is one of the most frequent gastrointestinal complaints in the United States. At least 2.5 million people see their doctor each year due to constipation.

People of all ages can have an occasional bout of constipation. There are also certain people and situations that are more likely to lead to becoming more consistently constipated (“chronic constipation”). These include:

• Older age. Older people tend to be less active, have a slower metabolism and less muscle contraction strength along their digestive tract than when they were younger.
• Being a woman, especially while you are pregnant and after childbirth. Changes in a woman’s hormones make them more prone to constipation. The baby inside the womb squishes the intestines, slowing down the passage of stool.
• Not eating enough high-fiber foods. High-fiber foods keep food moving through the digestive system.
• Taking certain medications (see causes).
• Having certain neurological (diseases of the brain and spinal cord) and digestive disorders (see causes).

How does constipation happen?

Constipation happens because your colon absorbs too much water from waste (stool/poop), which dries out the stool making it hard in consistency and difficult to push out of the body.

To back up a bit, as food normally moves through the digestive tract, nutrients are absorbed. The partially digested food (waste) that remains moves from the small intestine to the large intestine, also called the colon. The colon absorbs water from this waste, which creates a solid matter called stool. If you have constipation, food may move too slowly through the digestive tract. This gives the colon more time – too much time – to absorb water from the waste. The stool becomes dry, hard, and difficult to push out.

Pathway of food waste through colon, rectum and anus.

Can constipation cause internal damage or lead to other health problems?

There are a few complications that could happen if you don’t have soft, regular bowel movements. Some complications include:

• Swollen, inflamed veins in your rectum (a condition called hemorrhoids).
• Tears in the lining of your anus from hardened stool trying to pass through (called anal fissures).
• An infection in pouches that sometimes form off the colon wall from stool that has become trapped and infected (a condition called diverticulitis)
• A pile-up of too much stool/poop in the rectum and anus (a condition called fecal impaction).
• Damage to your pelvic floor muscles from straining to move your bowels. These muscles help control your bladder. Too much straining for too long a period of time may cause urine to leak from the bladder (a condition called stress urinary incontinence).

Does not having regular bowel movements cause toxins to build up in my body and make me sick?

Don’t worry, this usually isn’t the case. Although your colon holds on to stool longer when you are constipated and you may feel uncomfortable, the colon is an expandable container for your waste. There is possibly a slight risk of a bacterial infection if waste gets into an existing wound in the colon or rectum.

Symptoms and Causes

What causes constipation?

There are many causes of constipation – lifestyle choices, medications, medical conditions, and pregnancy.

Common lifestyle causes of constipation include:

• Eating foods low in fiber.
• Not drinking enough water (dehydration).
• Not getting enough exercise.
• Changes in your regular routine, such as traveling or eating or going to bed at different times.
• Eating large amounts of milk or cheese.
• Stress.
• Resisting the urge to have a bowel movement.

Medications that can cause constipation include:

• Strong pain medicines, like the narcotics containing codeine, oxycodone (Oxycontin®) and hydromorphone (Dilaudid®).
• Nonsteroidal anti-inflammatory drugs, like ibuprofen (Advil®, Motrin®) and naproxen (Aleve®).
• Antidepressants, including the selective serotonin reuptake inhibitors (like fluoxetine [Prozac®]) or tricyclic antidepressants (like amitriptyline [Elavil®]).
• Antacids containing calcium or aluminum, such as Tums®.
• Iron pills.
• Allergy medications, such as antihistamines (like diphenhydramine [Benadryl®]).
• Certain blood pressure medicines, including calcium channel blockers (like verapamil [Calan SR], diltiazem [Cardizem®] and nifedipine [Procardia®]) and beta-blockers (like atenolol [Tenormin®]).
• Psychiatric medications, like clozapine (Clozaril®) and olanzapine (Zyprexa®).
• Anticonvulsant/seizure medications, such as phenytoin and gabapentin.
• Antinausea medications, like ondansetron (Zofran®).

Many drugs can cause constipation. Ask your doctor or pharmacist if you have any questions or concerns.

Medical and health conditions that can cause constipation include:

• Endocrine problems, like underactive thyroid gland (hypothyroidism), diabetes, uremia, hypercalcemia.
• Colorectal cancer.
• Irritable bowel syndrome (IBS).
• Diverticular disease.
• Outlet dysfunction constipation. (A defect in the coordination of pelvic floor muscles. These muscles support the organs within the pelvis and lower abdomen. They are needed to help release stool.)
• Neurologic disorders including spinal cord injury, multiple sclerosis, Parkinson’s disease, and stroke.
• Lazy bowel syndrome. The colon contracts poorly and retains stool.
• Intestinal obstruction.
• Structural defects in the digestive tract (like fistula, colonic atresia, volvulus, intussusception, imperforate anus, or malrotation.)
• Multiple organ diseases, such as amyloidosis, lupus, and scleroderma.
• Pregnancy.

What are the symptoms of constipation?

Symptoms of constipation include:

• You have fewer than three bowel movements a week.
• Your stools are dry, hard and/or lumpy.
• Your stools are difficult or painful to pass.
• You have a stomach ache or cramps.
• You feel bloated and nauseous.
• You feel that you haven’t completely emptied your bowels after a movement.

Diagnosis and Tests

What should I expect when I talk to my doctor about my constipation?

Talking to your doctor – or anyone – about your bowel movements (or lack of them) is not the most pleasant of topics. Know that your doctor is there for you. Doctors are trained health professionals who have discussed just about every health topic you can think of with their patients.

Your doctor will first ask you questions about your medical history, bowel movements, and your lifestyle and routines.

Medical history

These questions may include:

• What are your current and past diseases/health conditions?
• Have you lost or gained any weight recently?
• Have you had any previous digestive tract surgeries?
• What medications and supplements do you take for other disorders and for the relief of constipation?
• Does anyone in your family have constipation or diseases of the digestive tract or a history of colon cancer?
• Have you had a colonoscopy?

Bowel movement history

These questions may include:

• How often do you have a bowel movement?
• What do your stools look like?
• Have you noticed any blood or red streaks in your stool?
• Have you ever seen blood in the toilet bowl or on the toilet paper after you wipe?

Lifestyle habits and routines

• What food and beverages do you eat and drink?
• What is your exercise routine?

Your doctor will also perform a physical exam, which includes a check of your vital signs (temperature, pulse, blood pressure). He or she will use a stethoscope to listen to the sounds in your abdomen. Your abdomen will also be touched to check for pain, tenderness, swelling, and lumps.

Be aware that your doctor will also perform a rectal exam. This is a finger exam of the inside of your rectum. It’s a quick check for any masses or problems that can be felt by finger.

What lab tests and other medical tests may be done to find the cause of my constipation?

Your doctor can order no tests or many types of tests and procedures. The decision of which ones your doctor might order for you depends on your symptoms, medical history, and overall health.

Lab tests: Blood and urine tests reveal signs of hypothyroidism, anemia, and diabetes. A stool sample checks for signs of infection, inflammation, and cancer.

Imaging tests: Computed tomography (CT), magnetic resonance imaging (MRI) or lower gastrointestinal tract series may be ordered to identify other problems that could be causing your constipation.

Colonoscopy: A colonoscopy or sigmoidoscopy– an internal view of your colon with a scope – may be performed. During this procedure, a small sample of tissue (biopsy) may be taken to test for cancer or other problems and any found polyps will be removed.

Colorectal transit studies: These tests involve consuming a small dose of a radioactive substance, either in pill form or in a meal, and then tracking both the amount of time and how the substance moves through your intestines.

Other bowel function tests: Your doctor may order tests that check how well your anus and rectum hold and release stool. These tests include a certain type of x-ray (defecography), done to rule out causes of outlet dysfunction constipation, and the insertion of a small balloon into the rectum (balloon expulsion test and anorectal manometry).

Management and Treatment

How is constipation treated?

Self-care

Most cases of mild to moderate constipation can be managed by you at home. Self-care starts by taking an inventory of what you eat and drink and then making changes.

Some recommendations to help relieve your constipation include:

• Drink two to four extra glasses of water a day. Avoid caffeine-containing drinks and alcohol, which can cause dehydration.
• Add fruits, vegetables whole grains and other high-fiber foods to your diet. Eat fewer high-fat foods, like meat, eggs and cheese.
• Eat prunes and/or bran cereal.
• Keep a food diary and single out foods that constipate you.
• Get moving, exercise.
• Check how you sit on the toilet. Raising your feet, leaning back or squatting may make having a bowel movement easier.
• Add an over-the-counter supplemental fiber to your diet (like Metamucil®, Citrucel®, and Benefiber®).
• If needed, take a very mild over-the-counter stool softener or laxative (such as docusate [Colace®] or Milk of Magnesia®). Mineral oil enemas, like Fleet®, and stimulant laxatives, like bisacodyl (Dulcolax®) or senna (Senokot®), are other options. There are many laxative choices. Ask your pharmacist or doctor for help in making a choice. Do not use laxatives for more than two weeks without calling your doctor. Overuse of laxatives can worsen your symptoms.
• Do not read, use your phone or other devices while trying to move your bowels.

Medication/supplement review

In addition to self-care methods, your doctor will review your medications and supplements (if you take any). Some of these products can cause constipation. If they do, your doctor may change the dose, switch to another drug and/or ask that you stop taking the supplement. Never stop taking your medications or supplements before talking with your doctor first.

Prescription medications

A few prescription drugs are available to treat constipation. These include lubiprostone (Amitiza®), prucalopride (Prudac®, Motegrity®), plecanatide (Trulance®), lactulose (Cephulac®, Kristalose®) and linaclotide (Linzess®). Your doctor will pick the drug that might work best for you based on the results of your tests.

Surgery

Surgery is rarely needed to treat constipation. Your doctor may, however, recommend surgery if constipation is caused by a structural problem in the colon. Examples of these problems include a blockage in the colon (intestinal obstruction), a narrowing in a portion of the intestine (intestinal stricture), tear in the anus (anal fissure) or the collapse of part of the rectum into the vagina (rectal prolapse). Some causes of outlet dysfunction constipation may be treated with surgery. This is best discussed after testing. You may also need surgery if cancer was found in your colon, rectum or anus.

