Constipation Causes and Remedies

Symptoms

In constipation, the habitual frequency of defecation is reduced. Defecation is difficult, painful, possible only with vigorous pushing, possible only with manual or medication assistance, or temporarily impossible. Stools are hard, lumpy, and patients feel they cannot adequately empty their bowels. Constipation may be accompanied by abdominal pain, cramps, discomfort, and an uncomfortable feeling of pressure. It often leads to anorectal complications, such as hemorrhoids, soreness, or an anal fissure, and limits quality of life. Constipation can be acute (temporary) or chronic.

Causes

The cause of constipation is often stools in the rectum that are not soft enough, contain too much water, and are slippery. Such occurs, for example, due to an excessively long transit time or insufficient secretion in the intestine. Numerous possible causes can underlie the complaints. These are outlined below along with a selection of risk factors.

  • Age: constipation is common in both children and the elderly.
  • Female gender
  • Disposition
  • Diet: low fiber diet, lack of fluid intake, eating disorders.
  • Dehydration
  • Suppression of the defecation stimulus
  • Pregnancy
  • Stress, mental stress
  • Irritable bowel syndrome
  • Constipation while traveling, such as due to the excitement and the different diet
  • Numerous drugs, such as opioids, antitussives, antacids, anticholinergics, antidepressants, neuroleptics, iron tablets.
  • Idiopathic / functional constipation.

Other causes:

  • Electrolyte disturbances: Hypokalemia, hypocalcemia
  • Colon cancer and other cancers
  • Constrictions in the intestine
  • Neurological causes, for example, Parkinson’s disease or multiple sclerosis.
  • Hypothyroidism
  • Inflammatory bowel disease

Diagnosis

Acute and uncomplicated constipation can usually be self-treated with remedies from the pharmacy. However, if it occurs chronically or is accompanied by unusual complaints such as blood in the stool or weight loss, it should be clarified by a doctor. Constipation is not always actually present. The frequency of bowel movements can vary greatly from person to person – from several times a day to a few times a week. The diagnosis is made based on the patient’s history, physical examination, and possibly laboratory methods and imaging.

Nonpharmacologic treatment

  • Patients should be informed that the frequency of bowel movements varies from individual to individual.
  • Do not suppress the defecation reflex.
  • Drink enough fluids during the day.
  • Eat fiber and high-fiber foods, for example, fruits, dried fruits, figs, vegetables, salad plates, whole grain bread, whole grain cereals, brown rice and beans. Eat a healthy diet, do not eat too much fatty and sweet.
  • Drink laxative fruit juices, for example, apple juice, grape juice, prune juice.
  • Physical exercise.
  • Therapy trial with probiotics.
  • Causing drugs if possible discontinue or replace.

The effectiveness of some of these measures is also critically discussed in the literature.

Drug treatment

Numerous drugs and supplements are available for the treatment of constipation. They are presented under the article Laxatives.