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The frequency of bowel
movement may vary from
individual to
individual. It may be
normal for some people
to have a bowel action
only three or four times
a week. The term
constipation refers to a
change in daily bowel
habits, particularly a
reduced in frequency of
bowel movements. This
may accompanied various
symptoms such as passing
small amounts of hard
and dry stool. The
level of comfort when
passing stool is also a
good way to determine if
one is constipated.
As food moves through
the digestive tract,
water and nutrients are
absorbed while forming
stool. Muscle
contractions push the
stool down the digestive
tract. By the time
the stool reaches the
rectum, it is solid as
most of the water has
been absorbed.
Constipation occurs when
too much water is being
absorbed in the large
intestine (colon) due to
conditions such as slow
or sluggish contractions
of the colon. As a
result, the stool moves
more slowly through the
intestines and hence
allowing too much water
to be absorbed, leading
to constipation.
Constipation itself is a
symptom, not a disease.
It may be an indication
of more serious problems
such as intestinal
obstruction,
hypothyroidism or a side
effect of medications.
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The person may experience
different symptoms.
These include:
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Bowel movement less
frequent than one’s
normal pattern.
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Difficulty in bowel
movement, often have
to strain.
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Passing small, dry,
and hard stools
(pellet-like
stools).
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May feel the urge
even after bowel
movements.
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Feeling bloated and
uncomfortable.
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Frequent passing of
air (flatus) because
there is excessive
gas in the bowels.
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These symptoms of
constipation may
resemble many medical
problems. Always
consult your doctor for
a diagnosis.
Treatment should address
the underlying
abnormality.
Chronic constipation can
lead to weakening of the
muscle tone in the
bowel, causing lifelong
problem.
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Not enough fiber or
fluids in the diet.
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Too much fat in the
diet.
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Reduce physical
activity, especially
in the elderly or
one who is sick and
confined to bed.
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Habitual use of
laxatives. The
body becomes
dependent on them
for bowel movement.
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Medications
including anti-parkinson
drugs,
anti-depressants,
iron supplements and
diuretics.
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Ignoring the needs
to go to the toilet
even when there is
an urge to have
bowel movement.
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Changes in lifestyle
or routine, such as
when traveling
overseas, which
disrupted one’s
usual diet and daily
routine.
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In women, hormonal
changes during
pregnancy or due to
the uterus
compressing the
intestine.
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Slow
metabolism as in the elderly. There is a
reduced intestinal activity and muscle tone.
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Specific diseases or
conditions, such as
stroke, or problems
associated with the
colon and rectum.
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There are many
interventions for
constipation, but the
most effect ways relies
on a clear understanding
of the underlying
causes. The following
are some useful advices:
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Know the normal
bowel habits of the
person so that you
can determine when
it is less frequent.
Consult your doctor
when you notice a
significant delay in
the normal bowel
habits.
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Eat a well-balanced,
high-fiber diet that
includes vegetables,
fruits, whole grains
and beans.
Fiber is important
in increasing the
bulk of stool and
making it softer.
If you are adding
fiber to the diet,
starting it slowly
and gradually will
help to reduce gas
and bloating.
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Eat a piece of fruit
one-half to one hour
before a meal or
about one hour after
meal is ideal.
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Prunes are good
remedy for
constipation.
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Food high in
magnesium such as
dark-green leafy
vegetables are very
helpful.
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Fat intake should be
reduced in the diet.
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Drink sufficient
amount of water.
Liquids add fluid to
the colon and hence
help to soften
stools, making bowel
movements easier.
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Drinking a cup of
warm water on rising
in the morning,
approximately one
half hour before
breakfast, may
promote bowel
movement.
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Moderate the intake
of coffee and
alcoholic drinks
because they cause
dehydration to the
system and increase
the risk of
constipation.
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Exercise regularly.
Walking is a good
exercise and can be
done with little
difficulty.
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Good
tone in the abdominal muscles is important.
Exercise such as raising the legs, while lying
on the floor or bed, without bending the knees
helps to strengthen abdominal muscles.
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If
the person is
confined to bed or
wheelchair,
encourage physical
activities by
frequent change of
position and limbs
movements if his
condition allowed.
Consult your
physiotherapist for
the appropriate
exercises.
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Avoid giving
laxative unless
prescribed by your
doctor. They
are not meant for
long-term use.
People who are
dependent on
laxatives need to
slowly stop using
them. Most
people are able to
restores their
colon’s natural
ability to contract
after stopping
laxatives.
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Develop a regular
bowel habit.
The usual time for
most people to feel
the urge is the
first hour after
breakfast; the
ingestion of food
stimulates the
necessary wave of
intestinal movement. The urge to have a
bowel movement
should not be
ignored.
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Discourage straining
to have a bowel
movement.
Straining can cause
problems such as
hemorrhoids or tears
in the skin around
the anus which may
lead to rectal
bleeding.
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Advise on correct
sitting position in
the toilet.
Sitting with knees
lower than the
bottom requires more
strains to empty the
bowels Squatting position
is the ideal
way for bowel
movements. To
achieve squatting
position in a
sitting toilet, one
should straighten
his back, lean
forward with
his knees raised higher than
his bottom. If
possible, provide a
stool to support his
feet. Ask him
to rest his elbows
on his knees.
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Bowel movement can
also be stimulated
by contracting
abdominal muscles or
exerting manual
pressure downward on
the abdominal.
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Recognise the signs
of complications.
Bleeding from the
rectum, severe pain,
fever and vomiting
may be an indication
of more serious
problems.
Consult your doctor
immediately.
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