Prevention

How can I prevent constipation?

Use the same home-based methods you used to treat constipation to prevent it from becoming a chronic problem:

• Eat a well-balanced diet with plenty of fiber. Good sources of fiber are fruits, vegetables, legumes, and whole-grain breads and cereals. Fiber and water help the colon pass stool. Most of the fiber in fruits is found in the skins, such as in apples. Fruits with seeds you can eat, like strawberries, have the most fiber. Bran is a great source of fiber. Eat bran cereal or add bran cereal to other foods, like soup and yogurt. People with constipation should eat between 18 and 30 grams of fiber every day.
• Drink eight 8-ounce glasses of water a day. (Note: Milk can cause constipation in some people.) Liquids that contain caffeine, such as coffee and soft drinks, can dehydrate you. You may need to stop drinking these products until your bowel habits return to normal.
• Exercise regularly.
• Treat mild constipation with a dietary supplement like magnesium. (Not everyone should take magnesium. Check with your doctor before taking.)
• Move your bowels when you feel the urge. Do not wait.

Living With

When should I call my doctor?

Call your healthcare provider if:

• Constipation is a new problem for you.
• You see blood in your stool.
• You are losing weight unintentionally.
• You have severe pain with bowel movements.
• Your constipation has lasted more than three weeks.
• You have symptoms of outlet dysfunction constipation.

Remember, talk openly and honestly with your doctor about your bowel movements and any questions or concerns you may have. Pooping is something we all should be doing. Constipation may be a temporary situation, a long-term problem or a sign of a more serious condition. Be safe. See your doctor, especially if you’ve noticed a change in your bowel pattern or if your life is being ruled by your bowels.

What to Do for Severe Constipation

Being constipated means your bowel movements are tough or happen less often than normal. Almost everyone goes through it at some point.

Although it’s not usually serious, you’ll feel much better when your body is back on track.

The normal length of time between bowel movements varies widely from person to person. Some people have them three times a day. Others have them just a few times a week.

Going longer than 3 or more days without one, though, is usually too long. After 3 days, your stool gets harder and more difficult to pass.

What Are the Symptoms?

You may have:

• Few bowel movements
• Trouble having a bowel movement (straining to go)
• Hard or small stools
• A sense that everything didn’t come out
• Belly bloating

You also may feel like you need help to empty your bowels, such as pressing on your belly or using a finger to remove stool from your bottom.

Why Does It Happen?

Some causes of constipation include:

What Should I Do If I Am Constipated?

Take these steps:

• Drink two to four extra glasses of water a day, unless your doctor told you to limit fluids for another reason.
• Try warm liquids, especially in the morning.
• Add fruits and vegetables to your diet.
• Eat prunes and bran cereal.
• Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
• Don’t ignore the urge to poop.

You can try taking a laxative, too. There are several types of laxatives, and you can buy many of them over the counter. Each of them works in a different way to ease constipation. Ask your doctor or pharmacist which kind might work for you and how long you should take it.

When Should I Call My Doctor?

Call your doctor right away if you have sudden constipation with belly pain or cramping and you aren’t able to poop or pass gas at all.

Also, make the call if:

• Constipation is a new problem for you and lifestyle changes haven’t helped.
• You have blood in your stool.
• You’re losing weight even though you’re not trying to.
• You have severe pain with bowel movements.
• Your constipation has lasted more than 2 weeks.
• The size, shape, and consistency of your stool has changed dramatically.

Your doctor may recommend some tests to find the cause of your constipation:

• Blood tests to check on hormone levels
• Tests that check the muscles in your anus
• Tests that show how waste moves through and out of your colon
• Colonoscopy to look for blockages in your colon

Can I Prevent Constipation?

In many cases, you can. These things can help:

Eat a well-balanced diet with plenty of fiber. Good sources are fruits, vegetables, legumes, and whole-grain bread and cereal (especially bran).

Drink 1 1/2 to 2 quarts of water and other fluids a day (unless your doctor has you on a fluid-restricted diet). Fiber and water work together to keep you regular.

Avoid caffeine. It can be dehydrating.

Cut back on milk. Dairy products can constipate some people.

Exercise regularly. Do something active for at least 30 minutes a day, most days of the week.

Go to the bathroom as soon as you feel the urge.

Fecal incontinence – Symptoms and causes

Overview

Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. Also called bowel incontinence, fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control.

Common causes of fecal incontinence include diarrhea, constipation, and muscle or nerve damage. The muscle or nerve damage may be associated with aging or with giving birth.

Whatever the cause, fecal incontinence can be embarrassing. But don’t shy away from talking to your doctor about this common problem. Treatments can improve fecal incontinence and your quality of life.

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Symptoms

Fecal incontinence may occur temporarily during an occasional bout of diarrhea, but for some people, fecal incontinence is chronic or recurring. People with this condition may be unable to stop the urge to defecate, which comes on so suddenly that they don’t make it to the toilet in time. This is called urge incontinence.

Another type of fecal incontinence occurs in people who are not aware of the need to pass stool. This is called passive incontinence.

Fecal incontinence may be accompanied by other bowel problems, such as:

• Diarrhea
• Constipation
• Gas and bloating

When to see a doctor

See your doctor if you or your child develops fecal incontinence, especially if it’s frequent or severe, or if it causes emotional distress. Often, people are reluctant to tell their doctors about fecal incontinence. But treatments are available, and the sooner you’re evaluated, the sooner you may find some relief from your symptoms.

Causes

For many people, there is more than one cause of fecal incontinence.

Causes can include:

• Muscle damage. Injury to the rings of muscle at the end of the rectum (anal sphincter) may make it difficult to hold stool back properly. This kind of damage can occur during childbirth, especially if you have an episiotomy or forceps are used during delivery.
• Nerve damage. Injury to the nerves that sense stool in the rectum or those that control the anal sphincter can lead to fecal incontinence. The nerve damage can be caused by childbirth, constant straining during bowel movements, spinal cord injury or a stroke. Some diseases, such as diabetes and multiple sclerosis, also can affect these nerves and cause damage that leads to fecal incontinence.
• Constipation. Chronic constipation may cause a dry, hard mass of stool (impacted stool) to form in the rectum and become too large to pass. The muscles of the rectum and intestines stretch and eventually weaken, allowing watery stool from farther up the digestive tract to move around the impacted stool and leak out. Chronic constipation may also cause nerve damage that leads to fecal incontinence.
• Diarrhea. Solid stool is easier to retain in the rectum than is loose stool, so the loose stools of diarrhea can cause or worsen fecal incontinence.
• Hemorrhoids. When the veins in your rectum swell, causing hemorrhoids, this keeps your anus from closing completely, which can allow stool to leak out.
• Loss of storage capacity in the rectum. Normally, the rectum stretches to accommodate stool. If your rectum is scarred or stiff due to surgery, radiation treatment or inflammatory bowel disease, the rectum can’t stretch as much as it needs to, and excess stool can leak out.
• Surgery. Surgery to treat enlarged veins in the rectum or anus (hemorrhoids), as well as more-complex operations involving the rectum and anus, can cause muscle and nerve damage that leads to fecal incontinence.
• Rectal prolapse. Fecal incontinence can be a result of this condition, in which the rectum drops down into the anus. The stretching of the rectal sphincter by prolapse damages the nerves that control the rectal sphincter. The longer this persists, the less likely the nerves and muscles will recover.
• Rectocele. In women, fecal incontinence can occur if the rectum protrudes through the vagina.

Risk factors

A number of factors may increase your risk of developing fecal incontinence, including:

• Age. Although fecal incontinence can occur at any age, it’s more common in adults over 65.
• Being female. Fecal incontinence can be a complication of childbirth. Recent research has also found that women who take menopausal hormone replacement therapy have a modest increased risk of fecal incontinence.
• Nerve damage. People who have long-standing diabetes, multiple sclerosis, or back trauma from injury or surgery may be at risk of fecal incontinence, as these conditions can damage nerves that help control defecation.
• Dementia. Fecal incontinence is often present in late-stage Alzheimer’s disease and dementia.
• Physical disability. Being physically disabled may make it difficult to reach a toilet in time. An injury that caused a physical disability also may cause rectal nerve damage, leading to fecal incontinence.

Complications

Complications of fecal incontinence may include:

• Emotional distress. The loss of dignity associated with losing control over one’s bodily functions can lead to embarrassment, shame, frustration and depression. It’s common for people with fecal incontinence to try to hide the problem or to avoid social engagements.
• Skin irritation. The skin around the anus is delicate and sensitive. Repeated contact with stool can lead to pain and itching, and potentially to sores (ulcers) that require medical treatment.

Prevention

Depending on the cause, it may be possible to improve or prevent fecal incontinence. These actions may help:

• Reduce constipation. Increase your exercise, eat more high-fiber foods and drink plenty of fluids.
• Control diarrhea. Treating or eliminating the cause of the diarrhea, such as an intestinal infection, may help you avoid fecal incontinence.
• Avoid straining. Straining during bowel movements can eventually weaken anal sphincter muscles or damage nerves, possibly leading to fecal incontinence.

Dec. 01, 2020

Irritable Bowel Syndrome: Controlling Your Symptoms

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education website.

Information from Your Family Doctor

Am Fam Physician. 2010 Dec 15;82(12):1449-1451.

What is irritable bowel syndrome?

Irritable bowel syndrome (IBS) is a common problem with the intestines. The cause is unknown, but it may have to do with the movement of the intestines, sensitivity of the intestine to pain or nerve signals, or changes in the bacteria that live in the gut. IBS usually begins around age 20 and is more common in women.

IBS is also called functional bowel syndrome, irritable colon, spastic bowel, and spastic colon. It’s not the same as inflammatory bowel diseases like ulcerative colitis.

What are the symptoms of IBS?

• Bloating and gas

• Mucus in the stool

• Constipation

• Diarrhea, especially after eating or first thing in the morning

• Feeling a strong urge to have a bowel movement

• Feeling like you still need to have a bowel movement after you’ve already had one

• Stomach pain and cramping that may go away after having a bowel movement

The symptoms may get worse when you’re under stress, such as when you travel, attend social events, or change your daily routine. Your symptoms may also get worse if you don’t eat enough healthy foods or after you’ve eaten a big meal. Some people are bothered by certain foods. Women who have IBS may notice more frequent symptoms during their periods.

