We might not talk about this much, but constipation effects everyone from babies to the elderly. You can meet the definition of constipated even if you have one bowel movement per day if it is hard and painful. On the other hand if you normally use your bowels every second or third day and it passes easily, you are probably not suffering from constipation. It does however particularly effect people who need to take strong pain medication. The good news is that there is a lot you can do to manage it successfully.

This is probably the number one reason people get constipated. Having a bottle of plain water to drink every day, helps balance out the other drinks we have that often contain diuretics, sugar or alcohol. Chronic dehydration is the best way to have hard, dry stools which are hard to push out, require straining and then give haemorrhoids a chance to get worse. It’s really easy to prevent dehydration by having a drink of water in-between every other drink. If you don’t like water, sip it slowly, add mint leaves and cucumber pieces and see if that helps.

Diet related constipation
Foods that are made from refined carbohydrates, sugar, having little or no fibre content are a sure recipe for constipation.
Fried foods, salty, fast foods, hot chips, cakes, biscuits, refined breakfast cereals, white bread, donuts, pizza, pasta with minimal vegetables, fried chicken, hamburgers, pancakes with no fruit, sugary milk drinks, chocolate without nuts…..a diet full of this sort of food often contributes to constipation. This food will also make you thirsty because it uses up so much more water to process. If you have lemonade or cola instead, you have not resolved your body’s thirst.
The key word is balance, when you love the above list of foods, just make sure you are still having the bulk of your diet coming from fruit, vegetables and whole grains.

What to do when you are constipated
Don’t let too many days go by before taking action. In addition to increasing your water intake, try some natural remedies first. Fennel tea is brilliant for tummy cramps related to constipation and wind; aloe vera juice with herbs like marshmallow root and slippery elm bark are very helpful when taken daily for about three to five days.
Adding psyllium to your breakfast along with linseeds provides excellent fibre. One of the benefits of following the fruit, vegetable and whole grain rich diet is you are much less likely to require any stool softeners or laxatives.
Smoothies have become a very popular way to get the fibre into your diet that you might have been missing out on.
Massaging your abdomen in a clockwise direction with lavender oil is very soothing and follows the anatomical movement of your bowel motions.
Reduce your meal size portions if you are in the habit of large platefuls, at least until some movement has occurred.
Exercise!! Move your body, move your bowels. Exercise increases motility of the gut and blood supply to the colon.
Include probiotics, figs, prunes and plum juice to your regimen.

Treatment for constipation
Before visiting your Doctor, visit your local Pharmacist. They are an often overlooked resource with the knowledge to advise on what to take. There is no gap payment and you don’t have to wait for an appointment.
Movicol is widely recommended as a safe and effective way to resolve constipation.
Avoid stimulant laxatives like senna, castor oil and bisacodyl unless all else has failed. These increase the motility of the bowel, but long term use can lead to a ‘lazy bowel’. They are very helpful in the short term. Bear in mind that aloe vera juice has a stimulant laxative effect as well, and should be considered a short term relief.
Osmotic laxatives like Lactulose, Milk of Magnesia and Fleet enema have a strong action and again should be used in consultation with your Doctor.
Microlax enemas and glycerin suppositories provide a stimulus for bowel motion as well as providing lubricant for a dry, hard stool.

When to visit the Doctor
When you are unable to resolve your constipation using the above methods and you have developed discomfort, nausea, a bloated stomach, fever, lethargy, muscle aches and bad breath, make an appointment.
You should also visit your Doctor if haemorrhoids are part of the problem, because it is much easier to treat them earlier rather than later. Haemorrhoids can be managed very well without surgery by following a diet and lifestyle that prevents constipation. This includes not sitting on the toilet for long periods of time which exacerbates the problem as blood pools via gravity and pressure, enlarging the haemorrhoids.

Constipation associated with illness and medications
If constipation is part of your experience associated with illness and medications, start pro-active choices as early as possible.
Ask your Specialist if there are likely to be any drug interactions you need to be aware of.
Don’t be embarrassed to talk about constipation, it is so common and your Doctor will be more than happy to help you deal with it the best way.

Erica Fotineas
June 2017

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