Constipation commonly affects 15-25% of the population and can be debilitating for individuals. Constipation is defined as at least two of the following: straining; hard or lumpy stools; incomplete evacuation; producing a stool 2 days or less per week; a sense of obstruction, or the need to do manual manoeuvres for at least 6 months. Apart from this, there are some additional signs of constipation.
Extra signs of constipation:
· Abdominal bloating
· Cramping
· Gut pain
· Excess wind
· Decreased appetite
Constipation is linked to increased toxicity in the bowels through the build-up of endotoxin from harmful bacteria, which can lead to leaky gut and irritable bowel syndrome (IBS). Some individuals have intermittent constipation with loose stools, which indicates IBS.
Contributing factors of constipation include:
· Inadequate water – adults are required to drink at least 2.1-2.6 litres per day
· Inadequate dietary fibre – adults require 25-30g daily
· Lack of movement or physical activity
· Food intolerances
· Irritable bowel syndrome
· Pregnancy
· Laxative abuse
· Medications like opioids such as codeine
Investigations should be performed for other conditions like food intolerances, IBS, and microbiome analysis, especially if simple dietary and lifestyle recommendations show no improvements for constipation. Water intake and increased fibre through dietary changes must be carefully considered. Certain herbs, nutraceuticals and probiotics also improve stool consistency and frequency.
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