What are the common causes of constipation. How does lifestyle affect bowel movements. Can medications lead to constipation. What role does diet play in preventing constipation. How can exercise help alleviate constipation. When should you see a doctor for constipation. What are the long-term effects of chronic constipation.

The Prevalence and Impact of Constipation

Constipation is a widespread digestive issue that affects people of all ages. It occurs when bowel movements become less frequent or more difficult to pass, often causing discomfort and frustration. While occasional constipation is common and usually not serious, chronic constipation can significantly impact quality of life and may indicate underlying health concerns.

The frequency of bowel movements varies from person to person, with some individuals having multiple daily movements while others may only have a few per week. However, constipation is generally defined as having fewer than three bowel movements per week or experiencing difficulty passing stools.

Key Indicators of Constipation

• Infrequent bowel movements
• Hard, dry, or lumpy stools
• Straining during defecation
• Feeling of incomplete evacuation
• Abdominal discomfort or bloating

Understanding the causes and risk factors for constipation is crucial for prevention and effective management. Let’s explore the various factors that can contribute to this common digestive issue.

Lifestyle Factors Contributing to Constipation

Our daily habits and routines play a significant role in digestive health. Several lifestyle factors can increase the risk of constipation:

Lack of Physical Activity

Regular exercise is essential for maintaining healthy bowel function. How does physical activity affect constipation? Exercise stimulates the muscles in the intestines, promoting peristalsis – the wave-like contractions that move food through the digestive tract. Additionally, physical activity helps strengthen abdominal muscles and the diaphragm, which are crucial for effective bowel movements.

People who lead sedentary lifestyles are more prone to constipation. This is particularly true for older adults, who may be less active due to physical limitations or health conditions. Incorporating regular exercise into your routine can significantly improve bowel regularity and overall digestive health.

Ignoring the Urge to Defecate

Repeatedly postponing bowel movements can lead to constipation. When you ignore the natural urge to defecate, the stool remains in the colon for longer periods, allowing more water to be absorbed. This results in harder, drier stools that are more difficult to pass.

Over time, consistently ignoring the urge to have a bowel movement can weaken the body’s natural signals, making it harder to recognize when it’s time to go. This can create a cycle of chronic constipation that becomes increasingly difficult to break.

Changes in Routine

Disruptions to your normal daily routine can often lead to constipation. Common scenarios include:

• Traveling: Changes in diet, sleep patterns, and bathroom access can affect bowel regularity
• Pregnancy: Hormonal changes and the physical pressure of the growing uterus can cause constipation
• Aging: Reduced intestinal activity and muscle tone often lead to more frequent constipation in older adults

Maintaining consistency in your daily habits, including meal times and bathroom routines, can help minimize the risk of constipation during periods of change.

The Role of Diet in Constipation

What we eat and drink has a direct impact on our digestive health. Dietary factors play a crucial role in both causing and preventing constipation.

Fiber Intake and Hydration

A diet low in fiber and inadequate fluid intake are common culprits in constipation. Fiber adds bulk to the stool and absorbs water, making it softer and easier to pass. There are two types of fiber:

1. Soluble fiber: Dissolves in water and forms a gel-like substance that helps soften stools
2. Insoluble fiber: Adds bulk to the stool and helps it move through the digestive tract more quickly

How much fiber should you consume daily? The recommended daily intake is 25-30 grams for adults. Good sources of fiber include fruits, vegetables, whole grains, legumes, and nuts.

Adequate hydration is equally important. Water helps keep stools soft and easier to pass. Aim for at least 8 glasses of water per day, and increase intake when consuming high-fiber foods or during hot weather.

The Impact of a High-Fat Diet

Diets high in fat and low in fiber can contribute to constipation. Fatty foods take longer to digest and can slow down the movement of food through the intestines. This prolonged transit time allows more water to be absorbed from the stool, leading to harder, drier stools that are difficult to pass.

Balancing your diet with a variety of nutrient-dense, fiber-rich foods and limiting excessive fat intake can help maintain regular bowel movements.

Medications and Their Effect on Bowel Function

Many prescription and over-the-counter medications can cause or exacerbate constipation. Understanding these effects is crucial for managing digestive health, especially for those on long-term medication regimens.

Opioids and Constipation

Opioid-induced constipation is a widespread side effect of these powerful pain medications. How prevalent is this issue? Studies show that approximately 94% of cancer patients taking opioids for pain management experience constipation, as do 41% of individuals using opioids for chronic non-cancer pain.

Opioids slow down the movement of food through the digestive tract and reduce the secretion of digestive fluids. This combination leads to harder, drier stools and less frequent bowel movements. For patients requiring long-term opioid therapy, proactive management of constipation is often necessary.

