Introduction:
Constipation is a condition of the bowels in which the feces are dry and hard and excretion is difficult and less frequent. It refers to the infrequency of defecation which would be less than three bowel movements per week based on studies in a normal person. It can be considered as abnormal hard stools or evacuation that requires excessive straining. This can also be called dyschezia. Moreover, it is reported, it is a common problem with as many as one in eight people taking laxatives at least once each month. There are many factors that can contribute to this condition but the most important factors are as follows:
- Ignoring bowel habits or lack of its development
- Lack of physical activity
- Unsuitable diet or use of artificial food
- anxiety or depression
There are two mechanisms to explain constipation.
- The first is slow-transit constipation, in which there is a failure of peristalsis to move the content present in the lumen through the colon. It results in more time for bacterial degradation of stool solids and there is more time for salt and water absorption, hence reducing stool frequency and urge to pass stool naturally.
- The second mechanism is functional outlet obstruction, in which abnormal function of the pelvic floor or the rectum and anus results in temporary obstruction and ultimately leads to constipation.
it can be secondary to other medical problems or may be primary or idiopathic.
Table of Contents
How to Evaluate and manage it?
Most patients with this condition try to treat constipation themselves rather than seek medical attention. They try different home remedies to get rid of this discomfort. People mostly ignore the urge to defecate and got in this condition. But when it gets worsens and becomes chronic they never know. It is therefore important to obtain a good history before the initiation of treatment. A physical examination includes a thorough rectal examination. Studies have shown that home remedies are more effective than taking medicines. There are many home remedies for the treatment of constipation and here are some :
Home remedies:
1. Drink plenty of water
Being dehydrated regularly can make a person constipated. To prevent this, it is important to drink plenty of water and stay hydrated. When a person is constipated, they may find some relief from drinking a little carbonated (sparkling) water. This can help them rehydrate and improve the mobility of the intestinal content as well. Some studies have found sparkling water to be more effective than tap water at relieving it. This includes people with indigestion, dyspepsia, heartburn, and people with chronic idiopathic constipation.
2. Intake of fruits and vegetables
All fruits and vegetables contain some degree of fiber which helps to reduce constipation. Fruits and vegetables with edible peels (apples, pears, dates, sweet potatoes, and legumes) will enhance fiber intake even higher when the skin is consumed. However, prevention and treatments are individual, and it generally involves a more comprehensive approach to diet rather than focusing on one particular type of food. Fiber from fruits and vegetables is one component of a healthy dietary approach to relieve constipation. So, Eating a variety of both fruits and vegetables.
3. Intake of Fibre supplements
Fiber supplements are traditionally considered the first-line treatment. for constipation treatment, doctors often tell people to increase their dietary fiber intake. This is because increasing fiber intake may enhance the bulk and consistency of bowel movements, making them easier to pass. It also helps them pass through the digestive tract more easily. But Fibre supplements are less effective in patients with slow transit constipation or defecatory disorders than in those with normal transit constipation.
4. Biofeedback
This represents a behavioral treatment in which patients learn the physiological mechanisms of evacuation and how to use their diaphragms and abdominal and pelvic floor to enhance the urge and effort to pass stool. Interestingly, Instrumental treatment is less effective than the counseling of physicians. If the patients take the advice of their doctors more seriously and are willing to combat this disorder by their own efforts and will they do it more efficiently rather than using medication?
5. Exercise
Research has shown that exercise could help improve the symptoms of constipation. some Studies have considered sedentary lifestyles with an increased risk. Therefore, some healthcare experts and doctors recommend increasing exercise to get the stool moving and passing easily. it is important to ensure that not all studies agree that exercise treats it well. Therefore, more research is needed.
6. Take Senna, a herbal laxative
The herbal laxative Senna is popular among the multiple remedies for constipation. It stimulates the nerves in the gut to enhance bowel movements. Senna is a popular, safe, and effective herbal laxative that helps in the treatment of constipation. It is available over the counter (can be used without a physician’s prescription at the time of need) in both oral and rectal forms. Senna contains plant compounds called glycosides, which stimulate the nerves in the gastrointestinal tract.
Doctors consider Senna safe for adults for short periods of time, but people should consult a doctor if their symptoms do not settle after a few days. Senna is usually contraindicated in pregnant women, those who are breastfeeding, or people with certain health disorders, such as inflammatory bowel disease.
7. Eat prebiotic foods
Prebiotics are basically indigestible carbohydrate fiber. Prebiotics contain oligosaccharides and inulin. Foods that constitute prebiotic fibers can improve digestive health and the balance of beneficial gut bacteria. Prebiotics may help relieve constipation. Although rich fibers diet plans can reduce constipation by improving the consistency and bulk of stool. Prebiotic fibers increase digestive health by feeding the beneficial bacteria in the gut, which boosts probiotics and enhances the balance and motility of the gut bacteria. In fact, some prebiotics may help increase the frequency of bowel movements, improve the urge to pass stool as well as make stools softer.
