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Last Medical Review: March 26, 2020
Medically Reviewed by Dr. David Costa Navarro
Constipation (March 26, 2020)

What is constipation

Constipation is a decrease in the frequency of evacuations and/or a qualitative modification of the stool, which becomes hard and scarce. The frequency of defecation varies from person to person and it is wrong to believe that you are constipated if the intestine is not released every day; one evacuation every three four days, as well as three evacuations per day are to be considered normal, if they do not cause disturbances and a subjective sensation of fullness or pain.

How it manifests itself

Two different forms of constipation can be distinguished: an acute and a chronic one. The first is a temporary ailment that can be secondary, for example, to surgical interventions, which force forced immobilization, acute diseases, or even simply to a long journey; in general, once the contingent moment is passed, constipation resolves in a short time. Chronic constipation, when it does not depend on other pathological causes that must be investigated by the doctor, is generally linked to several conditions, including:

  • incorrect eating habits, especially a diet low in fiber and rich in refined carbohydrates, but also the irregularity of meals;
  • sedentary lifestyle. Poor (or absent) physical activity causes weakness of the abdominal muscles and, consequently, excessive intestinal laziness
  • particular living and working conditions, which sometimes do not allow an immediate response to the stimulation of defecation. The stools, remaining longer in the intestine, become harder, making the evacuation more difficult and sometimes painful.

These conditions can also be aggravated by the concomitant presence of hemorrhoids or anal fissures, creating a vicious circle that further aggravates constipation. In addition, excessive attention to the line and the maintenance of healthy weight often leads to undergo irrational diets and to take purgatives or laxatives which, not only are not useful for weight loss, but are themselves the cause of constipation or diarrhea . The abuse of laxatives in fact induces an ” lazy ” of the intestine which, with the passage of time, completely loses its ability to contract. It is important to remember, finally, that even some drugs taken habitually can cause constipation.

What are the causes

The modification of the composition of the feces is usually due to an excessive loss of water, due to both the prolonged stationing of the feces in the colon, but also to the absence (or scarce presence) in the feces of indigestible material (fiber). Generally, those suffering from constipation feel a sense of heaviness and widespread malaise. Many people, however, believe that they suffer from constipation despite their normal intestinal function: very often it is simply a subjective feeling of dissatisfaction related to evacuation.

What should be done

By excluding the conditions in which constipation is secondary to other diseases (e.g. colon, rectum, neurological or metabolic), constipation can be resolved by changing one’s dietary and life habits. The diet, in particular, must be rich in fiber and must include the intake of high quantities of liquids, which have the function of hydrating the stool and increasing its volume, reducing the transit time in the intestine and the effort at the act defecation. It is important to follow even light but constant physical activity (for example walking or cycling) which promotes the maintenance of an adequate tone of the abdominal muscles. It is also useful to respect fixed times in defecation, supporting the stimulus when it occurs and taking a correct position, adopting, if possible, a squatting position, or sitting on the toilet resting your feet on a support about 30 cm high to facilitate the push of the abdominal muscles. When, despite the adoption of dietary and behavioral rules, no results are obtained, laxatives can be used, but only if specific rules are followed to avoid possible damage associated with their use. Among the laxatives available on the market, the “mass laxatives” based on vegetable fibers (e.g. bran, psyllium, etc.) are undoubtedly preferred, which act by softening and increasing the volume of the feces, promoting their expulsion . These products can be used safely even for long periods. All other laxatives, even those of vegetable origin and therefore considered ” natural ” (e.g. senna, cascara, rhubarb, etc.) can interfere with the normal functioning of the intestine and determine, if used in high doses and for a long time time, intestinal damage and addiction. The use of these laxatives must therefore be limited in time (1-3 days) and intended for occasional forms of constipation.

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