Other Medications Associated with Constipation

Various other medications can contribute to constipation, including:

• Antacids containing aluminum
• Antispasmodics
• Antidepressants
• Tranquilizers and sedatives
• Iron supplements
• Diuretics
• Calcium channel blockers
• Anticonvulsants

If you’re experiencing constipation and taking any of these medications, consult your healthcare provider. They may be able to adjust your dosage, switch to an alternative medication, or recommend strategies to manage constipation while continuing necessary treatment.

Medical Conditions Associated with Constipation

Constipation can sometimes be a symptom of underlying medical conditions. Understanding these associations can help in identifying potential causes and seeking appropriate treatment.

Irritable Bowel Syndrome (IBS)

IBS is a common digestive disorder characterized by abdominal pain and changes in bowel habits. For some individuals with IBS, constipation may be the predominant symptom, while others may experience alternating periods of constipation and diarrhea.

How does IBS cause constipation? The exact mechanisms are not fully understood, but it’s believed that altered gut motility, increased sensitivity to digestive processes, and changes in the gut microbiome all play a role. Managing IBS-related constipation often requires a multi-faceted approach, including dietary changes, stress management, and sometimes medication.

Neurological and Endocrine Disorders

Several neurological and endocrine conditions can lead to chronic constipation:

• Parkinson’s disease: Affects the nerves controlling intestinal muscles
• Multiple sclerosis: Can disrupt nerve signals to the digestive system
• Hypothyroidism: Slows down many bodily processes, including digestion
• Diabetes: Can cause nerve damage affecting digestive function

In these cases, treating the underlying condition is often key to managing constipation. However, additional interventions may be necessary to maintain regular bowel function.

Structural Issues and Obstructions

Physical obstructions or changes in the structure of the digestive tract can also cause constipation. These may include:

• Bowel cancer: Can cause narrowing of the intestinal passage
• Diverticulitis: Inflammation of small pouches in the colon wall
• Adhesions: Scar tissue from previous surgeries
• Strictures: Narrowing of the colon or rectum

These conditions often require medical or surgical intervention to address the underlying cause of constipation.

The Dangers of Chronic Constipation

While occasional constipation is common and usually not serious, chronic constipation can lead to complications and impact overall health. Understanding these potential risks is important for recognizing when to seek medical attention.

Potential Complications

Long-term constipation can result in several health issues:

• Hemorrhoids: Swollen veins in the rectum due to straining
• Anal fissures: Small tears in the skin around the anus
• Fecal impaction: Hardened stool that becomes stuck in the rectum
• Rectal prolapse: Protrusion of the rectum through the anus
• Bowel incontinence: Loss of control over bowel movements

In rare cases, severe chronic constipation can lead to more serious complications such as bowel obstruction or perforation, which require immediate medical attention.

Impact on Quality of Life

Chronic constipation can significantly affect daily life and well-being. It may cause:

• Physical discomfort and pain
• Reduced appetite
• Fatigue
• Mood changes and irritability
• Social isolation due to embarrassment or discomfort

Addressing chronic constipation is crucial not only for physical health but also for overall quality of life and mental well-being.

When to Seek Medical Attention for Constipation

While most cases of constipation can be managed with lifestyle changes and over-the-counter remedies, there are instances where medical intervention is necessary. Recognizing these signs is crucial for timely treatment and prevention of complications.

Red Flags for Serious Conditions

Seek immediate medical attention if you experience constipation along with any of the following symptoms:

• Severe abdominal pain
• Unexplained weight loss
• Blood in the stool
• Persistent changes in bowel habits
• Fever
• Vomiting

These symptoms may indicate more serious underlying conditions such as inflammatory bowel disease, bowel obstruction, or colorectal cancer.

Chronic Constipation

If you’ve been experiencing constipation for several weeks or longer, despite trying lifestyle changes and over-the-counter treatments, it’s time to consult a healthcare provider. Chronic constipation may require a more comprehensive evaluation to identify underlying causes and develop an effective treatment plan.

Your doctor may recommend tests such as:

• Blood tests to check for hormonal imbalances or other systemic issues
• Imaging studies like X-rays or CT scans to examine the structure of your digestive tract
• Colonoscopy to inspect the lining of your colon and rectum

Based on these findings, your healthcare provider can develop a tailored treatment approach to address your specific needs and underlying causes of constipation.

Effective Strategies for Managing and Preventing Constipation

While constipation can be uncomfortable and sometimes concerning, there are numerous strategies to both manage existing symptoms and prevent future occurrences. A combination of lifestyle changes, dietary adjustments, and, when necessary, medical interventions can help maintain regular bowel function.

