An average human being visits the toilet six times a day and stays there for about two minutes. However, attending the call of nature is not always this easy. Sometimes, a common gastrointestinal condition called constipation occurs. It becomes difficult to expel the feces. A desire to visit the washroom is not enough to physically eliminate the feces.
Why Do We Constipate?
What are the changes that occur in the body to cause constipation? In order to understand the simple mechanism behind constipation, you must understand how the human body excretes under normal conditions.
Role Of The Large Intestine
The stool moves into the large intestine as a semi-solid mass composed of ingested food, dietary fiber, sloughed-off mucosal cells, bacteria, dead organic matter, bile and intestinal juices. The large intestine or colon is made of fur sub-parts:
- Ascending colon
- Transverse colon
- Descending colon
- Sigmoid colon
The sigmoid colon connects with the rectum and anus at its distal end. The rectum is the part that stores the stool for some time before it is expelled through the anus. When stool enters the colon, the organ reabsorbs most of the water and other liquid particles. This helps to solidify the stool. As a result, it becomes an almost dry mass that gets stored in the rectum. A final bout of reabsorption also takes place in the sigmoid colon.
Role Of The Rectum
Once in the rectum, it causes the internal anal sphincters to relax and the rectum to distend. This aids in the expulsion of feces. Moreover, it is also the point when you decide whether to expel or retain the stool. In addition to anal sphincters, another muscle involved in bowel movements is the puborectalis. The fibers of this muscle surround the rectum on two sides, forming an anorectal angle. And as we voluntarily relax our external anal sphincter, the puborectalis also relaxes emitting the stool.
Pathology Of Constipation
Let’s focus on the question of the hour. Why does it become hard to defecate sometimes?
There are two reasons as to why we experience constipation sometimes.
- The muscles of the pelvic floor malfunction leading to an effortful defecation.
- The stool moves slowly through the colon slowly.
Pelvic Floor Dysfunction
The muscles of the pelvic floor are actively involved in stool expulsion. These muscles support the bladder, uterus, and colon. Among these, the key muscles that play a role in defecation are:
- Internal and external anal sphincters
Normally, these muscles contract and the body rids itself of solid waste. In the constipated state, the puborectalis is tightened and the anorectal angle is reduced. In case of childbirth and sometimes during old age, the bladder or uterus may shift towards the rectum, altering the pelvic angle.
The movement of stool through the colon is exceptionally slow. It causes over-absorption of water and other liquid components. Thus, the stool becomes needlessly dry and hard. Not only does this stool mass takes longer than usual to get expelled, it is also painful to defecate.
Signs And Symptoms Of Constipation
The length and frequency of bowel movements vary from person to person. Some people excrete stool three times a day. Others, three times a week. So how do you know if you are constipated? Doctors say that going three days without a bowel movement is worrying and most likely the result of constipation. After three days, it becomes harder to expel feces. The symptoms of constipation include:
- Lower abdominal discomfort
- A sense of incomplete evacuation after visiting the toilet
- Anal bleeding or fissures from the trauma
- Hard/small stools
- Excessive time needed to pass stools
- Abdominal pain and bloating
- Straining while visiting the bathroom
- Weight Loss
- Rectal Bleeding
Tips To Get Rid Of Constipation
Constipation can be a painful and challenging experience. However, its effects can be alleviated when the right measures are taken at the right time.
Visit Your Doctor
If complications arise and you simply can’t get rid of your stool, then you should visit your doctor at the earliest. In the clinic, a Bristol Stool Chart is used to accurately diagnose constipation. First-line treatment includes laxatives and fiber supplements such as milk of magnesia, polyethylene glycol, Cisapride, and Psyllium.
Sit Properly On The Toilet Seat
The best way to use the toilet seat is to squat over with your buttocks placed on the seat. You can use a stool to raise your knees above the pelvic floor. Lean forwards with a straight back. As it straightens the anorectal angle, this is the ideal position to expel feces.
Change Your Diet
Simple dietary changes can also reduce your risk of constipation.
- Drink six-eight glasses of water daily. Drinking water and fluids such as juices and milkshakes can help you stay hydrated and keep things moving. Most of the processes within the system occur in the soluble medium. So gulp down that water and keep things moving.
- Eat more dietary fiber especially soluble fiber. The increase in dietary fiber correspondingly elevates the wholeness and consistency of stools. Foods rich in soluble fiber include barley, oats, nuts, seeds, beans, lentils, peas and cereals.
- Drink caffeinated coffee. The caffeine in coffee can stimulate the muscles of the digestive system. You may have noticed an urge to visit the bathroom after drinking a cup of coffee. Moreover, it also contains traces of fiber that assists the passage of stool through the colon.
- Eat probiotic foods like yogurt and kimchi.
- Eat Shirataki noodles which are rich in Glucomannan. A study in children found that those consuming glucomannan experienced lesser constipation as compared to others in the control group.
Regular visits to the gym or simply running home from school/work can help restore your health. Also, it may be useful to try out some work-outs designed for the pelvic floor. Moreover, an abdominal massage can relax the muscles and strengthen them.
Give Herbal Medicine A Try
If you suffer from chronic constipation, you might want to try Senna. It is a herbal laxative that you can buy from your local drugstore easily.
Constipation is an irritating and difficult illness to deal with. But by employing the right strategy and using the tips described above, you can find relief and restore your health. However, if symptoms persist, visit a gastroenterologist. He will examine you for CIC (Chronic Idiopathic constipation) and offer the right advice and guidance.