The word constipation comes from the Latin constipare meaning "to press, crowd together", and from 1400 A.D. Latin Constipationem.
Constipation is a condition of the digestive system. The sufferer has hard feces that are difficult to expel. In most cases, this occurs because the colon has absorbed too much of the water from the food that is in the colon.
The slower the food moves through your digestive tract, the more water the colon will absorb from food. Consequently, the feces become dry and hard. Defecation (emptying the bowels) can become very painful, and in some serious cases there may be symptoms of bowel obstruction. When the constipation is very severe; when the constipation prevents the passage of feces and gas, it is called obstipation.
Causes of constipation
Constipation happens when the colon absorbs too much water, or if the muscles in the colon are contracting slowly or poorly so that the stool moves too slowly and loses more water.
Let's look at the most common causes of constipation:
1) Lack of fiber in diet
It is well known that people whose diets include a good quantity of fiber are significantly less likely to suffer from constipation. Foods low in fiber are high fat foods, such as cheese, meats, and eggs. If you consume them, make sure you are also eating enough fruits, vegetables, and whole grains - which are rich in fiber.
A diet that contains a good quantity of fiber helps prevent constipation.
There are two main types of fiber, soluble and insoluble. Soluble dissolves in water, while insoluble doesn't. Fiber cannot be digested. However, soluble fiber is transformed as it passes through the digestive tract, where it is fermented by bacteria. Soluble fiber absorbs water, and becomes gelatinous as it does so. Insoluble fiber passes through the gut without changing its form.
Quite simply, fiber promotes bowel movements and prevents constipation. Studies have indicated, however, that fiber is not that useful in dealing with constipation, it is better at preventing it.
2) Physical inactivity
Constipation can occur if someone becomes too physically inactive. This is especially the case if the person is elderly
We know that if somebody has had to lie down in bed for a long time, perhaps for several days or weeks, his/her risk of having constipation is significantly increased. Experts are not sure why. Some say that physical activity keeps our metabolism high, making most things in our bodies happen more rapidly. Elderly people tend to have a more sedentary life, compared to younger, people, and are therefore at higher risk of constipation. Physically active people are much less likely to become constipated than inactive people.
3) Some drugs
It is common for people to forget that there are a lot of medications that can cause constipation. The most common ones are:
- Narcotic (opioid) pain drugs, such as codeine (Tylenol#3), oxycodone (Percocet), and hydromorphone (Dilaudid)
- Antidepressants, such as amitriptyline (Elavil) and imipramine (Tofranil)
- Anticonvulsants such as phenytoin (Dilantin) and carbamazepine (Tegretol) Iron supplements
- Calcium channel blocking drugs such as diltiazem (Cardizem) and nifedipine (Procardia)
- Aluminum-containing antacids such as Amphojel and Basaljel
- Diuretics such as chlorothiazide (Diuril)
Some people become constipated when they consume milk and dairy products.
5) IBS (irritable bowel syndrome)
People who suffer from IBS get constipation much more frequently, compared to the rest of the population.
Pregnancy brings about hormonal changes which can make a woman more susceptible to constipation. Also, the uterus may compress the intestine, slowing down the passage of the food.
As we get older our metabolism slows down, resulting in less intestinal activity. The muscles in the digestive tract do not work as well as they used to.
8) A change in routine, such as when travelling
When we travel our normal routine changes. This can have an effect on our digestive system, which sometimes results in constipation. Meals are eaten at different times, we might go to bed, get up, and go to the toilet at different times. All these changes may raise the risk of constipation.
9) Overuse of laxatives
We all think we should go to the toilet at least once a day - this is a myth. To make sure that happens many people self-medicate with laxatives products they buy at the pharmacy. Laxatives are effective; they do help bowel movements. The problem is that if we keep taking them we gradually have to up the dose for the same effect. Laxatives can be habit-forming. When we become dependent on them there is a significant risk of constipation when we stop taking them.
10) Not going to the toilet when you feel the urge to
There can be many reasons for this. Perhaps we are not at home and would prefer to wait till we get back. It is surprising how many people never open their bowels in the toilets at work or at school. Others may be too busy to go, while some people don't because of emotional stress. Children often stop going if they are being toilet trained and find the whole training program nerve-racking. Sometimes children are too busy playing and put off going to the toilet. However, if you ignore the urge to have a bowel movement, that urge can gradually go away until you no longer feel the need to go. The longer you delay it, the drier and harder the stool will become.
11) Not drinking enough water (dehydration)
Experts say that if you already have constipation, drinking more liquids might not relieve it. However, if you regularly drink plenty of water you are less likely to become constipated. If you tend to suffer regularly from constipation you should seriously consider increasing your consumption of water. Many sodas and drinks containing caffeine may cause dehydration and worsen your constipation. Alcohol also dehydrates the body and should be avoided if you are constipated, or very susceptible to constipation.
12) Problems with the colon, or rectum
Tumors can compress or restrict the passages and cause constipation. Also scar tissue (adhesions), diverticulosis, and abnormal narrowing of the colon or rectum (colorectal stricture). People with Hirschsprung disease are susceptible to constipation (a birth defect in which some nerve cells are absent in the large intestine. The intestine does move stool through, consequently the intestine becomes blocked, causing the abdomen to enlarge).
13) Some diseases and conditions
Diseases that tend to slow down the movement of the feces through the colon, rectum, or anus are more likely to cause constipation. They include the following:
- Neurological disorders
MS (Multiple Sclerosis), Parkinson's Disease, Stroke, Spinal Cord Injuries, Chronic Idiopathic Intestinal Pseudo-Obstruction
- Endocrine and metabolic conditions
Uremia, Diabetes, Hypercalcemia, Poor Glycemic Control, Hypothyroidism
- Systemic diseases (Diseases that affect a number of organs and tissues, or affects the body as a whole)
Lupus, scleroderma, and amyloidosis
Mainly due to the medications for pain, and chemotherapy. Also if a tumor blocks or squeezes the digestive system.
On the next page we look at common treatments for constipation, including laxatives, and we discuss how common constipation is.