By Dr. A.J. Morgan
Dear Readers,
H.D., a 28-year-old woman from Brown's Town, St. Ann, says that constipation runs in her family. She has suffered with it all her life and she now notices that her two-year-old son has problems passing his stool. Sometimes, when he wants to stool he walks around a lot and even cries before he stools. Sometimes the stool is small in quantity and hard. H.D. asks LIFELINE'S advice on how to correct and prevent constipation.
Constipation usually refers to a change in the daily bowel habits. Constipation is present if there is:
(1) A decrease in the number or consistency of bowel movements with infrequent passage of faeces (stool).
(2) Pain or difficulty experienced in the passage of stool.
(3) Medical evidence of retention of stool.
If an individual experiences pain or difficulty in passing a large or small but hard stool, that person is very likely to be constipated. Constipation is often also associated with colicky abdominal pains and loss of appetite. In young children an increase in urinary tract infections or bed wetting might be noticed due to the heavy loading of the rectum and colon. About 70 per cent of constipated children also experience episodes of soiling of the underwear as there is often leakage of the more liquid part of the faeces around the hard stools. Parents are sometimes even misled into thinking that the child is experiencing diarrhoea. Constipation is often contributed to by insufficient fluid intake and not enough dietary fibre. Without fluid and roughage, the stool becomes hard. Lack of exercise can also contribute to constipation.
Functional constipation refers to constipation for which there is no obvious cause. This is the case in the majority of children and adults presenting with constipation. Both children and adults sometimes "hold back" when the urge to defecate is felt.
A busy person or playful child might not wish to stop his or her activities to have a bowel movement. The stools then become dehydrated and hard and the rectum becomes distended and non-sensitive. Constipation can also be due to intestinal mobility disorders where the bowel is relatively inactive and large amounts of stool remains in the rectum and colon. Children with cerebral palsy or spinal cord abnormalities often have a difficult time with constipation as reduced sensation and muscular weakness added to the lack of intestinal mobility make constipation difficult to cure.
In addition physical abnormalities which may be present and require medical intervention, can also lead to constipation.
Anal Fissure where passage of hard faeces tears the anal verge making it painful to have further motions.
Anal stenosis where the anus is strictured and the sphincter is tight causing constipation in a young age group.
Hypothyroidism - where there is often generalised muscular weakness which has an effect on bowel movements.
Lack of adequate fluids and poor nutrition can result in small, hard stools.
Most cases of constipation will respond to simple life-style changes such as increasing the amount of fibre and fluids in the diet. Stool softeners can be prescribed to soften the stool and help it to pass more easily. Bulk laxatives such as FIBRECON and METAMUCIL, increase the stool to make it easier to pass. Stimulant laxatives such as DULCOLAX and castor oil, which both contain bisacodyl, work by stimulating contractions in the intestine and can cause some cramping. Laxatives should not be used too regularly as dependency on them can develop. Regularly as depending on them can develop. Regularly as dependency on them can develop. Mineral oil is also useful as it lubricates and coats mineral oil is also useful as it lubricates and coats the stool and helps it to slip out more easily. Once the rectum and colon are emptied, regular bowel habits must be established. Time must be made to visit the lavatory without rushing.
Modifying the diet is very useful in the control of constipation.
Increase the intake of fluids. Drink a lot of water, juices and soups.
Increasing dietary fruits and vegetables provides fibre and helps to resolve constipation.
Eating hot cereals every morning adds fibre and stimulates the intestinal tract.
Eating green leafy vegetables also protects against constipation.
Aloe Vera juice, drunken regularly, has been proven to be useful in resolving constipation.
A.J.M.
