The term constipation; To a lesser extent, it can be perceived as hard, infrequent and difficult defecation (defecation). Although there is difficulty in defecation, the feeling of not emptying after defecation, and defecation in the usual time and consistency, it may be evaluated as constipation by some patients. Constipation is a symptom, not a disease. However, it should not be forgotten that there are many organic diseases that cause this symptom. In constipation, the consistency and number of stool (stool) are in the foreground. Although it varies depending on societies, individuals and foods; 3 or less defecations per week, hard and difficult defecation can be evaluated as constipation.
How does normal defecation (defecation) occur?
The intestinal contents coming from the small intestines in semi-liquid consistency come to the first part of the large intestine. Here, the water is absorbed and the usual consistency of the stool begins to form.
The large intestine has 3 types of movement.
1-The contraction of the material in the intestine as an increase in the absorption of water
2-Short back and forth movements to continue the absorption of water.
3-Forward-push movements that allow the stool to move through the large intestine.
As a result of these processes, the stool, whose consistency becomes denser, comes to the upper part of the hindgut and is stored here. Usually, after meals, stool is pushed into the hindgut with the gastroenteric reflex. Stool that starts to accumulate in the last intestine stretches the last intestinal wall and creates the need for defecation. With the contraction of the last bowel muscles, intra-abdominal muscles, defecation occurs.
In summary, constipation;
1- The scarcity of the material reaching the first part of the large intestine (as a result of hunger and feeding with a diet that does not leave pulp)
2- Decrease in the movements of the large intestine that push the stool forward correctly (as in some neurological diseases)
3- Defecation system
It occurs with the last intestine and anus, as in the events that prevent the excretion of stool due to organic, neurological and psychological reasons).
Common causes of constipation;
Not getting enough fiber in the diet
Lack of physical activity (especially in the elderly)
Medical treatments
Irritable colon syndrome (IBS)
Routine Life-changing situations (pregnancy, aging, travel)
Use of multiple laxatives
Suppression of defecation requirement due to unsuitable conditions,
Dehydration
Other causes of constipation:
Congenital disorders,
Cultural, psychological, environmental factors,
Diseases that make it difficult for stool to progress in the intestine,
Preventing proper defecation position in the elderly Some neurological diseases such as disorders,
joint problems,
Parkinson’s disease can cause constipation.
Apart from the reasons mentioned above, the most common cause of constipation in our country and in the western world is the wrong and inappropriate use of constipation relief drugs.
When should I see a doctor for constipation?
Individuals suffering from long-term constipation should consult a doctor and have some tests done in order to determine the cause. Apart from this, in case of a recent change in defecation habits, weight loss, severe abdominal pain or blood with defecation, a doctor should be consulted immediately. These symptoms can be a sign of a very important condition. Defecation habits may also change in goiter gland disease and diabetes.
What tests should be done in those with constipation?
First, the severity of the problem should be determined. Physical examination and laboratory tests should be done. Colonic cinema or endoscopic examinations may be requested. Colonoscopy can be performed in which the entire large intestine can be evaluated. In this case, polyps or tumors can be detected.
How to solve the constipation problem?
Eating regularly, healthy foods and sufficient fluids should be taken. Systematic training, feeding with strong fiber foods, to summarize, 6-8 glasses of water or liquid a day, physical activity, a diet with plenty of fiber.
What is fiber?
Fiber is the indigestible part of plant foods. There are 2 types of fiber. Water soluble and insoluble. Water-soluble fibers are digested by bacteria in the large intestine. Oat bran is an example of water-soluble fiber. It helps in lowering blood cholesterol. Water-insoluble fibers are best for constipation. Wheat bran, cereal grains and the peels of various fruits such as apples and pears can be given as examples.
Why is fiber valuable?
Fibers increase stool volume. Fibers retain water, increasing stool size and water content. In this case, they help by increasing the movement of the material in the large intestine along the intestine.
From which foods can you get fiber and to what extent should we get it?
30-35 grams of fiber per day should be taken for a proper bowel movement. There are many foods rich in fiber. Fruits, vegetables, and wholemeal flour are the best examples. Brown rice is used instead of white rice. Bran is a great source of fiber. It is abundant in various natural grain artifacts. Ready bran can be eaten by mixing it with other foods.
Toilet requirement after an adequate breakfast, which consists of eating a few dried apricots, dried figs or prunes on an empty stomach in the morning, after drinking 2 glasses of water, adding thyme, 6-7 olives in extra virgin olive oil and eating brown or wholemeal bread dipped in it. whether or not you go to the toilet and sit for 5-10 minutes. The bowel habit that can be achieved in this form will be relaxing for a long time. The individual should set aside time for this defecation attempt every morning in the morning. In this defecation training, more appropriate results are obtained in young people. Osmotic excretory agents (Magnesium salts, sodium phosphate, lactylose are from this group) can be used safely for a long time. Drugs that stimulate bowel movements and cause defecation are consumed in the market in the form of many tablets or dragees. These drugs can cause electrolyte disorders, osteoporosis, protein loss and addiction. When some are used for a long time, they can cause pigment accumulation in the intestinal mucosa and lead to the formation called melanosis coli. In particular, drugs that act by increasing bowel movements lead to the destruction of the borders within the intestinal wall. Severe constipation, which does not heal easily, may occur. Liquid petroleum jelly, mineral oils, can be given orally or by enema. In severe constipation, especially if there is swelling in the abdomen, the bowel should be tried to be evacuated with an enema.
