We all have our own digestive rhythm, and healthy bowel movements range quite widely from three a day to three a week. Going to the toilet less than usual is known as constipation, a widespread symptom in women and the elderly that may have a lot to do with our daily habits.
However, you cannot always treat constipation at home. In some cases, this symptom can be related to major illnesses, which is why it is essential to acknowledge the warning signs and see a doctor to assess them.
- Having fewer than three bowel movements a week is called constipation. It becomes chronic constipation if this symptom lasts for more than three months.
- Constipation is a symptom, not a disease. This means that it can occur for a number of different reasons, each requiring a different type of treatment.
- Over-the-counter drugs that help alleviate constipation, such as laxatives, do not usually address the cause of the problem. As such, we strongly encourage you to consult your doctor if your constipation continues for an extended period of time.
Constipation: What You Need to Know
To begin to understand what constipation is and how to deal with it, it is essential that you learn to identify it correctly. In the following section, we will explain everything you need to know about it!
What is constipation?
Many of us have a sense of what constipation is, but we often mistake a day without going to the toilet for this symptom. In fact, people are not aware that they suffer from constipation when they haven’t used the toilet for over a week.
We talk about constipation when you have fewer than three bowel movements a week (this means you only go to the bathroom twice or less). In addition, this symptom is often accompanied by very hard stools that are difficult to pass (1, 2). You may sit on the toilet for a long time and feel like “pooing” without being able to.
It is also necessary to distinguish between acute and chronic constipation. Health professionals have different opinions about when the latter starts, saying it becomes chronic after 3 or 6 months (3, 4, 5).
Constipation at different stages of life: recognising and treating it
Constipation can happen to anyone. However, certain individuals are much more likely to become constipated. In some cases, it is also much more difficult for them to recognise this symptom. Let’s see how we can identify constipation at different ages and under different conditions:
Women who are not even pregnant are much more prone to constipation than men of the same age. In fact, they are twice as likely to experience it (5, 6)!
Now imagine that a pregnant woman undergoes both hormonal changes (due to an increase in progesterone) and anatomical changes due to the presence of a new being in her womb. She will almost certainly have this symptom! So, what can they do to manage it? Here are some tips for you (7, 8):
- Drink more water: Water doesn’t simply hydrate your cells; it can also hydrate your stool to make it easier to pass. We recommend that you drink 6 to 8 glasses of water a day. You can also have plum juice (9).
- Add some fibre to your meals: Start by gradually increasing your consumption of vegetables, fruit, pulses, and cereals. If you dramatically raise your intake overnight, you may feel discomfort and even get diarrhoea. Keep in mind that the recommended amount of fibre per day is 25-30 grams (10).
- Move your body: Exercising is one of the best ways to get your bowels moving. During pregnancy, we suggest low-impact activities such as walking on flat ground, aquatic fitness, or yoga.
- If all else fails, try medications prescribed by your physician: Various constipation drugs can be used during pregnancy. The most common are laxatives (stool softeners) and fibre supplements such as Metamucil (11). Be sure to follow your doctor’s advice, especially if you’re taking laxatives (12).
Iron supplements may be contributing to your constipation. We do not recommend that you stop taking them, but you may want to discuss this with your doctor and consider changing the supplement or dose (11).
Constipation in babies and adults are very different. Babies rarely suffer from this symptom, but we can be concerned if they don’t fill their nappy for a couple of days. The consistency of bowel movements will be different depending on your baby’s age. We’ve designed a handy chart to help you recognise what’s normal and what’s not (13):
|Age||Normal bowel movements||Warning signs: call your paediatrician!|
|First days of life||The baby will pass meconium in the first 24-36 hours. These stools are green and yellow.||The baby has not passed any stools after the first 36 hours.|
|First week of life||About 4-8 bowel movements per day||The stools are infrequent, hard, and require a lot of effort from the baby to be passed (they turn red from the effort or tighten their abdomen).|
|From 28 days of life to 3 months||The frequency of bowel movements decreases. Several days may go by without a bowel movement, but the stool should be soft and easily passed.||The stools are infrequent, hard, and require a lot of effort from the baby to be passed.|
|After starting to eat solid food (six months onwards)||The baby will typically have a bowel movement after meals or at least 1-2 times a day.||The stools are infrequent, hard, and require a lot of effort from the baby to be passed.|
If your baby shows any warning signs, don’t try to solve it at home. It’s time to see your paediatrician!
