Constipation is the infrequent and difficult passage of stool, the stool maybe too hard, infrequent, small or difficult to expel. It occurs when a person has difficulty emptying the large bowel. Home remedies and lifestyle changes can help to resolve it, but sometimes it may need medical attention. In some people constipation is sudden and often a manifestation of another abdominal problem,such as a bowel obstruction. The incidence of constipation increases with age and its most common after 60 years. A change in bowel habit without a change in diet is a significant symptoms which should be brought to the attention of your doctor.


                Types of constipation

 Acute constipation

    As the name suggests, comes on abruptly and may end up being severe enough to reguired immediate medical attention to discover the causes, though it is usually caused by too much stress, or when you are under pressure at work, it can also happen when you travel. It usually goes away if the outside cause is taken away.

 Hypotonic constipation

  If someone have a chronic version of constipation that is when Hypotonic constipation can happen. This type of constipation is caused by a weak condition abdominal muscle and the person is unable to defecate normally because the muscles are too weak to work properly in the intestine. It canbe caused by many things, such as being to sedentary, not enough fibre in the diet and not enough water inthe diet.

Spastic constipation 

    The opposite of these is Hypotonic,  which is also called Spastic constipation. This means the patients experience cramps and pains, but still not defecate. The stool instead doesn't move through the intestine properly. This can cause someone irritable bowel syndrome, a condition of alternating diarrhoea and constipation.

Rectal constipation 

     Rectal constipation is caused by a person bathroom habit. It happens when someone repeatedly doesn't go to the bathroom even when they feel the urge to defecate, which eventually cause the body not to send the proper signal to the brain to produce a bowel movements. Then the person will get dried up stool inside the intestine and become obstructed and unable to defecate.

Functional constipation 

    Functional constipation means that a reason cannot be found as to why a seemingly healthy individual develops constipation and no cause can be found.

                  Causes of constipation 

Lack of physical exercise 

Not getting enough exercise or insufficient exercise can increase your risk having constipation. People who spends weeks or days on bed or on a chair are at a higher risk of getting constipation. Past studies have found that physically fit people, more especially race runners are less likely to experience constipation. 

Pregnancy and childbirth 

 This can also be a source of constipation among women. A pregnant woman or a lactating mother are at a higher risk of experiencing constipation as a result of Hormonal Changes in the body. 

Travelling 

 People who suffer from travelling frieght or those who are not always comfortable outside their home, may have constipation whenever they live their home. Environmental changes can be a major cause of constipation. 


Less intake of water 

       Getting insufficient stool, which allows stool to dry out, canbe a major cause of constipation. You can drink any other fluids, you can drink vegetables and fruits juice. Becareful, some liquid can cause dehydration and make constipation worse for some people . 

Not eating enough fibre foods 

      Fibre based diet can help reduce the rate of constipation. People who consume more of dietary fibre are less likely to experience constipation. This is because fibres promote regular bowel movements, especially when it is combined with proper hydration. 

Routine changes 

      Undergoing some changes in your routine can also cause constipation. Changes such as your eating habits, your eating time, sleeping time, and even your bathroom time can cause constipation.

Some medication 

        Taking certain medication can cause constipation, some medication that can increase your risk of having constipation are, opiates, calcium channel blockers, this drug lower blood pressure eg nifedipine. 
Having certain disease or conditions such as, diabetes, lupus, and multiple sclerosis. 
Having some intestine problems such as an obstruction, irritable bowel syndrome, and tumor. 

                   Symptoms of constipation 

 Constipation on its own canbe uncomfortable, but it not life threatening. However, it can become a problem if it is a symptoms of a more serious underlying condition, or if it starts to cause more damage. Some symptoms of constipation include. 
  •     Infrequent bowel movements 
  • Straining when going to the bathroom 
  • Hard and  small faeces 
  • The sense of incomplete evacuation after going to the bathroom 
  • Lower abdominal discomforts 
  • Abdominal bloating occasionally distension 
  • Anal bleeding or fissure from the problem caused by hard stool. 
  • Rarely colonic perforation 
  • Possible aggravation or diverticular disease, hemorrhoids and Rectal prolapse. 
  • Obsession with having to go to the toilet  

                  DIAGNOSIS And TEST

 Blood tests 

Your doctor will look for a systematic condition such as low thyroid (hypothyroidism) 
 An X-ray or rectum during defecation. During this process your doctor will insert a soft paste made of barium into your rectum. You then pass the barium paste as you will pass stool.
  Examination of the rectum and the entire colon (colonscopy). The diagnosis procedure allows your doctor to examine the entire colon, with a flexible camera equipped tube. 