Lifestyle Modifications

Incorporating healthy habits into your daily routine can significantly improve bowel regularity:

• Regular exercise: Aim for at least 30 minutes of moderate activity most days of the week
• Establish a toilet routine: Set aside time each day for undisturbed bathroom visits
• Respond to natural urges: Don’t ignore the need to have a bowel movement
• Stress management: Practice relaxation techniques like deep breathing or meditation

Dietary Changes

Adjusting your diet can have a profound impact on digestive health:

• Increase fiber intake: Gradually add more high-fiber foods to your diet
• Stay hydrated: Drink plenty of water throughout the day
• Limit processed foods: Focus on whole, nutrient-dense foods
• Consider probiotics: These beneficial bacteria can support digestive health

Over-the-Counter Remedies

For occasional constipation, several OTC options are available:

• Bulk-forming laxatives: Add fiber to the stool
• Osmotic laxatives: Draw water into the colon to soften stool
• Stool softeners: Increase the water content of stools
• Stimulant laxatives: Trigger intestinal contractions (use sparingly and under medical guidance)

It’s important to use these remedies as directed and not rely on them long-term without consulting a healthcare provider.

Medical Treatments

For chronic or severe constipation, your doctor may recommend:

• Prescription medications to increase intestinal motility or secretion
• Biofeedback therapy to improve coordination of pelvic floor muscles
• In rare cases, surgery to address structural issues causing constipation

The key to effective constipation management is a personalized approach that addresses your specific needs and underlying causes. By combining lifestyle changes, dietary adjustments, and appropriate medical interventions when necessary, most people can achieve regular, comfortable bowel movements and improve their overall digestive health.

Common causes of constipation – Harvard Health

Many factors can dispose a person to constipation. Some can easily be prevented by changing habits and lifestyle (although the role of lifestyle factors may not be as important as once thought). Often, the cause has to do with physiological problems or diseases.

Following are the more common causes of constipation:

Lack of exercise. People who exercise regularly generally don’t develop constipation. Basically, the colon responds to activity. Good muscle tone in general is important for regular bowel movements. The abdominal wall muscles and the diaphragm all play a crucial role in the process of defecation. If these muscles are weak, they’re not going to be able to do the job as well. But exercise is not a cure-all. Increasing exer-cise to improve constipation may be more effective in older people, who tend to be more sedentary, than in younger people.

Opioids. The digestive tract has receptors for opioids, and constipation can occur (or worsen) when people take opioid pain medications. Opioid-induced constipation occurs in roughly 94% of cancer patients taking opioids for pain and 41% of people taking opioids for chronic noncancer pain.

Other medications. Constipation is a side effect of many prescription and over-the-counter drugs. These include antacids that contain aluminum, antispasmodics, antidepressants, tranquilizers and sedatives, bismuth salts, iron supplements, diuretics, anticholinergics, calcium-channel blockers, and anticonvulsants.

Irritable bowel syndrome (IBS). Some people who suffer from IBS have sluggish bowel movements, straining during bowel movements, and abdominal discomfort. Constipation may be the predominant symptom, or it may alternate with diarrhea. Cramping, gas, and bloating are also common.

Abuse of laxatives. Laxatives are sometimes used inappropriately, for example, by people suffering from anorexia nervosa or bulimia. But for people with long-term constipation, the extended use of laxatives may be a reasonable solution. In the past, long-term use of some laxatives was thought to damage nerve cells in the colon and interfere with the colon’s innate ability to contract. However, newer formulations of laxatives have made this outcome rare

Changes in life or routine. Traveling can give some people problems because it disrupts normal diet and daily routines. Aging often affects regularity by reducing intestinal activity and muscle tone. Pregnancy may cause women to become constipated because of hormonal changes or because the enlarged uterus pushes on the intestine.

Ignoring the urge. If you have to go, go. If you hold in a bowel movement, for whatever reason, you may be inviting a bout of constipation. People who repeatedly ignore the urge to move their bowels may eventually stop feeling the urge.

Not enough fiber and fluids in the diet. A diet too low in fiber and fluids and too high in fats can con-tribute to constipation. Fiber absorbs water and causes stools to be larger, softer, and easier to pass. Increasing fiber intake helps cure constipation in many people, but those with more severe constipation sometimes find that increasing fiber makes their constipation worse and leads to gassiness and discomfort.

Other causes. Diseases that can cause constipa-tion include neurological disorders, such as Parkinson’s disease, spinal cord injury, stroke, or multiple sclerosis; metabolic and endocrine disorders, such as hypothyroidism, diabetes, or chronic kidney disease; bowel cancer; and diverticulitis. A number of systemic conditions, like scleroderma, can also cause constipation. In addition, intestinal obstructions, caused by scar tissue (adhesions) from past surgery or strictures of the colon or rectum, can compress, squeeze, or narrow the intestine and rectum, causing constipation.

