Constipation is inability to pass stools within 24 to 48 hours. Though a functional problem, it causes much suffering to the affected individual. One with constipation does not realise that the lethargy, weakness, abdominal pain, body ache, nausea, burning pain in chest, eructation, etc., and all other symptoms he is experiencing are because of the loaded bowels. In the majority of cases, it occurs due to lifestyle factors. Inadequate intake of water and dietary fibre makes the intestines sluggish, resulting in constipation. Taking meals late in the evening, eating heavy meals in the evening, are other factors that contribute to it, as bowels do not get enough time to digest food and clear the waste in such cases. If these factors are not corrected in time, this augments progressively. Lack of physical exercise also contributes to it. As lethargy of intestines increases, constipation also increases, becoming troublesome overtime. People affected, spend their valuable time and money in visiting hospitals and buying medicines, for something which they can rectify themselves by correcting their habits. They take to the bed complaining of abdominal pain, discomfort, nausea, among other things. In fact, what is needed is drinking plenty of water and moving around enthusiastically to activate the bowels for emptying. 10 per cent of cases occur due to medical problems, like T.B., diabetes, and spinal diseases/injuries. Any one of these diseases, if present, can be diagnosed easily with relevant investigations and are treatable. Few cases occur when the intestine gets occluded somewhere, needing surgical intervention. At times, it may be a side effect of drugs like painkillers, and antispasmodic drugs. Constipation can occur at any age. With advancing age, intestinal motility tends to reduce, causing constipation in elderly people. The young mostly suffer from it due to defective lifestyles and stress. But if it starts from a young age and is not corrected, the intestines will become more sluggish as age advances and the problem will augment. High carbohydrate foods like potatoes, sweet potatoes, bananas, aggravate constipation as their fibre content is negligible. Fresh green vegetables and fruits like pineapple and citrus fruits help in correcting it. Papaya is very useful in this regard as it has fibre and naturally occurring digestive enzymes. Whole grains are rich in fibre and vitamin B complex, which both aid in digestion and bowel movements. Evening meals should be taken early, at least one to two hours before sleeping, as this gives enough time for food to be digested and bowels to be emptied. Drinking plenty of water ensures good bowel movement and helps to control constipation. One suffering from constipation should drink hot water in the night before sleeping. Many people drink one to two glasses of hot water first thing in the morning and then go for a brisk morning walk or do some other physical exercise. This helps to cleanse the bowels regularly and activate them. Regular physical exercise is helpful for constipation. There are specific exercises in yoga which activate and strengthen the bowels. A person needs to have patience after adopting these measures. One surely gets positive results, but overtime. The intestines which have become sluggish over the years take time to restore their normal function. Regular use of laxative drugs for relieving constipation should be avoided. These drugs are habit forming. After some time of laxative use, bowels become habituated to it and fail to function without it. Gradually the dose has to be increased for necessary effect. With increased dose there is risk of dilatation of the large intestine, which aggravates constipation. Constipation is a correctable problem but causes much sickness and suffering in people due to ignorance and negligence about it. Dr Rachna Pande is a specialist in internal medicine.