        Treatments and medication for                                    constipation 

 Although constipation usually resolve itself without the need for prescription treatment. In most cases making lifestyle changes such as getting more exercise, eating more fibre and drinking more fluids can help. Below are some treatments for constipation depending on the cause.

Removal of the impacted faeces 

       Removing the faeces which may resolve enemas, stool softeners and short term course of laxative. 

 More fluids 

    Liquid helps to pump out more faeces, drink enough fluids, this will help prevent constipation. However, it is important to restrict the intake of diuretic drinks, such as   tea, caffeine and alcohol. 

Dietary changes 

   Increasing the amount of fibre in your daily diet. Dietician daily recommends about 30 grams of fibre every day. Good sources of fibre includes, wholegrain, cereal, fruits and vegetables and legumes. The intake of foods such as, milk, cheese, white rice, white flour, and red meat should be restricted, because they tend to  contribute to constipation. 

Fibre supplements 

      Maybe helpful if the patients is reluctant or unable to include more wholegrain foods, fruit and vegetables in their foods. As fibre supplements can aggregate or cause constipation, always check with your doctor or dietician before using them. 

Exercise 

      One of the many benefits of regular exercise is improving bowel motility. Ideally, exercise should be done every day, for about 30 minutes. 
People with condition that affects mobility needs to be as active as possible each day, as every bit of regular exercise helps. 

Treatments for an underlying disorder 

      Such as sugar to repair abdominal hernia, hormones replacement therapy, for hypothyroidism, or anesthic cream and sitz bath for anal fissure. 

Laxative 

     Laxative are of two types, bowel stimulant and agents that increases the water current of the stool. Bowel stimulant increase bowel contraction but may cause cramp, agents that increase the water content may interferes with the absorption of water from the bowel,or swell or buckle up the stool with fluids. When used appropriately, laxative can greatly relief acute and chronic constipation. There is little evidence that chronic use of laxative at an inappropriate dose will lead to a lazy or twisted bowel. 
          Just about everybody has trouble going to the bathroom, at some point. If you are not having bowel movements as often as you used to, usually it's no cause for worry. Often, constipation will go away on its own within a few days, get better after you use laxative or other constipation treatments. 

            Prevention of constipation 

  Certain foods and drink and proper amount of exercise can help alleviate the symptoms of constipation. 
  
 FOODS AND DRINKS
  •   Eat high fibre foods such as, raw vegetables, salad, bran cereal, whole grain, bread and fresh fruit. 
  • Eat prunes and fig. 
  • Eat oatmeal, applesauce, legumes, and barely to soften stool. 
  • Flax meal canbe purchased already ground, or you can buy the seeds and grind it yourself. Flaxmeal is a natural source of fibre and help promoting omega 3 fatty acids. It canbe stirred or sprinkled on foods. 
  • Drink plenty of water, at least 8 glasses per day. Water and herbal tea are best, juice are not recommended nor caffeinated drinks, as your body can be dependent on this at the long run. 
  • Drink several cups of warm to hot liquid inthe morning before taking your meal, water and herbal tea will be great. 
  • Exercise daily, like a brisk half hour walk. 
  • Visit the toilet for 15 minutes in the morning, even if you are unable to have a bowel movements. This relaxes and stimulate the digestive system. 
  • Sit quiet for 15 minutes after eating to aid digestion. 
  • Stick to a routine, try going to the bathroom at the same time everyday. 
  •  Allow the child to do something fun while sitting on the toilet, this will help them overcome bathroom anxiety and reduce constipation.