Constipation: Relief and Natural Remedies
Constipation is a common gastrointestinal problem that affects about 15–20% of the population and seriously reduces quality of life. This guide comprehensively covers the definition, causes, natural remedies, types of laxatives, and when to see a doctor for constipation.
- Straining during at least 25% of bowel movements
- Hard or lumpy stools (Bristol Stool Scale Type 1–2) in at least 25% of bowel movements
- Sense of incomplete evacuation in at least 25% of bowel movements
- Sense of anorectal obstruction or blockage in at least 25% of bowel movements
- Need for manual maneuvers to facilitate defecation in at least 25% of bowel movements
- Fewer than 3 spontaneous bowel movements per week
- Normal-transit constipation: the most common type. Colonic transit time is normal, yet the patient complains of constipation. Hard stools, bloating, and abdominal discomfort are typical.
- Slow-transit constipation (colonic inertia): colonic motor activity is reduced and stool moves through the colon slowly. It is particularly seen in young women. Bowel movements may occur less than once a week.
- Defecation disorders (outlet obstruction): difficulty defecating due to coordination problems in the pelvic floor muscles (dyssynergic defecation) or anatomical issues (rectocele, rectal prolapse).
- Medications: opioids, anticholinergics, calcium channel blockers, iron preparations, aluminum-containing antacids, tricyclic antidepressants
- Endocrine disorders: hypothyroidism, diabetes mellitus, hyperparathyroidism, hypercalcemia
- Neurological diseases: Parkinson's disease, multiple sclerosis, spinal cord injury, Hirschsprung's disease
- Metabolic causes: hypocalcemia, hypokalemia, uremia
- Structural causes: colorectal cancer, strictures, rectocele
- Psychological causes: depression, anxiety, eating disorders
- Insufficient fiber intake: when daily fiber intake is below 25–30 g, stool volume decreases and colonic transit time lengthens
- Insufficient fluid intake: the colon absorbs water from stool; when fluid intake drops, stools become harder
- Sedentary lifestyle: physical activity boosts intestinal motility; a sedentary life slows bowel movements
- Suppressing the urge to defecate: regularly suppressing the defecation reflex weakens it over time
- Stress and anxiety: activation of the sympathetic nervous system slows bowel movements
- Travel and changes in routine: time-zone changes, diet changes, and stress
- Soluble fiber: oatmeal, flaxseed, chia seeds, apple, pear, legumes. Forms a gel in water and softens stools.
- Insoluble fiber: whole-wheat bread, bran, vegetables, whole grains. Increases stool volume and stimulates bowel movements.
- New-onset constipation in patients over 50
- Blood in the stool or a positive occult blood test
- Unexplained weight loss (more than 10% in the last 6 months)
- Family history of colorectal cancer
- Progressively increasing abdominal pain and bloating
- Narrowing of stool caliber (pencil-thin stools)
- Constipation that does not improve despite lifestyle changes and laxatives
- Alternating bouts of constipation and diarrhea
- Acute-onset constipation with fever or vomiting
- Constipation with anemia
- Harrison's Principles of Internal Medicine, 22nd Edition — Chapter: Diarrhea and Constipation
- Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 11th Edition
- Rome IV Diagnostic Criteria for Functional Gastrointestinal Disorders, 2016
- Attaluri A, et al. Randomised clinical trial: dried plums vs. psyllium for constipation. Aliment Pharmacol Ther. 2011;33(7):822–828
- Rao SS, et al. Diagnosis and Management of Chronic Constipation in Adults. Am J Gastroenterol. 2023
Dr. Emre Gecer
Author
İlgilendiğim bazı şeyler var. Sinema kuramı, senaryo mekaniği, sanat akımları, jazz müzik, finans teorisi, python, yapay zeka, makine öğrenmesi ve tıpın ilgimi çeken konuları gibi. Bunlar hakkında not düşebileceğim, düşüncelerimi paylaşabileceğim bir alan yaratmak istedim. Birazda hayatın içinden anlar, hikayeler eklerim diye düşünüyorum. Buranın zamanla gelişeceğine inanıyorum, belki de uzun vadede bambaşka bir şeye dönüşür. Neden olmasın?
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