Prebiotic foods include:
- garlic
- onions
- bananas
- leeks
- chickpeas
8. Use magnesium citrate
Magnesium citrate is a well-known home remedy for the treatment of constipation. It is a type of osmotic laxative that people can buy over the counter without a physician’s prescription. Taking magnesium citrate, an over-the-counter supplement can help relieve Using moderate amounts of magnesium supplements can help reduce the episodes of constipation. Doctors use higher dosages of magnesium citrate to prepare the patients for medical procedures and clean out the bowel before surgery or other medical procedures.
9. Try avoiding dairy
Dairy or lactose intolerance may cause constipation in some people. In these people, avoiding dairy from the diet can help go away the symptoms. For people who have an intolerance to it, eating dairy products can cause constipation due to its effect on the gut’s motility and results in constipation. This includes children who are intolerant to cow’s milk protein and adults with lactose intolerance. If somebody suspects a dairy intolerance, they can consult their doctor for a diagnosis. Your healthcare provider may recommend temporarily quit on dairy products from your diet, and suggest you get on other calcium-rich foods, to see the results and whether it improves the symptoms or not.
10. Drink coffee, especially caffeinated coffee
Coffee can help reduce constipation especially by stimulating the muscles in the gut. Drinking coffee may help relieve constipation. For some people, consuming coffee can enhance the urge to go to the bathroom. Because coffee stimulates the muscles in the digestive tract. A study done in 1998 found that caffeinated coffee can stimulate the gut in the same way that a meal can. This was a 60% stronger effect than drinking water and 23% stronger than drinking decaffeinated coffee respectively. Coffee may also enhance the balance of gut bacteria because it contains small amounts of soluble fibers that help reduce constipation.
11. Timed toilet training
People who have a normal bowel pattern usually pass their bowels at the same time every day. The body’s colon, or large intestine, becomes more active after waking up and after eating. This is known as the gastrocolic reflex. People who have trouble going to the bathroom, or constipation, can help their bodies by trying to use the toilet at least twice a day, usually 30 minutes after eating. They should also avoid straining for more than 5 minutes. This can help them have regular bowel movements and relieve constipation.
12. Stool softeners, suppositories, and enemas
. Suppositories may be used in patients with obstructed defecation to help with the rectal evacuation. People in this group use enemas to stop poop from getting blocked. Even though many people use them, medicine to make poop softer does not work well. Some people have problems with their body’s balance of salts or have hurt in their rectum after using certain types of enemas. When necessary, a tap water enema is the safest one to use. Newer and upcoming treatment options.
Pharmacological Treatment for constipation
People who are having a chronic and long-term history of constipation and do not get permanent relief from home remedies, have to take proper medical treatment by consultation with a physician in order to get constipation subsided.
Research has shown that polyethylene glycol (PEG), sodium picosulfate, bisacodyl, prucalopride, lubiprostone, and linaclotide are very effective medicines.
Laxatives
Laxatives are a type of medicine that can help in the emptying of the bowels if one is having trouble going to the toilet. They’re widely used to treat constipation if lifestyle changes, such as increasing the amount of fiber in your diet, drinking plenty of fluid, and taking regular exercise, haven’t helped and are not adequate measures for the treatment of constipation.
Milk of magnesia, lactulose, senna compounds, bisacodyl, and polyethylene glycol (PEG) preparations are commonly used as laxatives in clinical practice. Each of these medications works in a slightly different way and is used for different purposes, such as to relieve constipation, cleanse the colon before a medical procedure, or to treat certain medical conditions such as constipation, fecal impaction, or inflammatory bowel disease.
Lubiprostone
Lubiprostone is an oral tablet that increases complete spontaneous bowel movements per week, as well as improves stool consistency, straining, constipation severity, and patient-reported treatment effectiveness.
Prucalopride
Prucalopride, if used daily for 4 weeks was safe and well tolerated.
Linaclotide
Linaclotide stimulates intestinal fluid secretion and also proved effective in improving secondary endpoints, such as stool consistency, straining, abdominal discomfort, bloating, global assessments, and quality of life.
Colchicine
Colchicine is known to induce diarrhea when taken in higher doses. colchicine increases prostaglandin synthesis, intestinal secretion, and gastrointestinal motility.
Alvimopan and methylnaltrexone
Recently, alvimopan and methylnaltrexone have been introduced for constipation.
CONCLUSION
Constipation is a condition that can affect people of all ages and in this condition, the patient is unable to pass stool either frequently or with ease. There may be multiple factors that can contribute to this but the main causes are a low-fiber diet, a sedentary lifestyle, and dehydration. People who complain of IT feel difficulty in evacuation and if they pass stool, it is a very painful process for them. So in order to treat this disorder there are many home remedies that can be adopted to get rid of it.
This includes the use of more and more water to stay hydrated, use of a highly fibrous diet and supplements to enhance gut motility, intake of juicy fruits and vegetables, avoidance of dairy products if there is any complaint of lactose intolerance, Use of coffee, doing more exercise and activity.
All these home remedies may prove very beneficial to relieve constipation. And still, if it persists then there is a dire need for proper medical treatment and consultation with physicians. So, If home remedies are not enough to relieve and don’t affect it properly due to any reason then the treatment is switched towards pharmacological use of tablets and others medications on the prescription of a physician. There are many effective medications for the treatment of constipation e.g Lubiprostone, Prucalopride, Linaclotide, Colchicine, and Alvimopan and methylnaltrexone are very effective medicines to get permanent relief from it.