How is IBS diagnosed?

Your doctor may start by ruling out other illnesses. He or she will ask questions about your symptoms. If your symptoms have had a pattern over time, the pattern may make it clear to your doctor that IBS is the cause.

If your symptoms have just started, your doctor may need to do some tests to make sure that your symptoms aren’t caused by something other than IBS.

How is IBS treated?

The best way to manage IBS is to eat a healthy diet, avoid foods that make you feel worse, and find ways to cope with stress.

Why may fiber be helpful?

It can be helpful because it improves how the intestines work. There are two types of fiber:

• Soluble fiber helps relieve diarrhea and constipation. It dissolves in water and forms a gel-like material. Many foods contain soluble fiber, such as apples, beans, and citrus fruits. Psyllium, a natural vegetable fiber, is also a soluble fiber. You can buy psyllium supplements (some brand names: Fiberall, Metamucil) to drink, and you can add it to other foods.

• Insoluble fiber helps relieve constipation by moving material through your intestines and adding bulk to your stool. But this type of fiber can also make your symptoms worse. Insoluble fiber is in whole-grain breads, wheat bran, and many vegetables.

Increase the fiber in your diet slowly. Some people feel bloated and have gas if they increase their fiber intake too quickly. Gas and bloating usually improve as you get used to eating more fiber. The best way to increase your fiber intake is to eat a variety of high-fiber foods.

Do certain foods cause IBS?

No. Foods don’t cause IBS. But some foods may make you feel worse. Fat and caffeine can cause your intestines to contract, which may cause cramping. Alcohol and chocolate may also make you feel worse. If gas is a problem for you, avoid foods that tend to make gas worse. These include beans, cabbage, and some fruits.

Keeping a diary of what you eat and what your symptoms are for a few weeks may be a good way to find out if a food bothers you. If you think a food makes you feel worse, don’t eat it. Don’t cut out foods unless they have caused you problems more than once.

What about milk and milk products?

If milk and other dairy products bother you, you may have lactose intolerance. This means that your body can’t digest lactose (the sugar in milk).

Dairy products may make IBS symptoms worse if you’re lactose intolerant. If this is the case, you may need to limit the amount of milk and milk products you eat. Talk to your doctor if you think you have trouble digesting dairy products.

How can stress affect IBS?

Stress may trigger IBS. Talk to your doctor about ways to cope with stress, such as exercise or talking to a counselor.

Can my doctor prescribe medicine for IBS?

There is no cure for IBS. If you’re having bad symptoms, your doctor may prescribe medicine to help you manage or lessen your symptoms. For example, antispasmodic medicines may be prescribed to reduce cramping if your main symptom is pain. Hyoscyamine (some brand names: Anaspaz, Cystospaz, Levsin) and dicyclomine (some brand names: Bentyl, Di-Spaz) help relax the spasms in the colon. Heating pads and hot baths can also be comforting.

When diarrhea is a problem, medicine such as loperamide (brand name: Imodium) may help.

Will IBS get worse over time?

No. IBS will probably recur throughout your life, but it won’t get worse. It doesn’t cause cancer or require surgery, and it won’t shorten your life.

What if IBS interferes with my daily activities?

IBS may have caused you to avoid doing certain things, like going out or going to work or school. It may take some time, but you may find new freedom by following a plan that includes a healthy diet, learning new ways to cope with stress, and avoiding foods that make your symptoms worse.

Tips on controlling IBS

• Eat a varied healthy diet and avoid foods high in fat.

• Drink plenty of water.

• Try eating six small meals a day rather than three larger ones.

• Learn new and better ways to cope with stress.

• Avoid using laxatives. They may weaken your intestines and cause you to be dependent on them.

What Your Poop Is Telling You

By Vasudha Dhar, MD, Special to Everyday Health

As a gastroenterologist, I am somewhat surprised that people don’t pay more attention to their bathroom habits. While it’s not the most pleasant topic, there really is no easier way to discover what’s happening inside your body than seeing what comes out of it.

One of the biggest misconceptions about our bowel movements is the common belief there is an ideal result. A few years ago, a well-known doctor suggested that we should all strive to see a “perfect S” and that anything else could indicate some kind of problem.

After this announcement, my appointment calendar was booked solid for weeks. I explained to worried patients that, in fact, the famous doctor’s blanket statement was incorrect. Everyone’s GI tract operates differently based on a combination of constant and changing factors – genetics, hydration, dietary habits, medication use, and ongoing health issues.

Think about it – sometimes certain foods just don’t agree with you, and occasionally you don’t drink enough water. Or perhaps you are taking a new medication. These factors can change the consistency and caliber of your stool for a short time but things usually revert back to normal in a few days.

The frequency of bowel movements also varies. Not everyone is wired to have a bowel movement every day. Some people have one every few days while other people go more than once a day. Regardless, both are normal.

Changes in Bowel Habits

What’s important to be aware of is how your GI tract normally functions and what typical bowel activity is for you. If you notice a prolonged change, that’s when you need to closely monitor what’s happening. In addition, if you are feeling pain or other pronounced symptoms, it’s time to call your doctor.

Keep in mind, if your stool changes for a week or longer, it doesn’t necessarily mean the medical issue lies in your GI tract. Recently, I saw a female patient in her mid-forties who was concerned her stools had changed from regular to much looser consistency and the frequency had increased. She was also losing weight.

After running her blood work and conducting other diagnostic tests, we learned she had hyperthyroidism (an overactive thyroid), a condition where the thyroid gland produces too much of the thyroid hormone, which causes symptoms including accelerated metabolism (causing sudden weight loss), heart rate increase, sweating, and changes in bowel movements.

5 Signs of Bowel Trouble

The body has a way of expressing itself when there is trouble inside by changing your bowel movements. Here are five warning signs you shouldn’t ignore:

1. Blood in your stool.  If you see even a small amount of blood in your feces on a recurring basis, see a doctor. Blood can be a sign of hemorrhoids or anal fissures, pre-cancerous colon polyps, or an inflammatory bowel disease (IBD). In the worst case scenario, it could be a sign of cancer.
2. Change in stool consistency. Everyone has bouts of diarrhea from time to time. But if you used to have solid bowel movements and now have diarrhea frequently, it could be a sign of ulcerative colitis or Crohn’s disease, two types of IBD – especially if you also have abdominal pain, bleeding, and weight loss.
3. Color change. Bowel movements are generally brown  in color because of bile, which is produced in the liver. If the stool is black, it can be a sign of internal bleeding. Green stool is usually nothing to be concerned about. Stool color also changes depending on the kinds of food you eat.
4. Continual diarrhea. Diarrhea can be sign of infection or food intolerance. Ulcerative colitis and some other microscopic colon disorders can cause changes in frequency of the stool as well. It can also be a result of a change of medications or irritable bowel disease.
5. Constipation. If you have a new onset of constipation, it can be due to lack of proper hydration or side effects from a medication. Irritable bowel syndrome (IBS) may also be a consideration. If your symptoms don’t improve in a few days after an increase in fluids, see your doctor.

Better Lifestyle, Better Bowels

People who deal with chronic bathroom issues should be evaluated by a doctor. Most conditions can be treated with medication and lifestyle changes. Irritable bowel disease is one of the most common conditions affecting the large intestine (colon). It causes cramping, abdominal pain, bloating, gas, diarrhea, and constipation. It is a chronic condition that you will need to manage for the long-term with diet, exercise, stress management, and medication.

Most gastrointestinal problems can be resolved by making simple changes to your diet and lifestyle. For less severe cases, the following nutrition and exercise changes may prove helpful:

• Eat unprocessed, natural foods including fiber-rich vegetables.
• Avoid artificial sweeteners, fructose, chemical additives, MSG, excessive caffeine.
• Boost your intestinal flora by adding naturally fermented foods to your diet – sauerkraut, pickles, and kefir, for example.
• Add a probiotic supplement if you’re not getting enough good bacteria from your diet.
• Strive to drink two quarts of water daily.
• Exercise regularly.
• If you use medication every day, ask your prescribing doctor if it could be affecting your bowel movements.
• Take action to minimize chronic stress.

Be sure to talk to your doctor before making any changes to your healthcare routine. Pay attention to your bowel movements the same way you watch your weight, get your blood pressure monitored, and have your heart rate evaluated. Your bathroom habits can offer warning signs that something may not be quite right, and that you need to be checked out by a medical professional.

What It Means to Have a Normal Bowel Movement

What does it mean to have a normal bowel movement? Many people aren’t sure if their bowel movements are “normal,” which is probably because bowel movements are a difficult topic to discuss, even with a physician.

The truth is that there is no one complete definition or description of a normal bowel movement. Bowel movements are individual, and rather than one “normal” type of bowel movement that fits everyone, there is a spectrum of what would be considered in the range of normal.

Instead, be on the lookout for any signs that a bowel movement is outside the personal range of normal, or those bowel movements have changed over time, and bring that up at a doctor’s visit.

Illustration by Jessica Olah, Verywell

Normal Frequency of Bowel Movements

It’s a common belief that having a normal digestive system means having a daily bowel movement. However, this is not true for everyone.

In fact, normal could be anything from having a bowel movement a few times a day to a few times a week. In other words, there is no hard-and-fast rule as to what is typical because it varies from person to person.

The general range for bowel movements is from three times a day to three times a week. Less than three movements per week is generally considered constipation, while three or more loose stools per day is considered diarrhea.

If you do not have a daily bowel movement, it does not mean you are constipated. Having more than one movement a day does not mean that you have diarrhea. Constipation is hard, dry stool that is difficult to pass, and diarrhea is watery stool more than three times a day.

Most healthy adults will experience diarrhea or constipation at some point, but a consistent change in bowel habits should always be discussed with your doctor.

Constipation

Constipation is a common problem and is estimated to be the cause of about 2. 5 million doctor visits each year. Constipation is hard, dry, lumpy stool that is difficult or painful to pass and which may be accompanied by bloating and discomfort.

Chronic dehydration, lack of exercise, and low amounts of dietary fiber can all lead to developing constipation. Drinking enough water each day can help prevent dehydration.