For more on treating constipation and other gastrointestinal conditions, read The Sensitive Gut, a Special Health Report from Harvard Medical School.

Image: © Wavebreakmedia | GettyImages

Constipation – familydoctor.

org

What is constipation?

Constipation is a common condition that makes it difficult to have a bowel movement. A bowel movement occurs when the food you eat passes through your digestive system. Your body takes the nutrients it needs from that food. What’s left over is called stool. Your stool can be soft or hard. Bowel movements usually happen on a regular basis.

Everyone has a bowel movement schedule (how often, how consistent, and what time of day it occurs). However, if your bowel movements become less frequent (based on your history), are hard (and difficult to pass), and you are physically uncomfortable, you may be constipated. People of all ages experience constipation occasionally. Usually, it goes away and is not serious. See your doctor if your constipation is chronic (frequent). It may be a problem with your diet or a health problem.

Symptoms of constipation

• Feeling like you still need to have a bowel movement, even after you’ve had one.
• Feeling like your intestines or rectum (bottom) are blocked.
• Having hard, dry stool that is difficult to pass.
• Having fewer than 3 bowel movements in a week.
• Straining to have a bowel movement.

More serious symptoms include:

• Constipation is new and unusual for you.
• You have been constipated for 3 weeks or more despite dietary changes to help.
• You have abdominal (stomach) pain.
• You lose weight without trying.
• You notice blood or white mucous in your stool.
• You cannot pass the stool on your own.

Complications of chronic constipation include:

• Anal fissure (a tear in the skin around your anus).
• Stool impaction (when your stool becomes too large to pass on your own).
• Hemorrhoids.
• Rectal prolapse (when a small piece of your intestine comes out of your anus from straining to have a bowel movement).
• Encopresis (when your bowels are so backed up that only liquid can pass through). Many people mistake this for diarrhea take anti-diarrheal medicine, making constipation even worse.

Complications of constipation can become serious if left untreated. They may require surgery.

What causes constipation?

Constipation can be caused by your diet (too many processed foods and not enough fiber), certain medicines (opioid medicines given for pain and even too many laxatives, which usually help you have a bowel movement), dehydration (especially not enough water), too little physical activity, intestinal problems, and major life changes, such as pregnancy. Constipation becomes more common as you age. Certain diseases and disabilities also can cause constipation. These include multiple sclerosis, stroke, diabetes, hypothyroidism, and lupus.

Dehydration (not enough fluids) and dietary changes are the most common causes of constipation in babies. For example, changing from breast milk to cow’s milk or from baby food to solids can cause constipation.

How is constipation diagnosed?

Your doctor will ask you about your symptoms and medical history. This will include asking you about any medicines you take. Your doctor also will ask when you had your last bowel movement and how often you have them. Think about that before you see your doctor. It might be helpful to write it down for yourself or a child before your appointment. During the visit, your doctor may examine your rectum (the end of your large intestine near your anus). The doctor will insert his or her finger (while wearing rubber gloves) into your rectum to feel for blockages.

Your doctor may order additional tests, including a blood test and X-ray. A more thorough test is a colonoscopy. This is an invasive procedure done with anesthesia. During this test, your doctor will examine your colon with a long, flexible scope attached to a camera.

Can constipation be prevented or avoided?

There are things you can do to reduce constipation. These include:

• Add more fiber to your diet. Adults should eat between 20-35 grams of fiber each day. Foods, such as beans, whole grains, fruits, and vegetables are high in fiber.
• Drink more water. Being dehydrated causes your stool to dry out. This makes having a bowel movement more difficult and painful.
• Don’t wait. When you have the urge to have a bowel movement, don’t hold it in. This causes the stool to build up.
• Get physical. Exercise is helpful in keeping your bowel movements regular.
• Beware of medicines. Certain prescription medicines (especially pain medicines) can slow your digestive system. This causes constipation. Talk to your doctor about how to prepare for this if you need these medicines.
• Talk to your doctor if you are being treated for certain diseases that are related to constipation. He or she may have additional guidance for lowering your risks.

Constipation treatment

Most cases of constipation are easy to treat at home with diet and exercise. Some cases require doctor recommendations, prescription medicine, or a medical procedure.

