Constipation is a common disorder that affects approximately 10% of the population, while women are twice as likely to suffer from the condition as their male counterparts. Its symptoms can differ depending on the individual, with some common symptoms as follows: difficulties passing stools without excessive straining, hardened stools, taking a long time to empty the bowels, and wider digestive issues including stomach pain and gas.
Constipation refers to irregularities affecting bowel movements. Normal bowel movements occur 1-3 times a day or at least every 2-3 days in healthy individuals, and are not associated with stomach pain, stomach discomfort, or gas. Indeed, the stools passed through normal bowel movements are generally quite soft, and neither too hard nor too fluid. Healthy stools are also dark yellow or pale yellow depending on the person’s diet. Therefore, reddened stools can be a signal that digestive bleeding is taking place. Moreover, stools causing an oily residue to form in the water may be a signal of pancreas or bladder issues.
There are three main causes of constipation, as follows:
Patients who suffer from chronic constipation are susceptible to a range of other complications, including hemorrhoids or hardened stools that can cause colon or rectal ulcers, which result in passing blood with stools. Moreover, constipation can signal other physical ailments including an underactive thyroid and, in cases of alternating bouts of constipation and diarrhea or decreased stool size, it could even be a warning sign of colon cancer.
Additionally, studies have shown that issues surrounding bowel movements are capable of severely affecting a person’s mental health, with a great deal of research showing a link between bowel disorders—whether that means greater or fewer bowel movements than normal—and a severe reduction in emotional wellbeing. Indeed, patients suffering with irritable bowel syndrome (IBS), which can cause either constipation or diarrhea, have been found to be more at risk from mental health disorders, such as depression and anxiety, than the general population.
Constipation can generally be treated with lifestyle adjustments and laxative medication. However, patients also suffering from other symptoms, such as weight loss, passing bloody stools, alternating bouts of diarrhea and constipation, or a lump forming, as well as having certain risk factors, including a family history of colon cancer or constipation that first presents after the age of 50 years, should seek medical attention as it is possible they could be suffering from a more serious condition such as colon cancer.
Treating constipation using lifestyle modifications should involve increasing the intake of fiber, drinking more fluids, exercising regularly, applying bowel retraining techniques, and taking laxative medication.
Nevertheless, patients who have used laxative drugs for a certain period without success are recommended to consult a trained specialist, who will be able to carry out anorectal manometry to assess organ function. Proper function involves the rectum constricting as the muscles in the anus relax. However, this does not occur in some patients, while others experience a tightening of the anus instead, which can lead to difficulties emptying the bowels. Fortunately, this screening is quick and painless.
Patients suffering from chronic constipation who have undergone a general diagnosis and have tried the aforementioned treatments without success could be suffering from dyssynergia, which accounts for up to 30% of secondary constipation cases. Many either tense up or do not relax the anus during bowel movements, making it difficult to pass stools. Unfortunately, there are not many hospitals that can diagnose dyssynergia using anorectal manometry. However, when successful diagnosis does take place, patients will be given biofeedback training instead of being prescribed laxatives, which can benefit them in the long-term.
Preparations for the test require patients to empty their bowels naturally or through the use of an enema procedure at least 2 hours prior to testing. Patients should lay on their side while waiting for the test to begin as there is no anesthetic required. The test starts with medical staff gently inserting a tube into the patient’s anus and asking the patient to tense and relax that muscle periodically so that analysis of anus and rectum function can take place. If patients are found to have issues with their anorectal function, doctors may prescribe laxative medication alongside biofeedback training, which is 70% effective in treating the condition.
Patients suffering from chronic constipation are advised to seek diagnosis and treatment from medical professionals as this condition could be one of the warning signs for colon cancer.
The Liver and Digestive Institute at Samitivej Hospital, Bangkok uses innovative, state-of-the-art medical equipment necessary to provide speedy, accurate and reliable screening for a complete range of gastrointestinal and liver disorders. Our team of expert gastroenterologist and hepatologist has experience from within Thailand and abroad. The Liver and Digestive Institute, located on the 1st Floor of The Japanese Hospital, Samitivej Sukhumvit Hospital, Thailand.
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