Colorectal Surgery

Constipation – What You Need To Know

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    3 Mount Elizabeth
    #12-09 Mount Elizabeth Medical Centre
    Singapore 228510
    
    Tel: 6737 2778
    www.hkscolorectal.com.sg
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  • October 2, 2023
  • 2 minutes read

Constipation is a tricky term to define because there is no such thing as a “normal” amount or frequency for one’s bowel movements. While some people may need to defecate three times a day, others can go for a week or more without a bowel movement and experience no discomfort or harmful effects.

There are several possible reasons why one may experience constipation. Inadequate fibre and water intake, for instance, increases the odds that you will become constipated, as will a sedentary lifestyle or a sudden change in one’s environment. Constipation may also be aggravated by travel, pregnancy or a change in diet, and in some people, repeated suppression of the urge to pass motion may also result in a state of constipation.

There are also more serious and far more sinister causes of constipation. Growths or areas of narrowing within the colon, for instance, may also result in constipation, as may certain nervous or endocrine disorders (such as thyroid disease, multiple sclerosis, Parkinson’s disease, stroke and spinal cord injuries). As such, it is usually wise to seek a doctor’s opinion if you experience prolonged periods of constipation.

In fact, it is usually a good idea to seek medical attention if you experience any change in bowel habits for more than three weeks.  The keyword here is change: as long as there is an unexplained increase or decrease in frequency, a change in the size of stool, or an increased difficulty in passing motion for more than three weeks, you should immediately seek medical attention.

It is important to note that there are also several forms of medication known to cause or worsen constipation. Drugs known to do this range from painkillers and antidepressants to blood pressure medication, iron and calcium supplements, and antacids that contain aluminum. Check with your doctor if you experience constipation after starting a new course of drugs, that your doctor may explore new drug options for you.

How often you need to defecate depends on the total amount of fibre in your diet.  The more fibre you take, the more stools to pass.  However, taking more fibre does not necessarily means softer stools.  Everyone has a different requirement, and in some people, taking more fibre actually results in more constipation and bloating.  For some people, increasing fibre intake (including taking fibre supplements) without a corresponding increase in water intake would simply result in passing out greater amounts of hard stools.  For others, decreasing the fibre intake would actually reduce the feeling of bloating that some associates with constipation.

One common trigger for constipation is actually repeated delays in going to the toilet when feeling the urge.  By delaying the process, it leads to stools being jammed in the rectum and overstretching it.  The colon tends to absorb the moisture out of the stools, so that when eventually one goes, the initial piece is large and hard.

Laxatives are useful as a temporary relief when constipated. It acts to stimulate the colon to move faster and push out its contents. However, bear in mind that if the bottom end is choked up, it would still take some time for the medication to take effect and the bottom piece would still be difficult to pass out.

Prolonged use of laxatives results in over-stimulation of the colon. There becomes a state of dependence where more and more laxatives are required for the same effect, and it can come to a point where laxatives no longer work and surgery is necessary to actually remove the non-functioning colon to allow the rest of the intestines to work properly. A word of caution: some slimming tea, herbal tea or detox tea may claim to have all natural or organic products but contain senna leaves, a potent laxative. People who take this type of products for long term may find that they become dependent on it, and become constipated without drinking these products.

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