At home treatment includes:

• Diet: Eating a healthy diet with fiber and drinking plenty of fluids (water is the most helpful) can usually clear up constipation.
  • High fiber foods include beans, dried fruits, fresh fruits and vegetables, whole-grain foods (choose brown rice or whole wheat bread instead of white), flaxseed meal, and powdered products containing psyllium. For example, 3 cups of popped popcorn has a little more than 3 grams of fiber. One cup of oatmeal has 4 grams of fiber. Adding fiber to each meal and snack will help you reach your goal for the day. Fiber supplements are helpful. Processed foods, such as desserts and sugary drinks, only make constipation worse.
  • Men over the age of 50 should get at least 38 grams of fiber per day.
  • Women over the age of 50 should get 25 grams per day.
  • Children ages 1 to 3 should get 19 grams of fiber per day.
  • Children between 4 and 8 years old should get 25 grams per day.
  • Girls between 9 and 18 should get 26 grams of fiber each day. Boys of the same age range should get between 31 and 38 grams of fiber per day.
• Bowel training: Teach your children to go to the bathroom when they have to. Holding it can lead to constipation. This also may be necessary for your elderly parents, if you are caring for them.
• Laxatives: This is over-the-counter medicine that helps you have a bowel movement. Laxatives should only be used in rare instances. Do not use them on a regular basis. If you have to use a laxative, bulk-forming laxatives are best (two brands: Metamucil and Benefiber). These work naturally to add bulk and water to your stools so they can pass easily. Bulk-forming laxatives can cause some bloating (when your stomach feels full) and gas.

Doctor recommended treatments:

• Mineral oil: Do not use this without your doctor’s recommendation. Your doctor may recommend using it if you recently had surgery and should not strain for a bowel movement. Do not use it regularly. It causes your body to lose important vitamins: A, D, E and K.
• Enema: This is a liquid medicine. It is inserted into your anus to help with constipation. It is often used after a surgery or before some medical procedures.
• Prescription medicine. Your doctor will prescribe a medicine based on the reason for your constipation.
• Medical procedures. This is done to help remove stool from the intestine.
• Surgery: This is rare. It might involve removing a damaged intestine for serious reasons.

Living with constipation

Living with constipation can be uncomfortable and miserable. This is true when it’s just for just a couple of days. Routine (chronic) constipation can be so uncomfortable that it influences how your clothes fit, what foods you eat, and your everyday activities. Keep a journal of your bowel movements to see what a normal bowel movement schedule is for you or your child. A normal schedule is between 3 times per day to 3 times per week. Try to keep your diet and lifestyle as routine as possible to prevent constipation.

Questions to ask your doctor

• Does aging play a significant role in constipation?
• Does travel cause constipation?
• How can I avoid a power struggle with my child over going to the bathroom?
• Does straining during constipation affect your heart?
• How can I help my aging parents deal with constipation?

Resources

National Institute of Diabetes and Digestive and Kidney Diseases: Symptoms and Causes of Constipation

National Institutes of Health, MedlinePlus: Constipation

Constipation: Causes, Symptoms, Treatment | doc.

ua

Insufficient fecal eruption, some doctors distinguish it as an independent disease, while the other part considers it only a symptom. Be that as it may, the consequences of this seemingly harmless phenomenon can be serious. Therefore, it is necessary to have a fairly clear idea about it.

Causes

Although constipation manifests itself in the same way, the causes of their development can be completely different.

Among the causes of constipation

• sedentary lifestyle, sedentary work, bed rest due to illness;
• features of the diet, when the body receives an insufficient amount of vitamins and dietary fiber, dry food;
• bowel obstruction caused by tumors, the presence of fecal stones, the formation of diverticula – sac-like protrusions in the large intestine;
• diseases of the rectum, including fissures and hemorrhoids, proctitis, paraproctitis;
• long-term drug treatment of anemia;
• mental disorders, depression, diseases of the nervous system, as a result of which a violation of peristalsis develops.

It should be noted that constipation during pregnancy is a common phenomenon. It develops, in particular, due to the pressure of the uterus on the intestines. In addition, muscle activity and tone decrease during this period, the hormonal background changes. Sometimes anemia occurs during pregnancy, which requires medical treatment – this is an additional risk factor.

Symptoms

It is important to remember that the absence of daily stools does not always indicate a problem. However, many patients do not think so, and begin self-medication, which can lead to serious consequences.

Calorie eruption less than 3 times a week should alert. The development of the disease is evidenced by pain and bloating, severe straining during defecation, dense and hard feces. After going to the toilet, there is often a feeling that the rectum has not completely emptied.

Often, the disease is accompanied by a decrease in appetite, fatigue, sleep disturbances and drowsiness. The elasticity of the skin decreases, pallor and dryness appear.
The fact that the disease passes into the chronic stage, we can say if the above symptoms are disturbing for more than six months. If you suspect constipation in children, you should immediately consult a doctor. Pregnant women in this case should visit a gynecologist.

