Constipation: When is It A Bigger Cause of Concern?

Constipation is defined as having fewer than three bowel movements per week. A related condition is Dyssynergic Defecation, which refers to the need for excessive abdominal straining while defecating and is due to a pelvic floor dysfunction. People suffering from this condition often have to strain hard at bowel movement and may develop secondary problems such as bleeding from haemorrhoids or anal pain from anal fissures.

Constipation could affect anyone, regardless of age or gender. For the majority, constipation is short term, but some may face chronic constipation, causing great discomfort and adversely affecting their quality of life.

There are many different factors that could lead to constipation – in acute cases, constipation is often short term and would go away with an appropriate adjustment in lifestyle and diet habits.

However chronic constipation that lasts for a long term could signal a bigger cause of concern.

• Poor eating habits (e.g. too much caffeine, lack of fibre or fluids, irregular eating times)
• Lack of exercise
• Symptoms caused by certain medications (such as painkillers, diuretics, iron supplements and calcium supplements)
• Stress
• Pregnancy

• Tight Pelvic Floor: If the pelvic floor in the rectum is too tight and unable to relax, it becomes difficult for stool to pass. This can lead to straining during a bowel movement which causes muscles to tighten even further.  
• Weak Pelvic Floor: Weakness of these muscles, together with weakness of the anal sphincter (muscles around the anal opening) may cause fecal incontinence, causing it to become difficult to control the release of stool. 
• Overuse of laxatives
• Neurological conditions such as Parkinson’s disease or multiple sclerosis

There are many different factors that could lead to constipation – in acute cases, constipation is often short term and would go away with an appropriate adjustment in lifestyle and diet habits.

1. Hemorrhoids, which happens when the veins around the anus swell. This could essentially lead to serious blood clots or infections. 
2. Impaction, where the stools harden in the colon and they do not get passed out. This would lead to pain and vomiting.
3. Anxiety, Stress and Poor lifestyle habits due to constipation often lead to a vicious cycle and poor quality of life
4. Anal Prolapse, where the rectum slips out from your intestine. When this occurs, surgery may be required. In mild cases, strengthening the pelvic floor muscles is a good treatment.

There is a plethora of treatment options available from diet tips to lifestyle changes to medication. For many experiencing constipation, a very common and immediate solution would be laxatives.

• Fibre Supplements: these help to soften the stools and they do so by either stimulating bacteria to aid the digestion of  food in the gut or by absorbing water in the digestive tract.
• Osmotics: these work similar to fibre supplements to soften the stools, but do it by increasing the amount of fluids secreted within the intestines. They also increase the speed of intestinal contractions, regulating more bowel movements.
• Stimulants: these help to speed up movement of the intestinal muscles, promoting more frequent bowel movements.
• Glycerine suppositories: these are solid forms of medication that are inserted up into the anus. Once inserted, they will melt, lubricating and softening the faecal matter. They effectively aid in emptying the back passage of stools, and they serve as a good alternative if oral medication isare too hard to ingest or if they get broken down before reaching the intestines.

Laxatives are effective and usually provide immediate relief. However, long term overuse and overconsumption could lead to the digestive tract developing a dependence on them.

Home remedies and lifestyle changes are other great ways to naturally condition your body to gain control over your bowel movements.

• Drinking more water: this is probably the number one tip you’ll see when looking for natural constipation remedies. It is true, drinking sufficient amounts of water can help keep your stools soft and easy to pass, but do note that the key is staying hydrated. If you are already drinking enough water everyday, drinking more water will not help you cure chronic constipation.
• Drinking mint or ginger tea: mint contains methanol which helps to relax the muscles of the digestive tract while ginger has a warming effect that warms up the gut, both help to stimulate digestion.
• Increase your intake of dietary fibre: insoluble fibres help to clean the sides of your bowels and push the food through your system. Soluble fibres help to absorb water, making it easier for stools to be passed in bulk. However, increasing your intake of fibres may cause bloating and discomfort, so do check if your current fibre intake is already sufficient before increasing it further.
• Exercising regularly: regular exercise is an effective way to stimulate the muscles in the intestinal tract, and help pass food through your system more effectively. This is a safe and foolproof method that can definitely aid your digestion.

First, see a doctor or a colorectal specialist to check if you might have any underlying conditions. In many cases, it could be due to a pelvic floor dysfunction and/or a lack of circulation in the lower structures.

Seeking conservative treatment is often the first go-to solution to avoid surgery. This is an alternative to ingesting external medication or relying on laxatives, and a method that allows the body to naturally overcome this condition to allow longer lasting results.

Treatment at Orchard Clinic for chronic constipation and straining is to treat the pelvic floor dysfunction via HIFEM Technology.  A healthy and functional pelvic floor is essential in helping us defecate as the pelvic floor muscles surround the anal sphincters that support bowel movement.

Get in touch for a consultation to assess if you might require treatment from Orchard Clinic.