Dear Doctor, 

For the last two months, I have been experiencing frequent incidences of conspitation. I have tried to take lots of water as advised by most people I have consulted but my problem has refused to go away. What can I do?

Bizimana

Dear Bizimana,

Constipation in majority of cases is a functional problem. Due to defective diet, inadequate water, heavy meals, irregular meal times, stress, etc. the bowels start to become sluggish in function. Thus the faecal load is not emptied regularly.

Diseases like diabetes, hypothyroidism, cancer of the bowel, infections of bowel, irritable bowel syndrome, etc can cause constipation. Constipation occurs as an adverse effect of drugs like pain killers of opiate group, antidepressants, antispasmodics, e.t.c.

In your case, an organic problem causing constipation should be excluded first by simple lab tests. Any problem identified can be cured. Meals should be small and frequent and preferably in time. Food should include green vegetables and fiber rich fruits, like orange, pineapple. Papaya is very useful in this regard. Drinking hot water after dinner and first thing in morning serves as laxative and helps clear the bowels. There are specific exercises in yoga which aid to cure constipation. Also regular physical exercise stimulates the bowels as well. Try conditioning the bowels and make them more active. This can be done by sitting in the toilet at a fixed time each morning and trying to pass stool

Laxatives are alright for a short time, but their long term use leads to habituation, i.e. bowels do not move without them. With use of higher doses, there is risk of the bowel becoming dilated such that the problem is augmented.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital