Constipation

Constipation

DIGESTIVE DISORDERS- Constipation

Elimination of waste is equally as important as intake of healthy foods. That is why care is taken for proper evacuation right from birth. A newborn is watched for passing the meconium (first stool) within 36 hours of birth. Even in breast-fed infants, the passing of stool, at least once in three days, is essential.

For real internal health, good digestion and regular bowel movements/habits are very essential. The bile pigments and other wastages are usually excreted through faeces. So, even during fasting, small quantity of faeces will be passed on indicating the importance of defecation.

Less than 3 bowel movements in a week are considered medically as ‘constipation’. But, generally, ‘normal’ varies from person to person, i.e., some would go for stool once in 3 days and they won’t feel any discomfort or difficulty and would feel that is normal.

Some need coffee or milk or plenty of water or jogging to induce the act of defecation in themorning. Some need beer, alcohol, cigarette or tobacco or betel nut for free stools. Many people read the newspaper, enjoy music, enjoy smoking and work out the day planner in the toilet. These attitudes have brought about the closet trend to make bathrooms as glamour rooms with sophisticated accessories equal to living rooms. These things should be avoided and one should concentrate on passing the stool and leaving the toilet as early as possible.

Nowadays, people cannot digest food well and evacuate it effectively due to various reasons like bad quality of food, fast foods, drugs, habits, mental strain, etc. Also the tongue is given more importance than the stomach. For constipated people, constipation may be the first failure or upset of the day.

About constipation – Constipation is infrequent and inadequate defecation without satisfaction. Simply, it means difficulty in passing stool either in evacuating or act or time or in getting satisfaction. Some find difficulty in passing stool and take a long time in the toilet, due to hardness, bulkiness and dryness of the stool. Some may go many times to the toilet, but they may not succeed in emptying their bowels even though the stool seems to be soft. They constantly feel the urge and crumbling of stool in the rectum. All these will lead to lack of concentration and various health problems. Mostly, constipation occurs as a functional disorder, but people, due to carelessness and ignorance, make it a chronic problem. Also, many resort to self-medication and complicate it without finding the cause.

Incidence – Most people suffer from constipation at some time or the other. Old people suffer more commonly. At least 5–10 per cent of the population suffers and lives with constipation. Constipation can occur in all age groups, including newborn. Females suffer more commonly than males. They suffer especially during pregnancy and after delivery and develop fissures or piles. One who deviates more from nature in diet, living & sitting habits will usually suffer from higher incidences of constipation.

Pathophysiology – Easy defecation is close to good digestion. Good digestion starts from the mastication of food in the mouth. Our stomach and duodenum work more with digestion of food particles with gastric acid and bile. Coiled small intestines and large intestines work more with absorption. Nutrients and water are absorbed in the intestines as food passes slowly through this coiled long route with swaying motion of the intestines. As food loses nutrients and water while passing through these roller-coaster intestines, it becomes solid stool. In case of dehydration or increased absorption of water, the stool becomes dry and hard and gets stuck/impacted to the walls of the intestines to resist further movement, causing constipation. Water absorption from digested particles in the intestines plays a major role in constipation. The longer it remains, the more it becomes hard and dry.

Types of constipation – Constipation can be classified as acute and chronic depending upon the duration of suffering. Acute constipation with severe abdominal pain should be treated immediately to rule out any obstruction or impaction to avoiding serious consequences. Constipation can be classified into three types in the following manner:

Atonic constipation – Functional constipation occurring commonly due to lesser intake of water, less fibre content and irregular meals, vitamin deficiency, temporary and after effects of laxatives and purgatives.
Spastic constipation – due to irritability of intestines from foods, medicines, stress and strain, nervous disorders, etc.

Obstructive constipation – due to tumours or fecal impaction arresting the pathway

Causes – Human beings are often get constipated due to evolutionary changes, familial constitution and tension in the present world. Most times, the causes for constipation persist as hidden and no obvious reason can be traced and it becomes ‘non-specific’. It may be usually due to

Habits

• Failure in developing habits
• Controlling or suppressing the urge for a prolonged time
• Making changes in routines
• Habits of sedentary, being busy, long distance travel and alcohol
• Irregular food habits at irregular time

Food & water

• Low fibre food, highly-refined food, food with more spices and chillies
• Less intake of water and dehydration caused by carbonated drinks and alcohol may cause constipation
• Hereditary – Constipation is often found to run in families.
• Anatomical – Any malformation/abnormality in anus, rectum and intestines
• Physiological – Pregnancy, delivery and heavy exercises can cause constipation.

Pathological

• Digestive tract – Anal fissure, fistula, prolapse, pelvic and rectal tumours/cancer, liver and portal vein disorders, large megacolon, Crohn’s disease, intestinal obstruction / stricture / adhesions, etc., can cause constipation.
• Nervous disorders – Multiple sclerosis, Parkinson’s disease, stroke, spinal cord injuries, sluggish intestines, paralysis, etc.
• Hormonal – diabetes, hypothyroidism, hypoparathyroidism
• Psychological – Worries and mental strain can also cause havoc and lead to constipation
• Environmental – Unfamiliar environments and a hot summer can lead to constipation

Medications – Drugs used in irritable bowel syndrome, diarrhoea, painful conditions, psychological conditions (antidepressants) and neurological conditions will often cause constipation. Supplements like iron and calcium, abuse or regular use of antacids and laxatives can also cause constipation.