At least 30 minutes of exercise most days of the week is recommended for better overall health (even brisk walking is better than no aerobic activity) as well as better digestion. There should be enough fiber in the diet to ensure that stools are soft and pass painlessly and easily.

You should see a doctor about constipation if you are outside of your normal range of bowel movements for more than a week, are in pain, or find blood on the toilet paper. This is especially true if you are over 50.

Complications of Constipation

Women and older adults are especially at risk of having constipation that occurs frequently, which is called chronic constipation. Unfortunately, more than just being uncomfortable, chronic constipation could lead to other complications.

Straining to pass stool could lead to the development of hemorrhoids or an anal fissure (a tear in the skin of the anal canal). Another potential issue is fecal impaction, which is when the stool becomes hardened and gets stuck in the intestine and won’t move. This could require treatment in a hospital or a doctor’s office if it gets severe. 

Rectal prolapse, where part of the rectum can come out of the anus, can also occur after straining too hard to pass a bowel movement. Rectal prolapse could be treated at home but may require surgery in some cases.

Diarrhea

Diarrhea is loose, watery stool that occurs more than three times a day. For most adults, diarrhea is a common problem that happens a few times a year, usually lasts a day or two, and does not need any treatment. Causes of diarrhea include infection, side effects of medication, and food intolerance. 

You need to see a doctor if diarrhea lasts more than three days, especially if it there is pain, fever, bloody or black stools, or a pus discharge. Prolonged diarrhea can cause severe dehydration requiring emergency care.

Stool Color and Consistency

A bowel movement should be soft and easy to pass, though some people may have somewhat harder or softer stools than others. Generally speaking, a stool should be brown or golden brown, be cohesively formed, have a texture similar to peanut butter, and size and shape similar to a sausage.

In many cases, a stool that varies a bit from this description is no cause for alarm, especially if it is an isolated incident. There are, however, several indications that a bowel movement is abnormal and may be the sign of a more serious problem.

Among them:

• Blood in the stool is never normal and could be a result of several conditions that range from mild, such as hemorrhoids, to serious, such as infection or colon cancer.
• Black or tarry stools with a foul odor can be the result of eating certain foods, taking iron supplements, or possibly from internal bleeding high up in the gastrointestinal tract.
• Red or maroon stools could be caused by eating red-colored foods or by medical conditions such as hemorrhoids, diverticular bleeding, colon cancer, or inflammatory bowel disease.
• Green stools may be caused by green or artificially-colored foods, iron supplements, or decreased colonic transit time.
• Pale or clay-colored stools could be the result of lack of bile salt (which gives stool a brownish color), antacids, barium from a recent barium enema test, or hepatitis.

A Word From Verywell

If there’s one thing that causes almost everyone anxiety about seeing a doctor, it’s bowel movements. Many people keep their concerns about their bowel movements to themselves, but that could be a mistake.

A digestive problem is easier to deal with if caught early, rather than letting it go until it becomes more difficult to treat. Many digestive problems can be managed with lifestyle changes like eating more fiber, drinking water, or going for a walk, so make sure to bring any up at a doctor’s visit.

Constipation in Children: Symptoms, Treatment and Resources

How is Constipation Treated?

Treatment for constipation and soiling has three phases – clean out, maintenance, and reestablishing toileting behaviors.

Clean-Out Phase

The clean-out phase is designed to clear the stool plug out of the colon. This can be done with medicines taken by mouth, enemas and suppositories given in the rectum, or a combination of both. Small children who have holding behaviors because of painful bowel movements or fear of passing stools may do better with medicines given by mouth. Although gentle enemas are effective, they may make the child even more fearful.

Hard stool is very difficult and painful to pass. Your child’s clean-out phase may be started with large doses of mineral oil to soften the stool. Mineral oil is not absorbed and gradually seeps through the hard stool and softens it. It may take several days of mineral oil to soften a large amount of packed stool. Mineral oil is dangerous only if it gets in the lungs. This is why it should not be given to infants or children who have trouble swallowing. Mineral oil can be given by enema or by mouth. Since mineral oil has an oily feel to it, most children will take it better when it is mixed with another food. Some of the easier ways to give it include putting it in milk shakes, pudding, applesauce, ice cream, chocolate milk and in juice “slushies.”

Once your child’s stool is soft, your doctor or nurse practitioner may suggest that you add other medicines by mouth or rectum. It is very important to remove the entire stool plug during the clean-out phase or the next phase will not work as well.

Your child should be on enough medicine to prevent a stool plug from forming. Children on the proper therapy usually have one to three loose to very soft stools every day. If children on therapy go two to three days without a bowel movement, their therapy should be increased. Soiling usually means a stool plug rather than too much medicine.

Maintenance Phase

Once the clean-out phase is complete, your doctor or nurse practitioner will tell you what medicine your child will take every day. Small children who are afraid of painful bowel movements will receive medicine to soften their stool. Mineral oil is very effective for this, because it helps the stool slide out more easily. Fiber, which helps keep water in the stool, may also help wit this. The richest source of fiber is usually found in breakfast cereal. To find how many grams of fiber your child needs each day, add 5 to your child’s age. For example, a 3-year-old child needs about 8 grams of fiber every day.

Some laxatives are salts that hold water in the stool. Examples include Milk of Magnesia and Miralax. Other laxatives work by fermenting sugars and producing gas. These include apple juice, lactulose and maltsupex. These are not very good treatments, because they may cause gas cramps. Other laxatives may cause stretched and weakened muscles to contract. These include senna and bisacodyl. Your doctor or nurse practitioner can suggest the treatment that will work best for your child.

Mild constipation may be treated with diet changes. Increased fiber may soften stools. Sugary drinks that ferment (such as apple and fruit juice) may be used as well. Prune juice has the advantage of fiber as well as natural senna. Extra water or fluids generally don’t reach the colon.

Children with soiling or more severe constipation usually require medication. However, making changes in your child’s diet at the same time may help wean them from medications more quickly. Getting children, especially toddlers, to eat the diet we would like may be difficult, but the extra effort will be rewarded with happier children.

This chart lists some of the pros and cons of various treatments:

Treatments That Should NOT be Used in Children:

• Fleets Phospho-Soda enemas should not be used in children. They can severely disturb electrolyte balance when held in the colon.

• Milk and molasses or a lactulose enema can cause a distended (puffed out) belly above a stool plug with possible tearing. Therefore, these are not recommended for children with chronic constipation.

Reestablishing Regular Toileting Behaviors

Once your child is having soft, comfortable bowel movements on a regular basis, the next step is to get their regular toileting schedule back on track. Many times, this routine has been disrupted due to the child’s fear of having a painful bowel movement, or because they are less likely to sense when they need to use the toilet for a bowel movement. 

Our team includes behavioral specialists who provide additional care for patients with encopresis. These specialists help your child:

• Get a regular toileting routine started

• Have less anxiety around having a bowel movement

• Reduce their stool withholding behavior

• Have less conflict with their parents over the problem

• Feel that they are part of the treatment team

90,000 Constipation as a disease of civilization

Fixation or absence of daily stool – who has not encountered this problem in the modern lifestyle? As statistics show, there are practically no such people. At the same time, the topic is so intimate that it is unacceptable to talk openly about it, discuss it with family or with friends, not to mention the idea of ​​contacting and telling the doctor everything. Another thing, for example, peptic ulcer disease. They talk a lot about her, discuss and consult.Although few people know that constipation is a very serious symptom and the most important risk factor for colon cancer. With stool retention, toxins accumulate in the intestine, which damage the cells of the colon mucosa and trigger the mechanism of neoplasm, thereby increasing the risk of developing intestinal cancer. Conversely, daily bowel movement is the prevention of gastrointestinal cancer. It becomes clear how important this topic is in the period of a serious increase in the number of oncological diseases.

What is chronic constipation?

Quite often doctors and patients mean different manifestations under the term “constipation”. For the patient, this is, most often, a decrease in the frequency of going to the toilet. At the same time, for one person, stool every 5 days is familiar and does not cause anxiety, and for another, stool in a day will already be constipation.

In medicine, there is a clear definition of this concept. Constipation is a violation of the function of the colon with a decrease in stool frequency less than 3 times a week, with a change in its consistency to dense (in the form of “separate hard lumps of feces or nuts” or “feces of normal form, but with hard lumps”), with forced straining occupying more than 25% of the time spent on the toilet.

Lack of regular bowel movements – is it a diagnosis or a symptom?

From the point of view of experts, chronic constipation is an independent disease, but often it is also a harbinger of the development of other chronic diseases and not only of the gastrointestinal tract. It has now been established that the appearance of hard and irregular stools may precede the development of Parkinson’s disease by more than 10 years. Hence, it follows that constipation is a factor reflecting the likelihood of developing age-related neurological (neurodegenerative) diseases, including Alzheimer’s disease and age-related dementia, which are especially difficult to detect at an early stage.

Now consider a situation where constipation is a symptom of other diseases.

Constipation and colon polyps

As you know, polyps and other neoplasms occupy a leading position in oncopathology at the present time, especially in older age groups. In the presence of colon polyps and other neoplasms, there is a mechanical obstacle to the passage of intestinal contents, therefore, stool retention occurs and chronic constipation is formed.Screening examination with feces analysis for occult blood and the presence of inflammation, and, if necessary, video colonoscopy is an important diagnostic tool in clarifying the diagnosis of chronic constipation.

Constipation and thyroid gland

Constipation can be a symptom of thyroid disease, namely hypothyroidism. With a deficiency of thyroid hormones, the intestines become “lazy”, which leads to the formation of a fixed stool. Determination of the level of thyroid hormones is recommended for everyone when a fixed stool occurs.

Constipation as a side effect of drug therapy

Chronic constipation is a common complaint in patients who have to take 5 or more medicines at the same time due to concomitant chronic diseases. It turns out that the very fact of taking a large number of drugs at the same time causes a tendency to fix the stool. In such situations, the validity and expediency of taking each “pill” is necessary.

