Guide for the treatment of constipation

Constipation is today one of the most common gastrointestinal diseases. Although it is one of the most common conditions, if not treated properly, it significantly degrades the quality of life of individuals.

What is constipation?

Constipation is categorized into two main categories, chronic and acute constipation.

According to the American Society of Gastroenterology, constipation is defined as a combination of 4 factors:

1. in the difficulty in emptying, when it occurs 1 in 4 times
2. in the frequency of bowel movements, ie when they are 2 or less in a week
3. in the hardness of the stool, accompanied by pain
4. in the sense of incomplete emptying

What causes constipation?

The most common cause of constipation is lifestyle and diet. In particular, foods high in fat and protein, such as red meat, appear to reduce bowel contractions.

In general, a low-fiber diet (soluble and insoluble), dehydration, lack of exercise and even a delay in going to the toilet are some of the most common factors that alter bowel function and motility. Often, stress and travel affect the gut, causing constipation, but their effects are temporary. [1]

In addition to diet and lifestyle, there are certain conditions and diseases that can cause constipation or even hinder the normal functioning of the intestine. Similar conditions are pregnancy, irritable bowel syndrome, various neurological diseases, depression, bowel cancer and certain medications (such as iron, antidepressants and some antihypertensives). [1]

What are the symptoms of constipation?

Symptoms of constipation include: [1] [2] [3]

• Less than three bowel movements per week.
• Stools dry, hard and / or in pellets
• Abdominal pain and / or cramps
• Swelling and nausea
• Blood in the toilet or toilet paper after emptying
• Fever
• Weight loss (rare)
• Feeling tired and irritable

Constipation and pregnancy

According to studies, constipation is especially common during pregnancy. In particular, it is the 2nd most common gastrointestinal disorder in pregnant women, after nausea and peaks during the 1st and 2nd trimester of pregnancy. Nearly three in four pregnant women will experience constipation and other bowel problems at some point in their pregnancy. [1] [4]

It seems that the increase in the hormone progesterone during pregnancy causes the muscles of the body to relax. This includes the smooth muscle fibers of the intestine. Thus reduced intestinal motility implies slower digestion, which can lead to constipation. In addition, frequent consumption of iron supplements prolongs the problem of constipation during pregnancy. [1] [4]

How is it treated?

Fiber and probiotics

Psyllium Husk

Psyllium is a dietary soluble fiber that helps increase stool volume. It comes from a plant called Plantago and helps treat both diarrhea and constipation. The flea when in contact with water creates a gelatinous mass which facilitates the passage of feces through the gastrointestinal tract. [5]

Glucomannan

Glucomannan is a soluble fiber derived from the Konjac plant. As a fiber, it absorbs large amounts of water in its molecule, increases the peristalsis of the intestine and the volume of feces, thus helping to treat constipation. [8]

Probiotics

Probiotics are “friendly” bacteria for the gut that can help treat constipation. The combination of taking probiotics with strains of Lactobacillus, Bifidobacteria and Sacchromyces boulardi, in combination with prebiotics (“food” of probiotics) such as inulin, lacto- and fructo-oligosaccharides help to treat mild and severe difficulties. [6], [7]

Increased stool volume

Flaxseed

Contains soluble fiber and is available in whole seed and in powdered form. Linseed oil helps treat constipation. Can be mixed with food, water and juice.

Other foods that increase the volume of stool are oats, bran, trigonella (fenugreek – trigonella) as well as whole barley (barley).

Osmotic laxatives

Osmotic laxatives help the motility of the intestine, as due to their chemical structure they absorb large amounts of water in its molecule from the surrounding tissues. In this way they soften the mass of stool, increasing intestinal movements.

Macrogol

Macrogol is a substance that improves bowel motility and helps treat chronic and acute constipation. Because it is not metabolized by the intestinal flora, it does not present the unpleasant effects of common laxatives, such as flatulence and increased discomfort. The benefit of macrogol is that it can be used for a long time, while it is safe to take even by breastfeeding women.

Polyethylene glycol (Peg)

It is usually found in a solution with electrolytes and acts as a laxative. It causes diarrhea as it absorbs large amounts of water, increases intestinal peristalsis and significantly softens the stool. Used for a short time. [13]

Lactulose

Lactulose is a molecule whose structure is similar to that of carbohydrates. It is used to treat chronic constipation, but its action is relatively slower, compared to other laxatives. [14]

Glycerin

Helps in the occasional treatment of constipation. It acts osmotically, retaining many water molecules, softening the stool. It works as an excellent stool softener and helps empty the bowel. Available mainly in anal suppositories. [15]

Herbs

Senna

It is one of the most widely used herbs for the treatment of constipation. It causes contractions of the intestinal wall, thus facilitating emptying. Its use is for a short time. [9], [10]

Cascara sagrada

An herb that increases the frequency of bowel movements and at the same time improves the motility of the intestine. Overdose can cause diarrhea. [11]

Aloe Vera

Aloe vera with anthraquinone is a substance that has strong laxative properties. It belongs to the same family of plants as Cascara and senna and helps in the contraction and emptying of the intestine. Overconsumption can cause intestinal pain. [2]

Extra trips to treat constipation

What to avoid?

Processed foods

Foods such as fast food and high in sugar aggravate constipation. This is because such foods, in addition to fats, contain specific carbohydrates, but without the gut having the necessary enzymes to “destroy” them. This fact in combination with their fats increase the likelihood of constipation or its worsening.

Caffeine and alcohol

We now know how important hydration is in the treatment of constipation. However, caffeine and alcohol dehydrate the body and prolong the problem called constipation. [3]

What should you adopt?

Change your attitude to the toilet

The knees should be close to the torso during defecation, in order to achieve a “sitting” position, to change the “geography” of the intestines, while relaxing the muscles.

Use olive oil

For better intestinal function, include olive oil in your diet. Even if you are on a diet, do not hesitate to use olive oil in your daily menu.

Do not ignore your need for emptying

Adjust your meals so that you can plan your bowel movements by training your body. [2]

Hydrate

Water is valuable in preventing and treating constipation. [2]

Include exercise in your schedule

Walking and exercise in general promotes the proper functioning of the intestine and brings beneficial results to the body. [2]

Are there any tests I can do for constipation?

Your gastroenterologist will suggest appropriate tests that include a colon examination with a colonoscopy or imaging radiograph (usually an x-ray).

When should you see a doctor?

Call your healthcare provider if: [1]

• Constipation is a new problem for you.
• You noticed blood in your stool.
• You lose weight unintentionally.
• You have severe pain with bowel movements.
• Your constipation has lasted for more than three weeks.

Remember, talk openly and honestly with your doctor or pharmacist and give an immediate solution to the problem called constipation.

At Vita4you you can find a wide variety of supplements, foods and suppositories to treat constipation.

References

1. What to know about constipation
2. Constipation
3. Constipation
4. Functional bowel disorders in pregnancy: effect on quality of life, evaluation and management
5. 7 benefits of psyllium
6. Is a multispecies probiotic mixture effective in constipation during pregnancy? ‘A pilot study’
7. A Randomized, Double-Blind, Placebo-Controlled Trial: The Efficacy of Multispecies Probiotic Supplementation in Alleviating Symptoms of Irritable Bowel Syndrome Associated with Constipation
8. Glucomannan
9. Senna
10. Senna
11. Cascara Sagrada
12. Can Aloe Vera Juice Treat IBS?
13.  Randomized clinical trial: macrogol/PEG 3350 plus electrolytes for treatment of patients with constipation associated with irritable bowel syndrome
14. Lactulose
15. ADULT Glycerin Suppository, Rectal – Uses, Side Effects, and More