People over the age of 65 are three times more likely to be constipated (1). As our body ages, our bowel movements also become a little slower. In addition, certain diseases and the use of medication may contribute to this symptom (14, 15):
- Malnutrition and weakness
- Bowel obstruction
- Alterations in nervous regulation
- Use of powerful analgesics such as opioids
- Medicines such as antacids, iron supplements, antidepressants, and heart medication
Try to make small adjustments to your diet by increasing your fibre intake gradually, drinking more water, and avoiding very fatty foods. If your constipation doesn’t improve in the next three months, you are advised to consult your physician to determine if there is a major underlying cause.
Additionally, you should see your doctor immediately if your constipation is accompanied by other symptoms such as bleeding during a bowel movement or between bowel movements, weight loss, severe abdominal bloating, vomiting, or any other symptoms that prevent you from leading a normal life.
How Can You Treat Constipation?
From lifestyle changes to drug treatments, there’s a lot you can do to help relieve constipation!
You can do plenty from home to relieve your constipation, from drinking a little more water to exercising and slowly adding fibre-rich foods to your diet.
In addition to this, you can try to implement these three simple changes in your daily life:
- Colon massages: According to many studies, colonic massage can improve intestinal transit (16). To do it yourself, sit on the toilet and raise your knees to make your abdomen soft. Try massaging in the normal direction of your colon (from the top of your right hip, below your ribs, to the top of your left hip).
- Use a stool in the bathroom: Improving your posture in the bathroom can greatly help your intestines. Try raising your knees up to your chest using a stool to make your bowel movements easier. It’s quick and simple!
- Eat plums: This delicious fruit contains sorbitol, which works as a natural laxative and also contains plenty of fibre if eaten whole. Other useful foods include apples, pears, and cherries (17).
Probiotics for constipation
Probiotic supplements contain living microorganisms normally found in a healthy intestine. This means that they can help repopulate your colon with bacteria and fungi that are essential for restoring it to a normal state.
It has been shown that the alteration of the intestinal flora is related to the worsening of constipation; the use of probiotics could improve this condition (18).
Choose probiotics that contain 100 million to 1 billion colony-forming units (CFUs) and are protected by an enteric coating. This will help them reach your gut without being blocked by your stomach acids (19).
Drug treatments for constipation
If you cannot improve your constipation with the strategies we discussed above, you may need certain medications to give a little boost to your digestive system.
Laxatives are the most widely used drugs to relieve constipation and can typically be found as (20):
- Osmotic laxatives: They are the cheapest and fastest-acting. The elderly should refrain from using them as they can cause dehydration.
- Stimulant laxatives: They act a little more slowly, but are useful for treating constipation caused by medicines such as opioids.
- Emollient laxatives: They are the slowest to act, but can be used by people with heart and blood pressure conditions.
Please bear in mind that laxatives cannot cure the cause of constipation; they can only alleviate the symptom. See your physician to identify the cause of your chronic constipation.
Constipation is simply a symptom that can be related to an unhealthy lifestyle, changes in our bodies such as pregnancy or old age, or gastrointestinal diseases that require medical attention.
The first steps to counteract this can be taken from home by improving our habits and using certain supplements or over-the-counter medication. However, it is imperative that you seek medical advice if this symptom persists or worsens rapidly.
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(Source of featured image: Twinsterphoto: 50498522/ 123rf.com)