Complications

If constipation is ignored, the treatment will be more difficult and costly, and the consequences will be the most serious. Problems with the stool can even lead to the development of colon cancer. This happens because fecal stones (solid dense masses) accumulate in it, and toxic and carcinogenic substances are also released, which lead to oncology.

Another unpleasant phenomenon is hemorrhoids, in which inflammation of the hemorrhoidal veins occurs and hemorrhoids form. Here there is a vicious circle, because hemorrhoids can lead to anemia, the treatment of which causes violations of calorie.

Dysbacteriosis develops due to defecation disorders. As you know, with it there is a qualitative and quantitative change in the intestinal microflora. This is fraught with hepatitis, colitis, enteritis, diseases of the biliary tract.
A direct consequence of constipation is the formation of rectal fissures and megacolon. The last violation is characterized by an increase in the size of the colon and thickening of its walls.

Diagnosis

Diagnosis of the disease is carried out on the basis of patient complaints, anamnesis, blood, urine and feces analysis. Ultrasound of the abdominal cavity, colonoscopy, irrigoscopy, rectomanoscopy are performed. They allow you to identify the root cause of the problem, which may be, in particular, various neoplasms – tumors, polyps, etc.

If necessary, a biopsy is performed – examination of selected tissues for pathological changes. Other specialists are also involved in the examination of the patient – an obstetrician-gynecologist, an endocrinologist, a gastroenterologist. Only after that treatment is prescribed.

Treatment

They deal with the problem in different ways. A completely separate issue is constipation in newborns. In other cases, one of the most common methods is the appointment of a special way of eating.

Diet for constipation includes foods with sufficient fiber content. These include bread – black and with bran, cereals, dried fruits, fresh fruits and vegetables. The patient is advised to consume a sufficient amount of liquid – water, juices.

The inclusion of meat, smoked meats, herring, pickles, marinades, canned food in the diet contributes to health improvement. Fermented milk products are welcome – kefir, yogurt, sour cream, cream. Adults are allowed beer, kvass.

Along with the diet, drug treatment with laxatives is prescribed. At the same time, doctors warn that their uncontrolled intake can aggravate the situation, lead to unforeseen consequences and complications.

Quite often, physiotherapy exercises and enemas become components of therapy for defecation disorders.

Surgery is indicated for Hirschung’s disease, dolichosigma, paraproctitis and some others.

It should be noted that during pregnancy, the means and methods of therapy for such a violation differ significantly. Women are advised to change the way they eat, restore the intestinal microflora, prescribe mild laxatives that are allowed for pregnant women.

Prevention

In order to prevent constipation, the causes of which are described above, it is necessary to take preventive measures. As you know, the disease is easier to prevent than to treat.

Measures to prevent constipation are quite simple and accessible to everyone, and follow from the causes of the development of the disease

• To avoid defecation disorders, you need to review your diet. The food should contain enough fiber. To do this, you need to eat fresh vegetables and fruits, greens, cereals – buckwheat, barley, oatmeal.
• Meals should be 3-4 times a day. It is also required to establish a clear diet and, if possible, not deviate from it.
• Active motor mode plays a big role. Physical exercises contribute to the motor activity of the intestines, have a beneficial effect on the mental and nervous spheres. Avoid getting up late and staying in bed for a long time. Useful cycling, swimming, skiing. Sometimes it will be enough to walk at a calm comfortable pace.
• It is necessary to forget about self-treatment. Medicines should be prescribed only by the attending physician.
• Pregnant women must be registered on time – no later than 12 weeks of the term. After that, it is recommended to undergo regular examinations by an obstetrician-gynecologist in accordance with the schedule established by him.

causes, symptoms and treatment

1. home

2. Constipation in women: causes, symptoms and treatment

Current chronic constipation
represent a worldwide problem, as they affect the average
16% of the world’s adult population ¹ .

Difficulty in emptying bowels can adversely affect
on human performance and significantly reduce the quality
life ³ . Female gender in a sedentary lifestyle
and the use of a small amount of fiber is considered a factor
risk of constipation ² , in addition, women have a more severe
constipation occurs 2-3 times more often than in men ¹ .
Why women may get constipated, what are the common symptoms
and approaches to treatment, read the article.

Causes of constipation

In addition to common risk factors for constipation (such as insufficient dietary fiber and fluid intake, physical inactivity, forced suppression of bowel movements), women sometimes have a sex-related predisposition ^{1. 2} . It is noted that in men the feces are softer and larger in mass compared to women, and defecation in women occurs less frequently than in men ³ . Female constipation can be associated with the following reasons:

Premenstrual syndrome

Approximately 2 weeks before the expected menstruation, up to 85% of ⁴ women note the appearance of such unpleasant sensations as soreness of the mammary glands, irritability, headaches, swelling of the extremities, sweating. Gastrointestinal disorders may also occur, including bloating and constipation ⁵ . Such conditions are included in the concept of “premenstrual syndrome”. They are cyclic in nature and may be associated with increased sensitivity of the body to progesterone or with neuroendocrine disorders ⁵ .

