Constipation relief: It is possible!

Constipation is a common medical condition, with a prevalence around the world of around 15% of people suffering from it. It is one of the most frequent gastrointestinal diagnoses in ambulatory care settings, and while usually managed by primary care doctors, constipation is a commonly referred condition to gastroenterologists. Some of the uncomfortable symptoms include incomplete evacuation, straining, and decreased stool frequency, the causes of which can be primary or secondary. Primary causes include chronic constipation stemming from slow transit times (chronic idiopathic constipation, or CIC), or certain medical disorders. Secondary causes may be due to medications, or even certain anatomical issues.  Constipation can lead to a reduction in the quality of a person’s physical and mental health as well as socialization with others.  

The management of constipation usually starts with a detailed assessment of a person’s health history, a look at their diet as well as any medications or supplements they may be taking, and then devising a plan to find the root cause of the symptoms. Typically, increasing dietary fiber and water intake, as well as lifestyle or dietary modifications, are considered such as adding fiber to the diet. Fiber helps support a healthy gut microbiome and assists in gut motility by aiding muscle contractions in the intestines. However, when it comes to fiber, caution should be taken, as there are some people who may have CIC in which case fiber may make their symptoms even worse. Also, adding in too much fiber too fast could cause symptoms such as gas, bloating, or cramping; a gradual increase is a better approach.

After incorporating lifestyle changes, the next options your healthcare provider may consider may be medications such as stimulants or osmotic laxatives. If this fails, then the next consideration would be intestinal secretagogues or prokinetic agents. However, many drug therapies leave patients with unpleasant side effects or may not actually address the root cause of constipation.

Biofeedback is another method used in people who suffer from constipation. Controlled clinical trials have shown that this form of therapy which uses neuromuscular coordination and trains the person’s abdominal wall muscles using visual or audio techniques. This can be effective in improving the symptoms of the bowel linked to constipation. Breathing exercises,  muscle strengthening. and relaxation techniques are also utilized to help the person retrain the pelvic floor muscles.

Probiotics have also been investigated for their role in managing chronic constipation. Through their effect on the gut microbiota, the enteric nervous system and immune system there may be a  place for their use in the management of constipation. The evidence remains unclear as to their exact benefit and effect. While it may be helpful for some, it is not for others. There has been an increase in the use of probiotics by consumers for constipation and their effects show promising results. Adults with constipation tend to have decreased numbers of bifidobacteria and lactobacilli in samples of their stool. Probiotics may have a modifying effect on the gut environment and certain strains may influence motility in the gut and potentially provide relief in constipation. Further human studies are needed to understand the mechanism of certain probiotic strains in constipation; however. by adding in certain strains. There is a benefit in some patients with constipation through the changes seen in the gut microbiome 

Simple lifestyle changes may be all that is needed to help alleviate the symptoms of constipation,  but if it persists, or if you notice any unusual changes in your bowel movements, you should contact your doctor to consider further testing or assessments to rule out a serious medical condition. It is always important that you speak to your healthcare provider before making any changes to your health regimen.



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