A young girl of around 20 years of age was hospitalised for severe abdominal pain. Due to the pain, she was unable to eat and was feeling nauseous. After inquiries, I came to know that she had not passed stool for over a week- she was constipated. Prior to this however, she was only passing stool once in 2 to 3 days. She suffered so much just for a problem which could have been prevented easily. Constipation is inability to pass stool. One with constipation does not realise that abdominal pain, body ache, nausea, burning pain in chest, lethargy, eructation, among other symptoms they could be experiencing, are because of the loaded bowels. In majority of cases, it occurs due to life style factors. 10% cases occur due to medical problems like T.B, diabetes, spinal diseases/injuries. Few cases occur when the intestine gets occluded somewhere, needing surgical intervention. At times, it may be a side effect of drugs like opioid pain killers and antispasmodic drugs. Inadequate intake of water and dietary fibre makes the intestines sluggish. If 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 over time. People affected go to bed complaining of abdominal pain, discomfort, nausea and spend their valuable time and money visiting hospitals and buying medicine for something they can rectify by correcting their habits. In fact what is needed is drinking plenty of water and being active to activate the bowels for emptying. 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 life styles and stress. But if it starts from a young age and one does not correct it by life style measures, the intestines will become more sluggish as age advances and the problem will augment. High carbohydrate foods like potatoes, sweet potatoes and 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, both of which aid in digestion and bowel movements. Evening meals should be early, at least 1 to 2 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 1-2 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 in dealing with 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 over time. The intestines which have become sluggish over 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 dilation 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 Specialist internal medicine-Nyagatare Hospital E-mail – rachna212002@yahoo.co.uk
