Many of us will experience constipation at some time or other. Discover the facts about bowel irregularity. Learn what it is, why it happens and what are the ways to prevent and manage it so you can achieve effective relief.
A common problem
Even though constipation affects a great number of people at some point, it is not a topic most of us feel comfortable talking about. While it is generally a temporary, benign gastrointestinal complaint, it can still cause much discomfort and frustration. Constipation can interfere with a person’s daily activities and thus have an impact on quality of life. It can cause physical problems, as well:
- Painful bowel movements
- Dry, hard stool that blocks the rectum
- Bloating
Did you know?
- Chronic constipation affects 12 to 19 percent of North Americans.
- Women are three times more likely than men to suffer from constipation, a situation attributed to the hormones involved in the menstrual cycle.
What is constipation?
Constipation occurs when bowel movements become more difficult or less frequent than usual.
Here are some of the common symptoms of constipation:
- Fewer bowel movements than usual
- Less than 3 bowel movements per week
- Hard, dry or small stools
- Straining during bowel movements
- Feeling of incomplete evacuation
See a doctor if you experience:
- Sudden onset of constipation (a problem you have never had before) accompanied by blood in your stool, fever, vomiting or intense abdominal pain; these symptoms can be the sign of a serious disease;
- Constipation that lasts more than three weeks. Stubborn constipation can give rise to complications (hemorrhoids, anal fissures or intestinal obstruction). It can also mask a health problem that requires medical intervention.
Risk factors for constipation
Lifestyle
The digestive system is sensitive to changes in our diet and lifestyle. As is the case with fever, constipation is a symptom, not a disease. Here are some of the common causes of constipation:
- Poor diet (low in fibre, high in fat and sugar)
- Insufficient fluid intake
- Physical inactivity
- Ignoring the urge to defecate (this inhibits the defecation reflex)
Medications
Constipation is an adverse side effect of a surprising number of medications. Both prescription and non-prescription drugs can slow the movement of the colon. Here are a few examples:
- Pain relievers (particularly opiates)
- Aluminium and calcium antacids
- Blood pressure medications
- Parkinson’s medications
- Antidepressants
- Iron supplements
- Anticonvulsants
Ask your pharmacist if any of your medications could be causing constipation.
Life events or changes in routine
Certain life changes can alter the natural workings of the bowels:
- Pregnancy
- Childbirth
- Aging
- Surgery
- Stress
- Travel
Medical conditions
Several medical conditions and diseases can have an impact on regularity:
- Strokes
- Multiple sclerosis
- Parkinson's disease
- Spinal cord injuries
- Diabetes
- Hypothyroidism
- Depression
How laxatives work
- Polyethylene glycol 3350 (PEG) (e.g., RestoraLAX®)
Gradually increases the amount of water in the intestines, softening the stools. It increases bowel movement frequency without causing bloating, gas or cramps. May cause looser, more frequent bowel movements.
- Bulk-forming laxatives (e.g., Metamucil)
Contain fibre that increases the stool volume and retains water in the intestine to soften stool s. A high-fibre diet is important, but eating more fibre can cause bloating and excess gas.
- Stool softeners (e.g., Colace)
Increase the amount of water in the stools, softening the stools. While they have few side effects, prolonged use may lead to an electrolyte imbalance.
- Lubricant laxatives (e. g., mineral oil)
Coat the stools with a waterproof film making them easier to pass. They can cause deficiencies in vitamin A, D, E and K.
- Saline laxatives (e.g. milk of magnesium)
Increase the amount of water in the colon to make stools easier to pass. Prolonged use may lead to an electrolyte imbalance.
- Stimulant laxatives (e.g., Senokot)
Stimulate the intestinal muscles to accelerate the passage of stools through the colon. Can cause abdominal cramps; frequent use can lead to lazy bowel syndrome.
Use laxatives with caution
Just because there are many types of laxatives available over the counter, this does not mean these products are completely innocuous. Using them frequently or for long periods of time without first checking with your doctor can be harmful to the digestive system and lead to dependence.
Laxatives should be taken occasionally and only for a maximum of seven consecutive days. Only bulking agents, for example psyllium-based products, are safe for long-term use. To maximize their action, however, you need to increase your intake of water and other fluids.
Pharmacy services
Want to learn more about laxatives and how to use them? Talk to your family pharmacist for information and expert advice!
