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CONSTIPATION : The discomfort zone.

Digestive disorders are among the most common problems in health care. Approximately 30 to 40 percent of adults claim to have frequent indigestion. Dietary habits and specific food types can play a significant role in the onset, treatment and prevention of many GI disorders. In many cases, diet can also play a role in improving a patient's sense of well - being. In such a scenario amongst the many constipation is one such disorder seen in the people.

Constipation is a symptom and not a disease. It can be defined as the retention of the faeces in the colon beyond the normal length of the emptying time; it is irregular, infrequent or difficult passage of faeces. If too much water is absorbed by the colon; the result is hard-dry stool constipation. If the colon muscles are sluggish the result will be hard dry stool. It is a condition of stasis in the large intestine; under normal conditions the residue of the food eaten in the morning will reach the large bowel the following morning.

In this condition, there is resistance to movement of intestinal contents; consequently, there is distension and infrequent or difficult evacuation of faeces from the intestine. For bowel movement the frequency varies greatly among individuals. Most people have a daily movement but for some evacuation every 2-3 days is entirely normal. The amount of daily faeces one passes is 100-200gms; if it is less than 30 gms then it is considered to be constipation.

Infrequent or insufficient emptying of the bowel may lead to malaise, headache, coated tongue, foul breath, and lack of appetite. These symptoms usually disappear after satisfactory evacuation has taken place.

Constipation is mainly of two types. Atonic constipation, this is because of loss of muscle tone in the colon or rectum, which may cause difficulty in evacuation of stools and result in atonic constipation. The intestinal walls lack muscular tone so the peristaltic action is impaired. Bacterial action may be greatly increased owing to the stagnation of the material in the colon and possibly the products of this action may be responsible for at least some of the symptoms occurring as a result of constipation. This type of constipation is common in elderly, pregnant women, a person who is leading a sedentary life and selection of food is low in bulk, insufficient fluids, poor personal hygiene, lack of exercise, chronic illness, pregnancy or excessive use of enemas.

Spastic constipation; it occurs due to an increase in the muscle tone which narrows the cavity and the forward movement of faecces is retarded. The contraction throughout the tract acts in a spasmodic manner, causing the movement of food mass to be very irregular. Spasmodic movements cause acute pain. It is caused by inactivity, immobility or obstruction.symptoms may alternate between diarrhoea and constipation.

Constipation could occur due to numerous factors like inadequate diet and improper lifestyle, chronic use of laxatives, faulty dietary habits, such as inadequate fluid and fiber intake or use of highly refined and concentrated foods that leave little residue in the colon,interference with the urge to defecate brought on by poor personal hygiene or injury to the nervous mechanism difficult or painful defecation due to hemorrhoids or fissures, ingestion of drugs such as analgesic, anti-inflammatory agents, aluminium containing antacids, antidepressants, diuretics, iron, large amounts of sedatives. Determination of the cause is important so that proper treatment can be given. Formula fed infants have more chances of getting constipation then breast fed infants. In young child, constipation is some time due to emotional upset arising out of conflict with the mother over toilet training. In older children the cause is similar to those in adults. Pregnant women are often constipated due to pressure of gravid uterus on the colon which delays the movement of content.

Development of regularity with meals, physical activity, habit of evacuation: consumption of a high fibre diet that is soluble as well as insoluble fibre:ensure adequate intake of fluids, increase the activity level and exercise pattern may contribute towards the treatment of constipation. The intake of dietary fibre should be increased by eating whole grains and increasing consumption of fruits and vegetables. The most important factor is the water holding capacity of fibre. Fruits and vegetables whose fibre holds water effectively are oranges, apples, carrots and cabbage family. The diet should contain a serving of vegetables particularly in raw form and two such fruits each day preferably with skin and seed. Maize dry, bengal gram, onion, quinoa,curry leaves, field beans, soya beans, guava and sapota are good sources of fibre which prevent constipation. Drumstick leaves and tamarind leaves are also good sources of fibre.Fluid intake of 8 to 10 glasses a day is useful in keeping the intestinal contents in a semisolid state for the easy passage along the tract. Some individuals find that 1 or 2 glasses of hot or cold water, plain or with lemon, are helpful in initiating peristalsis when taken before breakfast. Many laxatives are available.Their continued use may lead to excessive sodium, potassium and water in the faces hence not recommended.Laxatives become a habit and natural peristaltic movement is affected.

Thanks Giving

This article is written and submitted to The E Today by Shrushti Mehta.

We thank her for her research and analysis and hope to see the awarenesses about health and nutrition being spread ahead to larger mass of our citizens.

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