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Magazine
Common problem
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In most cases, medical evaluation of constipation is a simple exercise of being thoroughly examined by the doctor, writes DR. UMA KRISHNASWAMY.
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Most patients respond well to changes in their lifestyle. Having foods rich in fibre is one.
CONSTIPATION affects almost everyone at one time or another. It is a common problem in women, the elderly and those who are physically inactive. Chronic constipation may be defined as having less than three bowel movements per week. There may be in addition excessive straining at toilet, passing of hard pellet-like stools or a sense of incomplete evacuation.
The common causes of constipation are:
a diet low in fibre
inadequate fluid intake
lack of exercise
medications including laxative abuse
changes in life or daily routine such as pregnancy, travel, advancing age, etc.
ignoring the urge to visit the toilet
Rarely, there may be serious underlying disease of the bowel, stroke, diabetes, etc.
Chronic constipation usually poses only a nuisance value to the patient, but occasionally complications may occur secondary to straining at toilet: piles, fissures, rectal prolapse, etc.
In the majority of patients, medical evaluation of constipation is a simple matter of being thoroughly examined by one's doctor. In intractable instances or where there is suspicion of underlying illness, the doctor may need to evaluate a patient more exhaustively through blood tests, barium studies, endoscopy, studies to assess the function of the large bowel etc.
Though the treatment of chronic constipation does depend on the severity and the nature of the underlying problem, most patients respond well to lifestyle changes. This includes:
A diet with about 20-35 gm of fibre per day
Foods rich in fibre include: beans, whole grains, fruits and vegetables. One cup of white rice for instance, contains approximately two grams of fibre, whereas, brown rice contains double the amount.
Drinking enough fluids such as water, buttermilk, tender coconut water, soups or juice. But it must be remembered that while vegetables and fruits are fibre rich, fruit juices and clear soups are not. For example, a medium orange contains about two grams of fibre, but a glass of orange juice will contain only half that amount.
Daily exercise is a must. A brisk walk every day is a simple solution.
Never ignoring nature's call and adjusting one's daily routine to giving oneself plenty of time for the same is important in today's pressurised life style.
A doctor may prescribe laxatives in some instances for a limited period of time to get over the problem. These have to be carefully chosen and taken only under supervision, as laxative abuse by itself can lead to a vicious cycle of constipation and more constipation.
In rare cases, other forms of treatment such as bio-feedback or surgery may be needed.
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