Coping with persistent constipation – The Washington Submit


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It’s regular to have an occasional bout of constipation. Uncomfortable as it could be, this often resolves inside just a few days. However the issue could also be persistent — and require some motion — if in case you have a minimum of two of the next signs for a minimum of three months:

  • You could have fewer than three bowel actions per week.
  • You might want to pressure for a minimum of 1 / 4 of all of your bowel actions.
  • Stool is commonly exhausting or lumpy.
  • Typically you’re feeling like your bowels haven’t been absolutely emptied.

For reduction, folks with persistent constipation could flip to laxatives.

“Many older adults assume that constipation is simply one other inevitable a part of growing older, however it may be averted by way of way of life [strategies and] occa­sion­ally medicine,” says Christian Stevoff, a gastroenterologist at Northwestern Medication in Chicago.

Know the causes of persistent constipation

Persistent constipation could be extra frequent in older adults, affecting about 26 p.c of ladies and 16 p.c of males over age 65, and 34 p.c of ladies and 26 p.c of males older than 85, in line with a 2021 research.

“As we age, our intestine and nervous system additionally age, and one of many penalties of that’s the degeneration of nerves and muscle tissue (that transfer waste alongside) in order that they don’t perform in addition to they used to,” says Satish Rao, chief of gastroenterology at Augusta College in Georgia.

However different elements, includ­ing inadequate fiber and too little bodily exercise, may contribute. Drugs corresponding to opioids and sure antidepressants, blood strain meds and Parkinson’s illness medicine are all potential culprits, Stevoff says.

Some over-the-counter (OTC) ache relievers, corresponding to ibuprofen and naproxen, are additionally related to constipation, and dietary supplements that comprise calcium or iron “can bind you up,” says William Chey, a gastroenterologist on the College of Michigan in Ann Arbor.

Hypothyroidism or neurological points corresponding to a number of sclerosis can result in constipation, too, as can pelvic ground problems — which have an effect on the flexibility to coordinate muscle tissue to push stool out, says David Poppers, a gastroenterologist at NYU Langone Well being in New York.

Strive these way of life steps

Way of life methods might be fairly efficient in the event you proceed them, however they’ll take a number of weeks to start working. When you want instant reduction — for instance, you haven’t handed stool in a number of days — you would possibly think about using an OTC osmotic laxative with polyethylene glycol (PEG), Stevoff says. (For some, stimulant laxatives, corresponding to senna and bisacodyl, could have harsher uncomfortable side effects than PEG-based medicines.)

All the time let your physician know in the event you haven’t had a bowel motion in a number of days. For the lengthy haul, strive these methods:

  • Improve your fiber. It helps bulk up stool, making it simpler to move. Analysis means that consuming 5 or 6 prunes every day is nearly as good for persistent constipation as some laxatives, Rao says. Or strive consuming two kiwi­fruits a day; Chey’s analysis finds that it relieves constipation in about half of individuals, with out a few of the uncomfortable side effects of prunes, corresponding to belly ache, bloating and fuel.
  • Ramp up your fiber consumption. Do that over a interval of days to weeks to permit your physique to get used to it, Chey says. When you discover it exhausting to get sufficient fiber by way of meals, think about taking an OTC fiber complement. The perfect proof is for those who comprise psyllium, Poppers says.
  • Drink sufficient fluids. Attempt to drink about eight 8-ounce cups of fluid each day. A cup of espresso may also be useful as a result of it’s a light gastro­­intestinal stimulant. Many older adults are perpetually dehydrated, which may worsen constipation, Chey says.
  • Take note of timing. Your bowels are usually most energetic inside a couple of half-hour after a meal, so ensure you have entry to a rest room then. It’s high-quality to spend about 5 to 10 minutes within the lavatory, but when nothing occurs in that point, strive later within the day, Poppers says.
  • Undertake the fitting posture. You need to hold your knees above your hips, which relaxes pelvic ground muscle tissue that loop across the again of your rectum, says Carrie Pagliano of the American Bodily Remedy Affiliation. “This fashion it offers a straight shot for BMs to exit,” she says. One possibility is to sit down on the bathroom together with your ft on a small footstool, such because the Squatty Potty. And keep away from straining­.
  • Train. A 2017 research discovered that girls with persistent constipation who walked on a treadmill for 60 minutes thrice per week for 12 weeks reported an enchancment in contrast with a management group.

When you want long-term assist

When you’ve tried way of life adjustments for 3 to 4 weeks and nonetheless expertise some persistent constipation, see your physician, Stevoff says. A doctor can do bloodwork to rule out medical circumstances, evaluation your meds and dietary supplements, and, if obligatory, carry out assessments corresponding to a colonoscopy to verify for an obstruction or a blockage. In case your persistent constipation is induced or worsened by pelvic ground issues, your physician could suggest pelvic ground bodily remedy, the place you’ll study strategies corresponding to belly therapeutic massage that may assist get issues transferring once more.

When there’s no clear trigger, Rao says prescription medicines could possibly be an possibility — quickly or in some circumstances long-term.

When the issue turns into extreme

In case your constipation is unresolved for too lengthy, it will probably result in fecal impaction, the place a lump of dry, exhausting stool turns into caught within the rectum.

Along with constipation, this may convey belly ache and a sense of fullness that impacts urge for food. Fecal impaction may result in diarrhea, due to watery stool from greater up within the gastrointestinal tract passing round caught stool, Rao says.

A health care provider can diagnose fecal impaction with a digital rectal examination and X-rays. They might attempt to take away the impaction manually or administer a warm-water enema to flush it out. If it doesn’t reply to those measures, or in case your physician sees indicators of a perforated colon, you would possibly want emergency surgical procedure.

As soon as the stool is eliminated, your physician will suggest a laxative or different steps to forestall a recurrence, corresponding to growing fiber consumption and staying energetic. You’ll additionally need to speak to your physician about medicines that will contribute.

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