Associated symptoms of constipation – Constipation as a symptom (not a disease) will not bother anyone in the initial days, but as time goes, it causes loss of appetite with abdominal discomfort/pain and bloating. While straining for passing dry hard stool, it may cause pain in the rectum/anus with occasional bleeding. Constipation usually accompanies belching, burning eructations, gas trouble, nausea, vomiting, headache, bad breath, weight loss, tiredness, lack of concentration, etc.

Diagnosis and investigations – Diagnosis is important to rule out any serious illnesses like obstruction, tumour / cancer and deformities. So investigation for the cause/disease should be properly done. Common tests which help in finding the cause are digital examination (finger palpation) / proctoscope / sigmoidoscope / colonoscope / endoscopy / barium enema X-ray (if necessary MRI or CT scan) / colorectal transit study / biopsy / stool examination / routine blood investigations with thyroid profile and calcium levels to rule out every possibility of presence of disease.

Preventive measures – The following procedures will surely help prevent/avoid recurrence of constipation

• Move more towards greens and nature.
• Don’t be sedentary and sit idle for a long time.
• Eat fibre-rich diet for good digestion and easy defecation
• Take plenty of water
• Take plenty of fruits/fruit juices
• Follow regular bowel habits and don’t be in a hurry in the toilet
• Always answer the morning call/urge
• Try to lead life without tension
• Indian style closet is always better than Western since squatting is the apt posture to compress the abdomen to increase pressure for easy evacuation

Precautions – Avoid the following things to avoid constipation and complications:

• Suppressing bowel movements or urge
• Self-medication with laxatives
• Continuous use of laxatives / stool softeners / enema
• Don’t go for purgatives to clean stomach (if you are cleaning naturally everyday, it is unnecessary for shut down cleaning)
• Straining severely for defecation
• Spicy foods, meat and processed foods which need more time to digest
• Carbonated drinks, alcohol and smoking

Self care and management – Taking

• Lemon, honey, guava, grapes will facilitate easy digestion and defecation
• Paraffin oil, olive oil, castor oil will facilitate passing of stool by lubrication
• Vegetables, green leaves, cabbage, carrot, beans, grains, cereals can ease stool

Complications of constipation – One should be very careful with constipation or otherwise it may lead to complications like piles, fissures and prolapsed anus/rectum. Straining at stool may often cause hernia. In case of patients suffering with coronary artery diseases (heart complaints), straining may also cause palpitations, fainting and sweating.

Treatment for constipation – This commonest complaint is very commonly left untreated or self-treated with drugs available across the counter. This attitude leads to recurrence of constipation and complications. Surely, it needs the advice/diagnosis of a doctor, even though self-care, diet care and lifestyle changes works good. Morning results of laxatives and immediate result of enemas often compel every doctor to prescribe it even for the mild constipation of every patient in a hurry. Nowadays different types of laxatives are available in the market like bulk-forming, saline laxative, stimulants, etc. Stool softeners and lubricants are sometimes prescribed, depending upon the causes. Impacted stool can be treated with medicines and stool softeners, but intusseuption (inner riding of intestines into another part of intestine) and obstruction due to growth will often require surgical correction.

Homeopathic approach – Best results are often shown when one reverts to nature in foods and habits rather than treatments. Keeping soft stool is the key to success in the management of constipation. The mode of treatment usually varies depending upon the cause, severity, and duration. Treatment mode / method may also vary according to the doctor and system. In Homeopathy, constipation is well treated with total care for its cause and associated symptoms.

Homeopathy always gives importance to the general symptom than the disease symptoms. Stool is a general symptom i.e., it affects the person as a whole. So, Homeopathy usually gives importance to stool habit like thirst, sweat, sleep, appetite, urine, menses, etc., while treating any disease. Rediscover of bowel health can be attained earlier compared to the use of laxatives / stool softeners / enemas.

Constipation may be the leader of diseases in some cases. For example, constipated people usually have headache. For this, instead of giving painkillers or vasodilator for headache, clearing constipation gives cure once for all, unlike other temporary managements. Also, every action has its own reaction. If you sleep with sleeping pills today, then tomorrow night will be a sleepless one. Likewise, giving laxative instead of treating the cause will lead to more and more constipation in future. Any supplement or anti-pathy mode of approach will often lead to dependency throughout life. So, to remind our body to function on its own, Homeopathy is the best way.

Homeopathic medicines commonly used in the case of constipation are Acid Nit, Aesculus Hip, Aloes, Alumina, Alumen, Ammon mur, Bryonia, Calc carb, Capsicum, Carboveg, Causticum, Chamomilla, Collinsonia, Conium, Graphites, Hamemelis, Hepasulf, Hydrastis, Hypericum, Ficus.R, Ignatia, kali carb, Lachesis, Lycopodium, Mag Phos, Mag Mur, Muriatic acid, Nat Sulp, Nux Vom, Opium, Paeonia, Phosphorus, Plumbum met, Podophyllum, Pulsatilla, Ratahnia, Ruta, Sanicula, Sulphur, Tarentula, Thuja, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)

Laxmi Homeo Clinic

24 E. New Mahalipatti Road

Madurai, TN 625 001

India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)

Fax: +91-452-233-0196

E-mail:  drcheena@yahoo.com

www.drcheena.com / www.drcheena.in

 

(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)