Constipation and emotional state

There is such a phrase that from stinginess to constipation is one step.It is noticed that if a person has excessive frugality and tries in every possible way to avoid spending of any kind, then he is so much afraid of parting with his “good” that, in the end, he begins to suffer from problems with the chair. According to experienced specialists, the inability to let go of something is often projected onto the emotional state. A person prone to super-economy is often unable to “let go” of old grievances, hatred, disappointment and other negative feelings, as a result of which they experience stress.Meanwhile, the modern rhythm of life: hard work, disturbances in work and rest, the need for night work also leads to excess production of stress hormones – adrenaline and cortisol, which reduce the motor activity of the large intestine. The ability to organize your work and rest regime, find a way to escape from the daily hustle and bustle and give an outlet to accumulated emotions is a guarantee not only of the health of the gastrointestinal tract, but of the whole organism as a whole.

Nutrition – as the basis for normal bowel function

By the 21st century, the development of the food industry led to the fact that a person eats refined, repeatedly processed, often artificial foods that are well “digested”, which leads to problems not only of obesity, but also of chronic constipation. Lack of fiber in the diet negatively affects the tone of our intestines, which becomes “lazy”. The main task of the intestine is to “take” everything the body needs and “remove” everything harmful, toxic, unused. And in order to “push” that unnecessary intestinal contents, active motor work of the large intestine is required. Consumption of sufficient amounts of coarse dietary fiber (dietary fiber) triggers this motor mechanism, and due to the ability of fibers to retain water, additionally leads to an increase in the volume of intestinal contents, thereby normalizing the motility of the “lazy” intestine.

Foods rich in dietary fiber include baked goods made from whole grains or containing a significant amount of bran, buckwheat, barley, oatmeal, nuts (almonds, peanuts, pistachios), fresh vegetables and fruits. According to the recommendations of the World Health Organization, the generally accepted norm is the intake of 25–35 g of fiber per day with the food eaten. An interesting fact is that the inhabitants of some African tribes, who ate mainly vegetables, fruits and milk and hardly eat meat, do not have constipation at all, while they naturally showed a decrease in the level of colon cancer.

How many times a day should you eat?

It turns out that regular food intake affects intestinal peristalsis. And all because after a meal, the active work of the entire gastrointestinal tract begins: there is a release of enzymes and substances necessary for the digestion process, among which there is bile. And bile (a product of the activity of liver cells) is a natural stimulant of intestinal peristalsis. The formation of bile occurs continuously, but the entry into the small intestine is periodically and directly related to food intake.It is optimal to eat 4-5 times a day for the full functioning of the biliary system of our body and regular bowel movements.

Why is drinking water so important?

One of the main functions of the colon is the reabsorption of water. In the “lazy” intestine, the contents spend more time, the time of the reabsorption of water increases, as a result of which the contents “dry up”, become denser, and decrease in volume. And the volume of feces is a necessary factor in the motor work of the intestines.Adequate drinking regime is one of the most important conditions for the normal functioning of the intestine. It is recommended to consume at least 1.5-2.0 liters of drinking water during the day, especially in the morning from 6 to 9 am. A glass of water on an empty stomach in the morning is a habit that can save your life in the future and will certainly improve its quality.

Constipation and physical activity

At present, everyday life and everyday life are arranged in such a way that a person lacks movement. Physical inactivity is the result of a modern urban lifestyle: transportation to and from work, office work, in turn, leads to the formation of a “lazy intestine”.It has been established that there are receptors on the heels of a person that are responsible for the functioning of the intestines, therefore, for example, walking for about 30 minutes a day improves the blood supply to the intestines, and thereby normalizes its work. Doing yoga, swimming or morning exercises at home on a regular basis, which will bring you pleasure and inner satisfaction, will tone not only the gastrointestinal tract, but the entire body as a whole.

Constipation that we ourselves create

Particular attention should be paid to the emergence of a sensation of urge and the need to go to the toilet.The urge itself arises reflexively as the contents enter the lower parts of the colon, but we can directly control the process of emptying the intestines thanks to the central nervous system of a person. However, the moment of urge and the possibility of visiting the toilet does not always coincide. What happens as a result? Frequent conscious suppression of the natural urge due to an unfavorable or unusual environment, lack of time or disgust of using a public toilet leads to a loss of reflex mechanisms for the emergence of urge and the occurrence of chronic constipation.

Therefore, it is important, starting from childhood, to form the habit of going to the toilet. Learn to take time for yourself, organize work and rest, monitor what we eat, and then the work of the gastrointestinal tract will not create inconveniences.

You can get advice on the diagnosis and treatment of constipation from the gastroenterologists GC Expert. For the diagnosis of bowel diseases, we suggest using the comprehensive Check-up program. Bowel examination.

How to deal with constipation in a child?

08/15/17

A guide for parents on a problem that is very common in children with autism

Symptoms of chronic constipation in a child include:

– Very hard and dense stools.

– Pain and difficulty in emptying the intestines.

– The child has a bowel movement three times a week or less.

Talk to the child’s doctor to see if the child is constipated.

What causes constipation in children with autism?

1. Stool retention

Some children try to hold on to stool and ignore the urge to have a bowel movement. This can happen for various reasons, for example:

– Fear of the toilet.

– Unwillingness to use the toilet outside the home.

– Unwillingness to interrupt the game.

– Fear of pain during bowel movement.

2. Toilet training

Children may resist and hold a chair when they are being toilet trained.This can become a habit that can be difficult to get rid of in the future.

3. Power Problems

– Lack of fiber found in fruits, vegetables and whole grains.

– Dairy products, if the child is allergic to cow’s milk or consumes too much dairy products.

– Insufficient consumption of water and other drinks, especially during illness.

– Changes in appetite or diet due to illness of a child.

4. Stress and changes in the daily routine.

Travel, weather changes, and stress can affect bowel function.

5. Medicines

Certain drugs, such as antacids, antidepressants, and some drugs for attention deficit hyperactivity disorder, can cause stools that are too hard.

6. Associated medical problems.

Constipation often occurs in children who have movement problems, including decreased muscle tone and cerebral palsy.Constipation is also possible in case of hypersensitivity to gluten or casein.

Acute constipation and encopresis

Acute constipation

Some (but not all) children with chronic constipation may experience this problem. Acute constipation can be caused by too much hard stool in the colon. As a result, the child cannot have a bowel movement for several days. Acute constipation is diagnosed by a doctor by palpation of the abdomen or using an X-ray.Acute constipation is often accompanied by loss of appetite and lethargy. After having a bowel movement, the baby feels better and the symptoms decrease.

Encopresis

This problem occurs in some (but not all) children with constipation. Encopresis means that a child has loose stools during constipation. This is a common problem.
Encopresis can develop if a child holds a stool for so long that it becomes difficult for him to have a bowel movement. The stool becomes larger and drier.Retention of large stools causes the intestinal muscles to tire and relax. After the muscles relax, loose stools may seep into your underwear.

The child does not feel that this is happening and cannot control loose stools. This usually happens several times a day, making your underwear dirty. Sometimes encopresis is confused with diarrhea, but in fact, the child does not have diarrhea, since the bulk of the stool in the intestines remains hard.

Many children with encopresis experience loss of appetite and decreased interest in daily activities.After having a bowel movement, the baby feels better and the symptoms decrease.

Treatment of constipation

There are three main approaches to the treatment of constipation.

Talk to your child’s doctor about which type of treatment is best for you:

1. Changes in nutrition

– Increasing the level of fiber in the diet will facilitate bowel movements.

– Increasing fluid intake of , especially water and juice, helps soften stools and reduces the likelihood of constipation.

2. Behavioral changes

– Regular exercise . Physical activity improves the function of the abdominal muscles, which makes it easier to have bowel movements. Regular exercise, including walking, jumping rope, ball games, cycling, and swimming, can help relieve constipation.

– Learning to empty the bowels in the toilet . It is important that the child knows how to use the toilet at the first urge. The best way to teach him this is through planned and prolonged “sitting on the toilet”, where the child is rewarded for just sitting on the toilet for a long time.

3. Medicines

Children often need medications to have regular bowel movements. It could be:

– Preparations for daily use.

– Preparations for a single dose that “cleanse” the intestines with severe difficulties with emptying.

Increase in fiber in the child’s diet

A high-fiber diet promotes regular bowel movements and prevents constipation. Fiber is a substance that the body cannot digest.There are two types of fiber – soluble and insoluble. Soluble fiber allows water to enter the intestines. Insoluble fiber promotes the passage of stools through the intestines. Both types of fiber are needed to prevent constipation.

Fiber is an important part of a healthy diet. Foods such as fruits, vegetables, whole grains, legumes, nuts, and seeds are high in fiber. They are also high in protein, vitamins and minerals. A diet high in these types of foods is the best way to get enough fiber.

Where to find fiber

When shopping for food, you can check the nutritional information of the food, including fiber levels. Foods that contain at least 2 grams of fiber per serving are good choices.

When shopping, check to see if foods contain whole grains, whole grain flours, and oatmeal. There are options for your child’s favorite foods with whole grains, which are higher in fiber.For example, whole grain cheese crackers, whole wheat breads, and high fiber cereals may work for you.

Recommended intake of fiber

– Ages 1 to 3: 19 grams per day (for boys and girls).

– Ages 4 to 8: 25 grams per day (for boys and girls).

– Ages 9 to 13: 31 grams per day for boys and 26 grams per day for girls.

Examples of high fiber foods

– White beans: 9.5 grams per 1/2 cup.

– Oatmeal: 8.8 grams per 1/2 cup.

– Red beans: 8.2 grams per 1/2 cup.

– Beans: 7.5 grams per 1/2 cup.

– Pear (with skin): 4.3 grams per small pear.

– Raspberries: 4.0 grams per 1/2 cup.

– Baked potatoes (with skins): 3. 8 grams per piece.

– Almonds: 3.3 grams per 30 grams.

– Apple (with skin): 3.3 grams per piece.

– Banana: 3.1 grams per medium sized piece.

– Orange: 3.1 grams per medium sized piece.

– Peanut butter: 3.0 grams per 2 tablespoons.

– Broccoli: 2.8 grams per 1/2 cup.

– Green peas: 2.5 grams per 1/2 cup.

– Avocado: 2.3 grams per 1/2 cup.

– Corn: 1.6 grams per 1/2 cup.

– Strawberries: 1.5 grams per 1/2 cup.

– Wild rice: 1.5 grams per 1/2 cup.

– Raisins: 1.4 grams per 1/2 cup.

