Constipation - A Multifaceted Concern (Part 1)

Constipation is a prevalent issue that affects individuals across all age groups. Often serving as a symptom of underlying medical conditions, constipation can lead to a range of physical and psychological symptoms if left untreated. In some cases, it may even contribute to the development of chronic diseases, including hemorrhoids, colonic aneurysms, anal fissures, and infections of the anus and rectum. 

This article, part 1 of a series, aims to explore the symptoms and causes of constipation, shedding light on the multifaceted nature of this common concern.

Symptoms of Constipation:

Prolonged constipation can give rise to a variety of distressing symptoms that affect individuals' overall well-being. These symptoms may include headaches, insomnia, bloating, excessive gas, reduced appetite and increased crying in children, as well as diminished appetite, fatigue, boredom, sadness, and depression in adults. 

Furthermore, if constipation persists over a long period, it may lead to complications that are difficult to cure and, in some cases, even increase the risk of developing conditions such as cancer.

When constipated, individuals typically experience fewer than three bowel movements per week. In severe cases, this frequency may decrease to less than once a week. Patients often struggle to defecate, experiencing abdominal cramps and passing dry, black, or lumpy stools.

Some individuals may also endure the discomfort of pushing hard during bowel movements, sometimes resulting in the presence of fresh blood and a burning sensation caused by hemorrhoids and anal fissures. Even after defecation, there is often a lingering feeling of incomplete evacuation, contributing to ongoing discomfort.

Children may exhibit specific signs of constipation, including changes in the frequency and consistency of bowel movements, such as solid and dry stools. They may also experience difficulties and pain during defecation, leading to crying and fear associated with bowel movements. 

Children may adopt uncomfortable postures, such as sitting on tiptoes, while exhibiting an overall reluctance to defecate. Additionally, pregnant women, newborn babies, and the elderly are more susceptible to constipation, often requiring more challenging treatment approaches.

Causes of Constipation:

Physical Diseases in the Gastrointestinal Tract: Certain conditions within the gastrointestinal tract, such as congenital megacolon in young children, colon tumors, and gastrointestinal tumors, can contribute to constipation. Extra-digestive diseases, such as tumors in other parts of the body, can also exert pressure on the gastrointestinal tract. 

Systemic diseases like hypothyroidism, hypercalcemia, decreased thyroid function, lead poisoning, and certain neurological conditions (e.g., Parkinson's disease) can impact digestive functions, leading to constipation. These conditions often generate worry, anger, and sadness, further exacerbating the symptoms.

Nutritional Factors: An improper diet lacking in fiber is a common cause of constipation. Fiber plays a crucial role in digestion, stimulating gastric contraction, promoting gastrointestinal motility, and softening stools. 

Additionally, fiber provides a suitable environment for beneficial microorganisms in the intestines, aiding digestion and supporting a healthy digestive system. Groups vulnerable to constipation due to dietary factors include pregnant women, infants on inadequate diets or weaning diets, malnourished children, and those who consume low-fiber diets.

Research indicates that 29% to 48% of constipation cases in children are associated with selective or fussy eating, while 47% of affected children have poor appetites. A substantial proportion of patients seeking  medical attention at gastroenterology-nutrition clinics, approximately 25% to 35%, present with constipation-related issues.

Inadequate Hydration: Water plays a vital role in the digestive process, aiding in the transport of waste products to excretory organs for elimination and facilitating the digestion of food. Insufficient water intake can contribute to constipation. 

The proportion of water in the human body ranges from 60% to 70% of body weight, with children, especially infants, having an even higher percentage. Water requirements vary depending on age, physical condition, underlying diseases, and environmental factors. Thus, dehydration or inadequate fluid intake can disrupt proper digestion and contribute to constipation.

Psychological and Lifestyle Factors: Psychological and lifestyle factors can significantly contribute to constipation. Habits such as refraining from defecation or occupations that involve prolonged sitting or immobility, like office work or driving, can increase the risk of constipation. 

Sedentary lifestyles coupled with high work pressure and excessive psychological stress can further aggravate constipation, especially among pregnant women and the elderly. Young children experiencing changes in their living conditions, lacking proper facilities and attention to hygiene, may also develop irregular defecation habits due to fear, shame, or aversion to dirt.

Other Contributing Factors: Constipation can also be caused by certain illnesses or the use of medications known to induce constipation. Long-term use of antibiotics, pain relievers, antacids containing aluminum and calcium, calcium channel blockers for low blood pressure, spasmolytics, diuretics, and other medications have been reported as potential causes of constipation, as acknowledged by medical professionals and users of these drugs.

Conclusion:

By gaining a comprehensive understanding of constipation, healthcare professionals and individuals can work together to address this common issue and improve overall digestive health.

Please note that this article provides general information and should not replace professional medical advice. If you are experiencing chronic constipation or have concerns about your digestive health, it is advisable to consult with a healthcare provider for a proper diagnosis and tailored treatment plan.