Constipation affects 1 in 4 people throughout their lives and is a very common health problem at any age; it is more common in women than men. It normally occurs just occasionally but in some cases can be chronic. Constipation is noted by an alteration in the number of stools the person produces; their consistency or shape; the effort required during defecation or the satisfaction afterwards. Thus, constipation is when it is difficult to defecate; the stools are hard; there is a sensation of incomplete evacuation afterwards; a feeling of obstruction; fewer than three bowel movements are made per week; or manual help is needed to evacuate.
A person may have slow intestinal transit which causes constipation, but there are also situations in which intestinal transit is normal and yet the person is constipated. Some of these cases may be due to episodes of stress or anxiety. However, constipation may also be a sign of a disease or an adverse reaction to a medication. Some examples of diseases that can cause constipation are inflammatory bowel disease, diabetes, hyperthyroidism, chronic kidney disease, some types of cancer, Parkinson’s disease and Multiple sclerosis, although there are others. Thus you should note the frequency and consistency of your bowel movements and be alert to any major changes in them. It can also be very helpful to know the warning signs so you can see your doctor if they occur along with constipation.
- Sudden change in the usual rhythm of bowel movements (for a period longer than six weeks) in people over 50 years of age.
- Presence of blood in the faeces.
- Anaemia or lack of iron.
- Unexpected weight loss.
- Family history of colon or rectal cancer or inflammatory bowel disease.
- Palpable abdominal or rectal mass.
"The first steps in a therapeutic approach are always non-pharmacological measures, which are lifestyle changes," comments Dr Sabela Carballal, a gastroenterologist at the Hospital Clínic, adding that the following steps may improve symptoms:
- Drinking water.
- Following a healthy diet, rich in fruit and vegetables.
- Avoid the use of laxatives unless medically indicated.
- Adopt a schedule for bowel movements.
If there is no improvement, any pharmacological treatment should always be prescribed by a health professional. For example, laxatives, which are drugs taken orally. Enemas, which are prescribed for patients who do not respond to oral laxatives; or biofeedback, which consists of the patient learning methods to relax or rehabilitate the pelvic floor muscles during defecation. It is important to solve constipation problems because, if they last over time, other problems can often arise, such as haemorrhoids or fissures in the anus.
Leading a healthy lifestyle by following a healthy diet and a weekly physical exercise routine can improve intestinal health and constipation. You should also pay attention to the stool rhythm because, if symptoms persist, it is advisable to consult a health professional to rule this out as a sign of disease.