The action of various hormones in the context of premenstrual syndrome can contribute to flatulence and bloating ⁵ . In addition, eating disorders often occur during premenstrual syndrome, for example, in the form of increased cravings for carbohydrate foods – sweets, which can increase the manifestation of constipation ^2.4 .

Postpartum conditions

Often, constipation can also occur in the postpartum period, for example, due to spasm of the internal anal sphincter. This condition may develop due to a disorder of nervous regulation ⁷ .

Pregnancy

Constipation can be a common problem during pregnancy and a combination of causative factors is at work. Increased production of progesterone can lead to the fact that stimulants of intestinal motility (gastrin, cholecystokinin, enkephalins) may act weaker, and the effect of the gastrointestinal hormone that depresses motility, on the contrary, increases. In addition, from the 16th to the 36th week of pregnancy, the production of one of the regulators of intestinal motility, the hormone motilin 9, may decrease.0093 6 .

Furthermore, changes in diet and use of medications can cause constipation in pregnant women. Sometimes a woman is forced to lie down all the time, and normal defecation requires at least minimal physical activity ⁶ .

Menopause

During menopause, women may often
observed changes in bowel function, including
and constipation due to changes in the endocrine system associated
with the entry of a woman into menopause
period ^8.9 .

And that’s not all
causes that may cause constipation in women.
Determine why there are problems with stool regularity,
alone in such a special group of patients as pregnant women
and lactating women, a doctor who should be consulted will always help,
if you are concerned about constipation.

Symptoms of constipation

The duration of passage of food through the entire gastrointestinal tract in
the norm is about 60 hours. Women take more time
approximately 72 hours, for men – 55 hours ³ . The longer
intestinal transit, the denser the feces can become and the more difficult
come out. Constipation in women can be accompanied by painful,
recurring symptoms.

Heaviness and discomfort

Patients with constipation can often feel heaviness and discomfort
in the abdomen, more often in its lower part ^2.10 .

Psychological and social difficulties

In addition, problems with defecation, especially
its morbidity, create psychological and social
difficulties ¹⁰ .

Flatulence

A rather painful symptom can be flatulence ² .

Postponing the act of defecation

Damage to the intestinal mucosa can occur during the passage
dry and hard feces and lead to the occurrence
anal fissures, causing them to delay defecation and provoke those
most aggravated constipation ^1,11,12 .

Treatment of constipation in
women

To understand the cause of constipation, and
also to choose the right treatment, you need to consult a doctor,
who will make a diagnosis and give recommendations. Usually constipation treatment
begins with a change in lifestyle: to the principles of non-drug
treatments for constipation include dietary modification and increased physical
activities ¹ .

1

Diet Correction

Compact, reduced stool may
have an inhibitory effect on intestinal peristalsis, which means
the movement of feces will be difficult. Adding to the food menu
fibers (fiber) contributes to the retention of water in the intestinal
contents, which can lead to softening, weight gain
feces and facilitate the process of defecation ^11.13 .

Can be used as a source of dietary fiber
eat fresh vegetables and fruits 450-500 g per day ¹³
or add 25-30 g of bran to meals during breakfast.
It is advisable to have breakfast within an hour after waking up ¹ .
In order for dietary fiber to have a laxative effect, you need to drink
a sufficient amount of water (1.5-2 liters per day), excluding sweet
drinks ¹³ .

2

Physical activity correction

The amount of physical activity should be increased.
This can be at least 30 minutes of brisk walking daily or
swimming in the pool for 40 minutes three times a week ¹³ . Also
it may be useful to regularly perform a set of exercises aimed at
to strengthen the muscles of the pelvic floor, abdominals, contributing to
improve stool excretion. For example, to strengthen the muscles of the anterior
abdominal wall, it is recommended to deeply retract the stomach and slowly
relax counting to ten ¹⁰ .

To improve the tone of the pelvic floor muscles,
alternately raise your knees in a prone or sitting position, with hanging
second leg. Then you need to pull the thigh to the side as much as possible
raised knee with a short-term retention of this position, and
then slowly lower your leg. To stimulate the passage of stool,
it is recommended to do pushes with the stomach: take a deep breath, pulling in the stomach, and
then, together with exhalation, sharply throw the stomach forward. Do exercise
required up to 10 times before each expected
defecation ¹⁰ .