– Popcorn: 1.2 grams per cup.

Increase in fiber and fluid in the child’s diet

It is advisable to offer fiber-rich foods to children from an early age so that they become a lifelong habit of eating them.

If your child is currently suffering from constipation, it is important to increase fiber levels very gradually – over 2-3 weeks. Increasing dietary fiber levels too sharply can worsen constipation or cause gas, abdominal pain and diarrhea.

Increasing fiber levels will only be effective if the child also drinks more fluids. Make sure your child is not just eating more fiber, but also drinking more water and juice.

How to Increase Fiber Levels Without Child Resistance

Children with autism often resist changes, especially dietary changes. Parents need to be patient and try different approaches, for example:

– Switch to whole grain crackers and pasta.

– Taste whole grain bread and pizza. Many types of whole grain bread do not differ in appearance from regular white bread.

– Offer your child whole grain muesli or popcorn as a snack.

– Offer your child dried fruits as a sweet treat (prunes, dried apricots, raisins).

– Try frozen fruit or berry cocktails based on juice or milk.

– Offer your child carrot, bell pepper or celery sticks to dip in nut butter, hummus, or salad dressing.

– Add chopped vegetables or vegetable purees to your child’s favorite meals, for example, they can be added to pasta or pizza.

– Make funny faces or figures from slices of fruits and vegetables.

– Have the child dip fruit slices in nut butter or their favorite yoghurt.

– Bake whole grain cookies, muffins or pies.

Increase in fluid intake

Adequate amount of water is required to maintain the health of the body.It is found in both foods and drinks. As you increase the amount of fiber in your diet, you also need to increase your fluid intake.

How much fluid is needed?

– Follow your thirst. The amount of water a child needs varies with physical activity and what the child eats. Therefore, it is very important to watch for signs of thirst in a child.

– When a child drinks enough water, his urine becomes clear, light yellow in color.Dark tea-colored urine usually means the baby needs to drink more.

Liquid types

1. Water: the best source of liquid.

2. One hundred percent juice: good for health, but it should be limited.

– 120-180 ml per day for children under 6 years old

– 240-360 ml per day for children over 6 years old

– Some juices (pear, apple, plum) contain sugars that act as a natural laxative and can help relieve constipation.

3. Milk:

– An important part of a child’s nutrition.

– Excessive consumption of milk can lead to constipation.

– Desirable rate for milk: 480-720 ml per day (2-3 cups).

4. Sports drinks and drinks with electrolytes:

– Sugar is often added to them.

– Not the best choice for kids.

– Check with your doctor before giving these drinks to your child.

5. Fruit drinks, sweet soda:

– As a rule, sugar is added to them.

– Not the best choice for kids.

– Better to save them for special occasions like holidays, not to give them to your child regularly.

Liquids and constipation

It is very important to increase your fluid intake while increasing your fiber intake. The liquid helps soften stools and makes bowel movements easier.

– Some juices (pear, apple, plum) are natural laxatives.

– It is advisable to give the child a lot to drink between meals, this promotes regular bowel movements.

– Drinks with a lot of sugar, caffeine, or “vitamin-fortified” drinks can worsen constipation.

Tips for increasing the amount of fluid in your diet

– Offer the child to drink water between meals, the child may drink too little on a full stomach.

– Offer your child fruits with a high water content, such as grapes, oranges or watermelon, during a light snack or as a treat.

– Keep a bottle or cup of water close at hand so your child can drink a little at all times.Add some citrus juice to the water to make it taste better. Or try adding a slightly different drink to the water.

– Lead by example. Children are more likely to drink water when they see their parents or siblings drinking water.

Training in bowel movement in the toilet

In case of constipation, it is very important to teach the child to use the toilet as soon as he feels the first urge. The easiest way to teach this is with a daily period of time when the child sits on the toilet for a long time.When your child gets used to sitting on the toilet for a long time, it will be easier for him to relax the muscles that hold the chair. By using daily sitting time on the toilet, your child will become less likely to hold a chair. When a child stops holding a stool, the intestines return to their normal size and become more sensitive.

How to teach a child to sit on the toilet for a long time every day

1. Be patient with yourself and your child. Learning a new skill, especially this skill, is never easy.

2. Start by teaching your child to sit on the toilet, even if he does not defecate:

– Start with 1-2 minutes. Increase the time very slowly to 10-12 minutes.

– Use a visual timer to help your child know how long they need to sit.

– Offer your child some quiet activity while sitting on the toilet. For example, reading a book, drawing, playing a handheld computer game, listening to music or audiobooks.

– Try to save the child’s favorite activity until the time of sitting on the toilet and do not offer it at any other time.

– Praise your child for even little progress.

– Never force a child to sit on the toilet and never hold him down by force unless you are working with a behavioral professional to help you do so safely.

3. Choose a time your child will use the toilet.

Making toilet use a regular part of your child’s daily routine will help develop a normal bowel movement.

– Children with autism often enjoy a routine. If sitting on the toilet becomes part of the daily schedule, it will reduce the risk of child resistance.

– Try using a visual timetable from pictures, one of which will be time in the toilet.

– If your child is most likely to have a bowel movement at some time of the day, try to schedule sitting on the toilet for that time.

– Morning will be the best time for most people, but it may not be suitable for a child who will be rushed to kindergarten or school in the morning.

– For some children, the best time is after coming home from school or kindergarten.

4. Make sure your baby is comfortable.

– Find the toilet seat or potty that is most comfortable for your child.

– Use a child toilet seat if the normal seat is too large for the child.

– Use a footrest if your child’s feet are not touching the floor.

How to teach to empty the bowels in the toilet

1.Make sure your child sits on the toilet for a long time 1-2 times each day.

2. Teach your child that “poop goes to the toilet” by emptying dirty diapers or laundry.

3. Try to sit on the toilet when you think your child is most likely to have stools.

4. Before sitting in the toilet try to stimulate the gastrocolic reflex. This reflex occurs after eating or drinking and allows the intestinal muscles to clear the stool after eating.To stimulate this reflex, try to have the child eat or snack and drink a warm drink before sitting on the toilet.

5. Observe possible signs in the child’s behavior. If you notice that he wants to use the toilet, then take him there. Signs may include:

– Changes in facial expressions.

– Attempts to go to a quiet part of the house.

– Muscle tension.

Positive reinforcement

– Start by rewarding your child for just sitting on the toilet.

– When the child starts to empty his bowels on the toilet, start rewarding him for it.

– Small rewards that the child receives immediately after the desired behavior work best.

– Give less rewards over time.

Try not to use food as a reward. Alternatively, you can reward the child with:

– Singing your favorite song with your child.

– Hugs, tickling, verbal praise.

– Favorite game with your child.

– Stickers that allow your child to track their progress.

– Time for your favorite pastime.

– Tokens (in the form of stickers, stars or other items), which can then be exchanged for very large rewards, for example, going to the cinema or to the park.

Many children with autism have special interests. They can be used when planning rewards. For example, if a child is interested in cars, then as a reward, he can view car magazines. If the child loves trains, then he can receive train stickers as a reward.

Positive rewards lead to the desired behavioral changes much faster than any punishment or criticism.

If the child gets dirty

– Say something like “I noticed that you got dirty” or “Please change your clothes.”

– Help your child to do this as needed.

– Do not scold the child and do not draw attention to what happened.

If the child does not want to sit in the toilet

– Try to keep the child as close to the toilet as possible when he starts to empty his bowels.If the child does it while standing in diapers, then try to have him do it while standing in the toilet.

– When the baby has defecated in the diaper, throw the contents of the diaper down the toilet in front of the baby.

– Teach your child to sit on the lowered toilet lid with clothes on. Give your child a toy to keep him busy for a while.

– Over time, move on to have the child sit on the toilet with the lid up, but in a diaper.

– Once your baby is comfortable sitting on the toilet with the lid up, cut a hole in the diaper and enlarge it over time.Try to get your baby to sit on the toilet in a diaper during a bowel movement.

Specialist assistance

Very often it is difficult for a family to change what is happening at home. Toilet training can be a very difficult behavioral problem. Some families need additional support from a specialist. Signs that the family needs more help include:

– The child gets very upset when taken to the toilet.

– The child keeps the chair longer.

– The child is developing constipation.

– Everything related to the toilet causes tantrums or aggression in the child.

Specialists may include child psychologist, behavioral analyst, pediatrician. Sometimes the staff of the child care institution that the child is visiting can help in finding the right specialist.

Preparations for daily use

– You can start taking them immediately if the child does not have acute constipation.

– Taken orally.

– Most effective when taken daily.

Purpose of taking the drug:

– Soft stools and bowel movements every day.

– All stools come out of the intestines.

Drug dosage:

– The initial dose of the drug must be prescribed by a doctor. Sometimes the dosage needs to be varied. Talk to your doctor about this to help you change your dosage.

When it is necessary to increase the dosage of the drug:

– Small and hard stools.

– The child does not have a bowel movement every day.

– It is difficult for the child to empty the intestines, or he experiences pain.

When you need to reduce the dosage of the drug:

– Loose stools.

– The child has abdominal pain or cramps.

Duration of drug treatment

– As a rule, the course of treatment lasts at least 6 months.

– After 6 months of daily bowel movements, the doctor may decide to gradually reduce the dosage of the drug.

– If you stop taking the drug before the intestines return to normal, constipation will begin again.

– It is important to make sure that the child has soft stools every day.

How do constipation medications work?

There are three types of laxatives. They act in different ways.

1. Osmotic laxatives. They transfer water to the stool to keep it soft. Safe and often prescribed for children. Usually taken every day.Suitable for long-term use.

Examples: polyethylene glycol without electrolytes, magnesium hydroxide, magnesium citrate, lactulose, sorbitol.

2. Stimulant laxatives. They promote the contractions of the intestinal muscles and propel the stool in the intestines. As a rule, they are prescribed for a single dose.

Examples: senna, bisacodyl.

3. Lubricating laxatives. Facilitate the passage of stools through the intestines with an oil base.

Examples: vaseline oil, glycerin suppositories.

Preparations for the treatment of acute constipation

Acute constipation occurs when large masses of hard stools block the intestines. If the doctor thinks that there is a blockage in the intestines, then as the first treatment option, he may prescribe a drug that “unclogs” the intestines.

