At Amazon Nutrition Cabinet in Kigali, a clinic that deals with diet, physical wellness, and lifestyle, health experts say that of late, there has been a big number of clients seeking help on the issue of constipation, which is one of the most frequent gastrointestinal complaints.

This, the experts say, is brought about by lack of enough fibre in one’s diet.

Gerald Ruzindana, a health consultant and wellness expert at the clinic, says when you look at the eating patterns of most people, it is evident that they are resorting to highly processed, packed, and over-fried foods which are low in nutrient value and high in sodium.

Private Kamanzi, a nutritionist at the same clinic, says constipation occurs when bowel movements become less frequent and stools become difficult to pass. It happens mostly due to changes in diet or routine, or due to inadequate intake of fibre.

He notes that normally, the digestive system works within 12 to 24 hours, so spending close to 72 hours means the bowel is not working well.

The most common course of this is lack of enough fibre in one’s diet; processed and unsaturated foods generally are dense in fibre.

Ruzindana explains that when you look at how the human body was created, there are natural receptors that are connected to plant-based natural receptors, which understand and interpret food by the time it goes through the digestive processes.

He says the problem occurs when people consume overly-processed food, which is food whose chemical components have been compromised. For instance, white rice (processed) when eaten as a grain, the body can easily break it down because it has not been separated (germ from bran). Grains are made up of three parts: bran, germ, and endosperm. The bran is the outer shell that provides a rich source of fibre, trace minerals, phytochemicals, and B vitamins.

On the other hand, the germ nourishes the grain and is packed with antioxidants, B vitamins, and vitamin E.

Ruzindana says when the grain is separated and you remain with an endosperm (which is the starch under it), when it starts the digestive process, the body will find it difficult to digest it.

"This is so because what supports that grain to go through the digestive system is the fibre, which is a germ and bran. When it’s processed and removed, it means we are causing a malfunction in our system,” he explains.

Another important aspect to understand, is that when you look at how food travels, it is cross-cutting. "When we talk of constipation, it’s a gut (gastrointestinal function), the whole process from the mouth to the anus.

"You find that this is the system organ that works closely in maintaining the smooth flow of the digestive system including bladder, liver, and pancreases,” he says.

Further, he notes that this is how other disorders occur, such as autoimmune disorders like diabetes, because now the sugar that has been digested by the foods, enters straight into the blood.

When one continues with such a lifestyle, he says, the pancreas starts getting the ability to manufacture insulin which has to be released in order to balance the sugar in the food.

"There is a need for people to be educated on the dietary pattern around the feeds, so as to start having foods in their natural form,” Ruzindana says. The whole food chain system has to be considered from farm to fork, this is the only way the problem can be curbed for good, he says.

Joseph Uwiragiye, the head of nutrition department at University Teaching Hospital of Kigali (CHUK), says because of the current lifestyle people are exposed to, constipation is common in all people, however; there is a certain group of people who are more likely to be affected.

He says these include old people, whereby they tend to be less active and have a slower metabolism, and they have less muscle contraction strength along their digestive tract than when they were younger. Also, he says being a woman is also a risk factor, especially when one is pregnant and after childbirth.

"Changes in a woman’s hormones make them prone to constipation. The baby inside the womb squishes the intestines, slowing down the passage of stool,” he says.

Uwiragiye says not eating enough high-fibre foods can also expose one to constipation, adding that high-fibre foods keep food moving through the digestive system.

Kamanzi says taking certain medications, especially antibiotics, can also cause constipation.

"Antibiotics can destroy normal flora (good bacteria) that normally live in the digestive tract that helps people to digest food,” he says.

Management and complications

Depending on the cause, Kamanzi says one can still manage constipation.

For instance, he says, drinking two to four extra glasses of water a day, adding fruits, vegetables, whole grains, and other high-fibre foods to diet are just some of the ways one can correct the condition. Also, exercising is vital as it has been known to keep constipation at bay.

Constipation, when not well managed or corrected, Kamanzi says, can lead to swollen, inflamed veins in the rectum, a condition called haemorrhoids. It can also lead to an infection in pouches that sometimes form off the colon wall from stool that has become trapped and infected, a condition called diverticulitis.