2

Physical activity correction

The amount of physical activity should be increased.
This can be at least 30 minutes of brisk walking daily or
swimming in the pool for 40 minutes three times a week ¹³ . Also
it may be useful to regularly perform a set of exercises aimed at
to strengthen the muscles of the pelvic floor, abdominals, contributing to
improve stool excretion. For example, to strengthen the muscles of the anterior
abdominal wall, it is recommended to deeply retract the stomach and slowly
relax counting to ten ¹⁰ .

To improve the tone of the pelvic floor muscles,
alternately raise your knees in a prone or sitting position, with hanging
second leg. Then you need to pull the thigh to the side as much as possible
raised knee with a short-term retention of this position, and
then slowly lower your leg. To stimulate the passage of stool,
it is recommended to do pushes with the stomach: take a deep breath, pulling in the stomach, and
then, together with exhalation, sharply throw the stomach forward. Do exercise
required up to 10 times before each expected
defecation ¹⁰ .

However, if lifestyle modifications do not have the desired effect, the doctor may prescribe medications, including laxatives, which include Guttalax® ^1.14 .

Guttalax® has a dual mechanism of action: not only helps to soften the stool, but also increases intestinal motility. In addition, the active substance of this drug – sodium picosulfate – is activated directly in the colon. Guttalax® promotes the natural process of defecation and is not addictive, while it can be used by women aged, after childbirth and during lactation ¹⁴ .

More about the drug

One of the enzyme preparations is Festal® ⁶ . In addition to pancreatin, it also contains bile extract and hemicellulase, which can complement its action. Due to the presence of bile acids in the composition, Festal® promotes bile secretion and the release of lipase by the pancreas ^{6, 7} .

The hemicellulase enzyme contained in the preparation helps to break down plant fiber, thereby helping to reduce gas formation in the intestines ^{6, 7} .

Excess gas in the intestines can make it difficult to see the abdominal organs during diagnostic procedures, so Festal® can be used in preparation for ultrasound and x-ray examinations ^{6, 8} .

THERE ARE CONTRAINDICATIONS. IT IS NECESSARY TO CONSULT WITH A SPECIALIST.

SOURCES
INFORMATION

MAT-RU-2106026-1.0-01/2022

1. Plotnikova E.Yu. Constipation needs to be treated. Medical advice. 2018; 14:61-66.
2. Samsonov A.A. Syndrome of chronic constipation. Regular issues of RMJ No. 4 dated February 27, 2009: 233.
3. Agafonova N. A., Yakovenko E.P. Chronic constipation syndrome in patients abusing irritant laxatives. Regular issues of breast cancer No. 28 dated 12/10/2010, p. 1735.
4. Unanyan A.L. Premenstrual syndrome: etiopathogenesis, classification, clinic, diagnosis and treatment. breast cancer. Mother and child. 32(1) dated 02/28/2018: 34-38.
5. Yakovleva E.B., Babenko O.M., Pilipenko O.N. Premenstrual syndrome // MNS. 2014. No. 3 (58).
6. Zaidieva Z.S., Lukyanova E.V. Prevention and treatment of constipation during pregnancy. breast cancer. Mother and child No. 4 of 25.02.2010: 209.
7. Shulpekova Yu.O. Algorithm for the treatment of constipation of various origins. Regular issues of RMJ No. 15 dated 19.08.2007: 1165.
8. Petrov V.N., Zakharchuk A.G. Prevention and treatment of constipation in the elderly // Russian family doctor. 2008. No. 4.
9. Marinchuk A.T., Bogatyrev V.G., Babieva A.M., Kumbatiadis D.G. Diagnosis and treatment of chronic constipation // Glavvrach of the South of Russia. 2012. No. 1 (28).
10. Bakumov P. A. Constipation: clinic, diagnosis, non-drug treatment. Vestnik VolGMU. 2006; 2(18):13-19.
11. Rivkin VL Chronic constipation // MS. 2013. No. 10.
12. I.V. Maev. Chronic constipation. Attending physician, 2001, No. 7.
13. Osipenko M.F., Shrainer E.V. The ever present problem of constipation. RMJ “Medical Review” No. 31 dated 12/29/2014: 2230.
14. Instructions for the medical use of the drug Guttalax® drops for oral administration 7. 5 mg/ml (RU P N015238/01).

others
symptoms

Constipation is one of the most common problems in children. By
statistics, in Russia, constipation occurs in everyone
fourth child. And this problem greatly complicates
a calm and cheerful life for both the child and the parents,
because constipation often causes pain, the child
the mood deteriorates, the parents are on their nerves – in general, good
few.

→
STATIC

Guttalax® is used
as a laxative to solve the problem of constipation.