Your doctor will work with you to determine the best type of drug. Sometimes drugs that are taken by mouth are best.Sometimes drugs that are injected into the intestines are better. This “cleaning” usually takes 2-3 days. It is best spent on weekends or vacations. The child will need to spend 2-3 days near the toilet and use it often.

Such drugs can only be prescribed by a doctor. He will tell you how long and how often to take the drug.

Enema Procedure

In most cases, constipation in children is treated with drugs that are taken by mouth.In some cases, children need a drug that is injected into the rectum. Talk to your doctor about the best treatment for your child. Do not give your child an enema without first talking to your doctor. The following is information on administering an enema if needed.

How to prepare a child for an enema

– Explain the procedure to the child in a way that he or she understands, perhaps using illustrations.

– Let your child examine and touch the enema bottle.

– Touch the tip of the enema to his hand so he knows what it is like.

– Help your child practice beforehand on how to lie properly during the enema.

Preparation for enema

– Read the instructions for the enema very carefully. Check the pictures and directions in the instructions.

– Make sure the enema is at room temperature.

– Prepare everything you need: a bottle of enema; a towel for the child to lie on; pillows; music, a favorite toy, or other items to help your child stay calm; wet cleaning wipes.

– Decide where you will administer the enema. Sometimes it’s best to place your baby on a blanket or large towel on the bathroom floor next to the toilet.

– Place towels and / or pillows for your baby to lie comfortably.

– Ask the other person to sit at eye level with the child during the procedure – read to him, sing, talk, play music or otherwise distract him and help him lie still.

How to do an enema

1.Wash your hands.

2. Remove the protective cap on the enema tip. The tip should have a lubricant to make it easier to administer the enema.

3. Help the baby to lie on the left side with the knees pressed against the chest.

4. Have your helper talk or sing to your child, trying to calm and reassure him.

5. Hold the enema in one hand. With your other hand, push your buttocks apart until you see the anus.

5. Very carefully insert the end of the bottle into the anus.Do not force it in.

6. Position the end of the enema towards the child’s back. The contents of the enema should fall on the intestinal wall, and not on the feces.

7. Squeeze the enema until almost the entire volume has been injected.

8. If possible, try to let the child lie down for 15-20 minutes. You can hold his buttocks to prevent him from pushing the enema out too early.

9. If your child wears diapers, put on a diaper.

10. If the child uses the toilet, put him on the toilet after 15-20 minutes. The liquid should go down the toilet with the stool.

If at any stage the child becomes very upset, starts crying, screaming, kicking, then it is normal to stop the procedure. Talk with your doctor about other treatments for constipation.

We hope the information on our website will be useful or interesting for you. You can support people with autism in Russia and contribute to the work of the Foundation by clicking on the “Help” button.

90,000 Constipation in a child is a cause for concern!

What to do?

Abdominal problems and stool disorders can occur in any child. If bowel movement is difficult, there are complaints of abdominal pain, the stool has become shallow and dry, it means that the child has constipation. This is a reason to contact a specialist – a pediatric gastroenterologist.

Causes of constipation in children

• Improper nutrition
• Fluid deficiency when the child drinks little
• Iron deficiency in the body
• Rickets
• Hormonal regulation disorders (diabetes, hypothyroidism, adrenal insufficiency, etc. ))
• Accumulation of feces in the intestine due to obstructions formed in it (tumors, polyps, etc.)
• Congenital organ pathologies
• Psychological constipation

Why is it necessary to treat constipation in a child?

Systematic untimely bowel emptying can have a detrimental effect on the digestive tract and on the entire body as a whole. Also, if the causes are not identified and eliminated, constipation can become chronic.

Treatment of child constipation

Treatment of constipation in children is an individual case, where all factors are taken into account: the severity of the disease, the causes, age and psychological characteristics of the development of the baby, concomitant diseases.

Correction of the diet is a mandatory link in the treatment of childhood constipation. In most cases, doctors advise changing the eating habits of each family member. It is also important to follow the correct drinking regime.

Copes with constipation, and physical activity and compliance with the regimen help to normalize the bowel function. It is necessary that not only every meal, but also a trip to the toilet, always take place at a certain time.

If a child is worried about constipation, parents should not cope with this problem on their own!

Specialists of the highest category of the Clinic Alexandria – will help you recognize the disease in time and prescribe an effective treatment.

90,000 5 Steps to Intestinal Health After Self-Isolation

During the long period of isolation, the way of life of Russians has changed significantly.

Stress, lack of physical activity, change in diet – all this can lead to negative consequences for the body, including the intestines. With the arrival of spring, I want to quickly return to my usual way of life and take care of my health.

Constipation is one of the pressing problems of residents of megacities and the most common complaint about gastrointestinal disorders. About 16% of people in the world suffer from them regularly (1). About a third of people over the age of 60 may have difficulty having a bowel movement. Therefore, this issue is especially acute for the elderly, who were first of all recommended to strictly observe the home regime.

Russian gastroenterologists recommend solving the problem of constipation in a complex way – through lifestyle and nutritional changes, taking medications (2).What simple steps can you take to get your bowels up and running after a long, sedentary period?

1. Check nutrition – do not skip meals and include in the diet a sufficient amount of foods containing fiber and other plant fibers – vegetables, fruits, bran, beans, cereals, nuts.

2. Drink enough water and other fluids to stay hydrated.Water helps fiber to work more efficiently and avoid constipation.

3. Play sports and move more. Getting enough physical activity is important for gut health.

4. Reduce stress. Nervous tension, depression, depressed mood can contribute to the formation of constipation.

5. If the listed methods do not help or if you want to solve the problem quickly, after consulting your doctor, you can try laxatives.Out of habit, many people choose senna and preparations containing it, focusing on the low price and “naturalness”. Long-term use of such laxatives can cause addiction and inflammation in the intestines, up to ulceration (3). A worthy example of an herbal alternative is Slabilen, an affordable laxative based on sodium picosulfate (4). It does not contain senna, stimulates the natural bowel cleansing process and allows you to plan your day with predictable effects in the morning when taken at night (5).

(1) Forutan M., Bagheri N., Darvishi M. Chronic constipation: literature review, Medicine, 2018 https: //journals. lww.com/md-journal/Fulltext/2018/05180/Chronic_constipation__A_review_of_literature …

(2) Constipation, Clinical Guidelines, Ministry of Health of the Russian Federation. http://www.gastro.ru/userfiles/R_zapor_2019.pdf

(3) Shulpekova Yu.O. Constipation and methods of its treatment // BC. Diseases of the digestive system.2006. Volume 8. No. 2.

(4) IMP SLABILEN® tablets from 28.12.2020 (RU No. LP-002500), drops from 20.10.2020 (RU No. 002911/01) https://products.veropharm.ru/products/gastroenterology/slabilen The Slabilen brand is included in top three

cheap laxatives based on sodium picosulfate according to IQVIA retail sales (Sell-out) at selling prices in November 2020.

(5) According to UTI 10-12 hours after ingestion.

Instruction SLABILEN® tablets RU No. LP-002500, drops RU No. 002911/01 products.veropharm.ru; JSC “VEROPHARM” 115088 Moscow, 2nd Yuzhnoportovy proezd, 18, building 9, floor 2. Tel./fax: (495) 792-53-30 / 792-53-28; LLC “VEROPHARM”, 601125, Vladimir region, Petushinsky district, pos. Volginsky, st. Factory, ow. 120. Tel./fax: (4922) 37-98-28. VER2187839 (v1.1) From 04/22/2021.

There are contraindications. Before use, you must read the instructions for use or consult a specialist.

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Gastroenterology – Insight Medical Kiev Poznyaki

This section presents articles and materials on the topic Gastroenterology

Cholelithiasis is a disease caused by impaired metabolism of cholesterol and / or bilirubin and characterized by the formation of stones in the gallbladder and / or in the bile ducts.

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Functional dyspepsia is understood as a complex of disorders that include pain and a burning sensation in the epigastric region, a feeling of fullness and discomfort after eating and early satiety, which have been observed in the patient for at least 3 recent months (with a total duration of complaints of at least 6 months) and which cannot be explained by organic lesions of the gastrointestinal tract (GIT).

More information …

Neshik Natalya Valerievna is a doctor who is in love with gastroenterology and is constantly improving. She has mastered everything that is possible to study for her work: dietology, helminthology, hepatology, ultrasound diagnostics.

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Nonlicobacter – are microorganisms that settle in the human body in the gastrointestinal tract, and cause inflammation and peptic ulcer disease.This is due to their ability to produce cytotoxins and specific enzymes that penetrate into the intercellular spaces and lead to damage to the cells of the gastric mucosa. Helicobacter microorganisms enhance the aggressive properties of gastric contents (hydrochloric acid, enzymes, etc.) and weaken the protective factors of the mucous membrane of the stomach and duodenum.

More information …

Constipation is delayed, difficult or insufficient bowel movement. Many people suffer from constipation. This problem, associated with many factors, disrupts the work of the whole organism and depresses a person emotionally. We can assert that a person suffers from constipation when the frequency of defecation is less than 3 times a week and if the process of defecation takes place with great straining in more than 25% of cases, as well as in patients who have “sheep feces” and complain of a feeling of incomplete emptying intestines after a bowel movement. If these symptoms persist for more than 6 weeks, we may be talking about chronic constipation.

More information …

Chronic pancreatitis. Slowly progressive inflammation of the pancreas, accompanied by dysfunctions, periods of exacerbation are replaced by remissions. The outcome of the disease is fibrosis of the pancreatic tissue or its calcification. May be a consequence of acute pancreatitis and damage to other organs of the digestive tract: cholecystitis, peptic ulcer disease, intestinal and liver diseases, conditions after cholecystectomy, infectious diseases, allergic reactions, endocrine diseases. Alcoholism plays an important role.

More information …

Chronic colitis – inflammatory, dystrophic and atrophic changes in the mucous membrane of the colon, which are accompanied by its motor and secretory “disorders. Causes of chronic colitis: infectious diseases (primarily dysentery), nutritional defects, exposure to toxic substances (lead, arsenic, mercury), drugs (uncontrolled intake of antibiotics, laxatives), allergies, diseases of the gastrointestinal tract (pancreatitis, gastritis).

