Are you experiencing bowel movements that are hard and dry, less frequent than usual, and difficult or painful to pass? If you answered "yes" to any of these, you may be experiencing constipation.
Occasional constipation affects almost everyone, including young children and seniors. Constipation also tends to be more common in women. Pregnancy, childbirth, and surgery can also contribute to constipation.
On the other hand, not everything that seems like constipation is. You may think you're constipated if you don't have a bowel movement every day, or if your stool is firm. But these by themselves don't necessarily equal constipation. "Normal," in terms of bowel movement frequency, depends on your age, physiology, diet, social and cultural influences, and other individual factors. There is no right or wrong number of bowel movements that you should have per day or per week. For example, while the normal frequency of bowel movements in Western society may range from 1 to 3 per day to 1 to 3 per week, in countries where a high-fibre diet predominates, normal bowel movements may occur as often as several times a day.
How does constipation happen? Water is absorbed from the food you eat as it moves through the colon (large intestine). What's left is a waste product, which doctors refer to as stool. As the muscles in the colon contract, the stool is pushed down towards the rectum. But when the muscles of the colon are sluggish, the colon absorbs too much water, and the stool becomes hard and dry, which makes it difficult to pass. This results in painful and difficult bowel movements.
What commonly causes constipation? Constipation can be caused by:
- a low-fibre diet
- not drinking enough fluids
- lack of exercise
- ignoring the urge to have a bowel movement
- a change in routine, such as travel
- pregnancy hormones
- older age
- certain chronic illnesses, such as irritable bowel syndrome or an underactive thyroid
- recovering from surgery
- taking certain medications.
There are several kinds of medications that can cause constipation. For example, up to 95% of people who take narcotics or opioid medications to control pain, either after surgery or for other reasons, experience constipation. Other constipation-causing medications include:
- antacids that contain aluminum or calcium
- antispasmodic drugs
- antipsychotic drugs
- iron supplements
- anticonvulsants for epilepsy
- antiparkinsonism drugs
However, if you have tried different treatments and lifestyle modifications unsuccessfully, but the constipation has not gone away, and it's been going on for a period of 3 months or more, you may be suffering from chronic constipation, also known as idiopathic or functional chronic constipation. Your doctor will use addition criteria to determine a diagnosis of chronic constipation, such as the frequency of bowel movements per week, how often you need to strain to have a bowel movement, feeling of incomplete evacuation, and consistency of stool. Seniors are particularly prone to chronic constipation because of age-related decreases in bowel function, diets low in fibre, lack of physical activity, and use of medications that promote constipation.
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