Constipation, Why Am I Constipated & Bowel Straining?There are numerous causes for this condition and these will be described here. One very common cause is though the deliberate suppression of the desire to defecate and this requires psychological management usually. There are lots of reasons for this including fear of experiencing pain e.g with hemorrhoids of anal fissures. Suppression for other reasons e.g social reluctance to open your bowels or other causes of fear for example a bad childhood experience. Diet is also an important factor as it is almost unheard of in people that take a high fiber diet as part of their normal diet. This is particularly so in the western world where diets are high in complex carbohydrate and low in fiber.
Obstructive causesColorectal cancerBenign strictures e.g. diverticular strictures, Crohn’s strictures
Hormonal causesHypothyroidism (underactive thyroid)Diabetes Mellitus
Disorders of metabolismHypercalcaemia (high Calcium levelsHypokalaemia (Low Potassium levels) Pregnancy
Neuropathic (Nerve related)NeuropathyMultiple Sclerosis Motor Neuron disease Parkinson’s disease Amyloidosis Myopathic conditions Hirschsprung’s disease
DrugsAnalgesics e.g. opiates such as MorphineAnti depressants e.g. Amitriptyline Antiparkinson treatments Blood pressure pills e.g. Amlodipine (calcium antagonist) Plus many more The list above gives you an idea of the complex nature of this disorder,although the majority are of idiopathic (unknown cause). Investigation Of SymptomsInvestigations are warranted particularly in people over the age of 55 years and also in sufferers with a strong family history of bowel cancer. The main investigations for these abnormal bowel movements are blood tests, stool samples and large bowel investigations such as flexible sigmoidoscopy, colonoscopy and barium enema. Sometimes transit studies are performed using markers that show up on xray when swallowed, to determine the time it takes for the bowel to pass them.
Treatment OptionsTreatment depends on the underlying cause. The most important thing is to treat the underlying cause, but if this is not possible then the treatment should be targeted at alleviating symptoms. This may include:
Fluid intakeIt is important to have a good fluid intake and I normally advise at least 2 to 2 ½ litres a day unless you have a medical condition such as heart failure which may worsen with this. Seek help from your doctor if unsure. I would try to avoid alcohol, tea and coffee as these can inadvertently dehydrate. Take fluid in the form of water and juices whenever possible.DietDiet is very important to prevent bowel straining. The most important foods are those high in fiber. These include fruits with their skins on, potato jackets, granary bread, brown bread, cereals and grains as well as a balanced intake of protein with meat, fish and poultry. Try to avoid white bread, white rice and pasta.ExerciseA largely forgotten way of improving constipation, exercise such as swimming, jogging and sports in general do help to improve bowel movements, possibly by increased gut motility as well as increasing intrabdominal pressure.LaxativesLaxatives for constipation should be avoided whenever possible, but are often inevitable too! Natural laxatives such as prunes, grape juice and senna can be tried. Senna is available in tablet and liquid formulations. Other laxatives such as Fybogel , Lactulose, Methylcellulose , Movicol and very strong laxatives such as Picolax and Fleet are sometimes used. These should be discussed with your doctor first.Feedback About Your Experience Of Constipation To Help Others
Feedback about your Constipation and how you manage your symptoms, to help other sufferers! By feeding back you are letting other sufferers know your experiences of constipation and also contributing to the IBS Help Online community. You may be helped from the comments of others too! What Other Visitors Have Fed BackClick below to see contributions from other visitors to this page...
No bowel control
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