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Constipation is a prevalent problem that affects many healthy individuals, with a higher incidence observed in females compared to males. However, the definition of constipation can vary depending on the individual. Some individuals define it as having infrequent, hard bowel movements, while others define it as passing stools less than once every two to three days.

It is crucial to note that constipation alone is not a concern, particularly if there are no accompanying abdominal symptoms or blood in the stool. It is a common misconception that holding onto feces for an extended period is harmful to the colon and can cause toxicity. However, it is also important to avoid regularly cleansing or douching the colon, as this can cause harm.

In conclusion, experiencing some degree of constipation is normal, as long as it does not cause discomfort or other issues.

Dietary causes

Dietary issues are one of the commonest causes for Constipation. Lack of water intake and lack of fibre intake are the two most common dietary causes for constipation. Lack of water produces hard stools which makes the colonic passage slower and the actual act of passing motion more difficult. Fibre on the other hand is needed to make the stools bulkier but yet fluffier and as such, the lack of fibre produces pellety hard stools. It is important to note that taking fibre alone without adequate water intake can worsen the pre-existing constipation.

Poor toileting habits

Constipation can occur if a person ignores the urge to have a bowel movement. Individuals with busy jobs or limited access to toilets may delay having a bowel movement, leading to weaker and infrequent urges over time. This results in the faeces staying in the rectum for a longer period, becoming harder and drier, and making it more difficult to pass.

Idiopathic and IBS (Irritable Bowel Syndrome)

Despite maintaining a healthy diet and good bathroom habits, a considerable number of individuals experience constipation. This issue may have persisted since their 20s and is usually intrinsic rather than being caused by external factors. Slow bowel transit, as detected by specialised X-ray studies, may also contribute to constipation in some individuals. Others may experience constipation due to irritable bowel syndrome (IBS), often accompanied by symptoms such as abdominal bloating, distension, or the feeling of incomplete evacuation. For such cases, certain pro-motility medications like Prucalopride or Lubiprostone may be beneficial in improving intestinal movement.

Low Thyroid hormone levels (Hypothyroidism)

Constipation can be caused by hypothyroidism, a condition that can be diagnosed through a thyroid function test. Treating hypothyroidism by correcting the levels of thyroid hormone can improve the constipation.

Obstructing Colorectal Cancer

The sudden onset of constipation can indicate an obstructed colorectal tumor. Typically, this is accompanied by acute distension of the abdomen, abdominal pain, and vomiting. Additionally, there may be no bowel movements or passing of gas. These symptoms are indicative of acute intestinal obstruction and require emergency surgery.

Getting advice from a gastrointestinal specialist could be beneficial. Before starting any medical treatment, it’s important to have a colonoscopy to eliminate the possibility of blockages in the colon. Pro-motility medications could be an option to increase bowel movements, and probiotics have been found helpful in easing constipation.