Constipation is characterized by the passage of hard, dry stools less frequently than the person’s normal pattern. The normal range may vary from 3 movements in 1 day to 3 in 1 week. Constipation is often associated with abdominal discomfort, bloating and nausea.
Often a person’s lifestyle may cause constipation. Being too busy to respond to the defecation signal is one of the problem. Another cause of constipation could be lack of physical activity. Although constipation usually reflects lifestyle habits, in some cases it may be a side effect of medication or may reflect a medical problem.
One dietary measure that may be appropriate is to increase dietary fibre. Some fibres (those found the cereal products) help to prevent constipation by increasing faecal mass.
Drinking plenty of water in conjunction with eating high fibre foods also helps with constipation.
Eating prunes can also be helpful. Honey can also have a laxative effect. Adding fat (the good fat) can relieve constipation.
Only when these measures fail should traditional laxatives be resorted to, after being sure that you are constipated. An osmotic or bulk-forming should be the first line of treatment.
The use of laxatives in children should be discouraged unless prescribed by the doctor.
BULK FORMING
These relieve constipation by increasing faecal mass which stimulates peristalsis. The full effect may take some days to develop. Adequate fluid intake must be maintained.
Examples include bran and ispaghula husk. They are the laxatives of choice.
OSMOTIC LAXATIVES
These act by retaining fluid in the bowel by osmosis or by changing the pattern of water distribution in the faeces. An example is lactulose.
STIMULANT LAXATIVES
Stimulant laxatives increase intestinal motility and often cause abdominal cramps. They work within 6-12 hours. They should be used for a maximum of 1 week. Examples include bisacodyl and senna.