More information …

Dysbacteriosis – violation of the qualitative and quantitative composition of the intestinal microflora, which normally populates it, and the reproduction of microbes, which are normally absent. Dysbacteriosis can be an independent disease or accompany diseases of the colon. The cause of its occurrence may be impaired digestion of food in various diseases of the gastrointestinal tract, uncontrolled or prolonged use of antibiotics that suppress the growth of normal intestinal flora.

More information …

What is chronic duodenitis? Course and symptoms

Chronic duodenitis. Disease of the duodenum, the main manifestation of which are changes in the mucous membrane in the form of inflammation, atrophy, erosions. It can be an independent disease, as well as concomitant peptic ulcer disease, chronic pancreatitis, cholecystitis, gastritis, food allergies, liver diseases.

More details…

Symptoms and diagnosis of gastritis

Chronic gastritis – chronic inflammation of the gastric mucosa. As a result, there is a violation of physiological regeneration, function, atrophy of the glandular epithelium, disorder of the secretory, motor and other functions.

This disease is characterized by frequent exacerbations, especially in the off-season, gastric ulcer and 12-p-intestinal ulcer, stomach neoplasms can develop.

More information …

90,000 Baby pot delicate problem

Various disorders of the digestive system in children are a frequent reason for seeking medical help. One of the most common complaints is constipation. The problem, despite its rather “intimate” nature, causes a lot of trouble for the child and parents.

What can be considered constipation?

If in children of the first year of life, receiving only breast milk, the frequency of stool varies widely – from 1 time in two weeks to 10 times a day, then after the introduction of complementary foods or with artificial feeding, stool should be at least three times a week, enough soft, without strong straining and in moderation.If the stool becomes sparse, dense, large, or requires excessive straining, you should seriously consider whether your child is constipated.

In childhood, especially at an early age, a number of intestinal features contribute to the development of constipation, while neuro-reflex connections have not yet been established, the defecation mechanism is developed gradually depending on the environment and the individual characteristics of the organism. “Maturation” occurs during the first months and years of a child’s life, and before that, the intestines remain extremely vulnerable to adverse factors.

Why does constipation occur? First, if too much water is absorbed, the stool becomes harder. This can happen if muscle contractions of the intestinal wall (called peristalsis) do not move food debris quickly enough through the large intestine to the rectum. Violation of muscle contractions of the intestine is caused by factors such as stress (during forced potty training, the beginning of a visit to a child care center, on a trip), illness, insufficient physical activity, taking certain medications, a small volume of fluid, the absence of formed habits for emptying the intestines, a small amount taken food and liquids, and especially a qualitatively unbalanced food composition with a lack of dietary fiber.Secondly, constipation develops when the emptying function of the rectum is disturbed, which, unlike other parts of the intestine, can be consciously controlled by the child from the second half of the year. Naturally, this function largely depends on the psychological state, although it also depends on many others, including the above factors. In 95% of children, the cause of constipation is precisely functional disorders.

Much less common causes of constipation are congenital anatomical anomalies of the intestine.Among bowel anomalies, there are more frequent enlargements of the lumen or an increase in the length of various parts of the colon, as well as complete and incomplete infections (called atresia and stenosis, respectively) of the rectum and anus. Diseases accompanied by a congenital anomaly in the development of the nerve plexuses of the intestinal wall include Hirschsprung’s disease. As a rule, congenital malformations cause pronounced manifestations of constipation at an early age and are subject to surgical correction. In early childhood, constipation can develop against the background of food allergies, cystic fibrosis, celiac disease, various diseases of the nervous and muscular systems (infantile cerebral palsy, myopathies, injuries and malformations of the spinal cord), endocrine pathology and metabolic disorders (especially with congenital insufficiency of thyroid function). glands, rickets).

Fortunately, despite the frequent complaints of parents about the difficulty of defecation in children, it is not always about true constipation. Numerous external factors contributing to stool retention, in most cases, lead only to a short-term disruption in the work of the intestines. Usually, normal bowel function is restored after elimination of the provoking factor (fear, acute infectious diseases, eating disorders or insufficient fluid intake). In other cases, the child’s body adapts to new conditions.This, as a rule, is a change in the nature of nutrition (transition to artificial feeding, the introduction of a new mixture, new in composition and culinary processing of dishes, an increase in the intervals between meals) or the regime of the day (change of home environment, strong impressions, lack of habitual conditions for “going on pot”). Only in a very small number of children the problem of obstructed bowel movement becomes protracted and becomes a reason for seeking medical help.

Particular attention should be paid to the likelihood of developing acute stool retention in some surgical diseases (mainly intestinal obstruction).At the same time, the child shows signs of an increasing deterioration in the condition (intense abdominal pain, signs of intoxication: fever, lethargy, a sharp decrease in appetite). There can be no talk of an independent resolution of the threat that has arisen and wait-and-see tactics! This situation requires urgent medical attention.

In what cases should parents get ready to see a doctor, and when can they wait? If your baby has constipation from birth, and the chair appeared in the hospital on time and the examination of the child did not cause anxiety in the pediatrician, then the mother should carefully review her diet.Its composition should include a sufficient amount of foods containing fiber (a variety of fruits, vegetables, cereals). But you should be warned against excessive enthusiasm for dairy food, since often an allergy to cow’s milk proteins is the cause of constipation in an infant. In addition, excessive consumption of flour, fatty foods, and sweets also inhibits intestinal contractions. It is necessary to avoid foods that delay bowel movement (strong tea, cocoa, semolina, rice, starch, from premium flour), rich in essential oils (radish, onion, garlic).And, of course, a nursing mother should drink enough fluids. Intestinal motility is negatively affected by smoking, alcohol intake, drugs, taking certain medications (antacids containing aluminum and calcium salts, antidepressants, diuretics, some heart medications, etc.).

All of the above nutritional recommendations should be applied subsequently to the child. Insufficient food intake will also lead to stool retention.

If for some reason you are forced to transfer your baby to artificial feeding, consult your pediatrician and get advice on the right choice.Many of today’s blends contain ingredients that improve bowel function (called pre- and probiotics). Timely introduction of complementary foods (at the age of 4 to 6 months) is necessary to stimulate intestinal peristalsis.

If you have carried out all the above measures, and the child continues to recover tightly and rarely, then you should not hesitate to visit a doctor to determine the causes of constipation and treatment tactics.

As they grow older, psychogenic influences on the child become quite important, of which fear has the strongest influence in the development of constipation.A previous intestinal infection or a course of antibiotics often leads to the destruction of normal intestinal microflora, which significantly increases the risk of constipation in children.

After the normalization of the diet, the correct choice of products, the creation of favorable living and social conditions, with a high degree of probability, it is possible to expect the restoration of normal bowel movement. If there is no improvement, a doctor’s consultation is necessary.

An approximate program of regime measures for constipation is as follows:

• Stimulation of the urge to defecate by taking cool water in the morning, followed by a visit to the toilet.
• Appointment of additional ballast substances – wheat bran in a dose – age in years + 5 g per day; adding to the diet of seaweed. These additives prevent the stool from thickening, increasing its volume.
• Creation of favorable conditions for defecation (observance of hygiene rules, calm familiar environment).
• Sufficient physical activity of the child, especially with exercises to strengthen the muscles of the anterior abdominal wall.
• Control over regular (1 time in 1-2 days) bowel movements, preferably in the morning.

If the constipation persists and is not taken care of, the child may develop fecal incontinence (calorification, or encopresis). It usually occurs due to the overflow of the dilated rectum and the inability to empty the bowels. Then the softer feces, flowing around a wide dense “cork”, are excreted through the anus in small portions, like “paste from a tube”.

As with other painful conditions, the sooner you pay attention to stool retention in your child, the more opportunities to cope with it faster and avoid very unpleasant complications in the future.

Zagorskiy Sergey Everovich – pediatric gastroenterologist, Ph.D. honey. sciences, associate professor

Zagorskaya Irina Valentinovna – doctor of the 15th children’s polyclinic in Minsk

90,000 Constipation in a child 2 years of age and older

3. Causes of constipation in children

The most common and easily eliminated causes of constipation in children are eating and drinking disorders.

Wrong diet

Constipation can be the result of an unbalanced diet in a child.Food that does not contain enough water and fiber makes it difficult for feces to move through the intestines. Children who eat mostly processed foods, hard cheeses, white bread and baked goods, and meat, constipation can be a frequent companion.

Violation of drinking regime

One of the most common reasons – the child drinks little. Normally, a child over one year old should receive at least 30 ml of liquid per kg of weight, and with an increase in temperature, hot weather or physical exertion, this rate can increase significantly.

Other causes of constipation in a child may include:

Taking certain medications

Certain medications, such as those used to treat iron deficiency, can cause constipation.

Power change

Constipation can occur in infants when switching from breast milk to infant formula or from infant formula to solid foods.

Potty training

When potty training becomes like “coercion”, babies can develop constipation due to psychological reasons – fear, inconvenience, unwillingness to learn.

Suppression of urge to go to the toilet

Some children avoid going to the toilet, even if they feel the urge. They can ignore internal sensations and restrain urges for various reasons: for example, because of the unwillingness to use the toilet away from home, hobbies and unwillingness to interrupt a fun game, or the need to ask an adult for help. Ignoring the urge to use the toilet in children can be a serious problem – this quickly leads not only to constipation, but also to a violation of the defecation reflex in general.

Stress

Stress can also lead to constipation. Children may suffer from constipation due to the need to start a new school or having some psychological problems at home. Research shows that emotional distress can affect how well your gut functions and can cause both constipation and diarrhea.

Irritable bowel syndrome

Some children suffer from constipation due to irritable bowel syndrome (IBS), which can occur when they are stressed or eat certain foods, such as fatty or overly spicy foods.A child with IBS may have constipation or diarrhea, as well as abdominal pain and flatulence.

Imbalance of intestinal microflora

Dysbiosis (dysbiosis) can be a common cause of various bowel dysfunctions, including constipation and diarrhea.

Other diseases

In some cases, constipation is a symptom of other medical conditions. Therefore, talk to your doctor if your child continues to have problems or if constipation lasts longer than 2-3 weeks.