Constipation is a common problem affecting most people at a certain point in their life. According to Tack et al., (2011), almost a quarter of the population with the constipation problem experience it as a minor annoyance, while in some it is a severe condition having significant debilitating consequences on their quality of life. The highest percentage of constipation patients are silent about the condition with many trying to self-medicate, with the ones seeking the medical help finding the treatments even unsatisfactory (Tack et al., 2011).
Currently, chronic constipation is affecting approximately 20% of the total population in which 821 million dollars are spent annually to the physicians and on the over-the-counter (OTC) laxatives (Portalatin & Winstead, 2012). Sobrado, Correa Neto, Pinto, Sobrado, Nahas, and Cecconell (2018) classify intestinal constipation as primary and secondary. In functional or primary, the constipation cause is not identifiable from the physical examination and the clinical history. Sobrado et al. (2018) further classify primary constipation as slow transit constipation (STC), normal transit constipation (NTC), outlet obstruction, colonic inertia, and the combined causes (outlet obstruction and slow transit constipation).
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In secondary constipation, clinical examinations identify the extra-intestinal or intestinal abnormalities, medications, and hormonal or metabolic factors as the root causes of the bowel movement disturbances (Solbrado et al., 2018). Tack et al. (2011) identify the common type of constipation as the normal transit, in which patients complain of bloating, hard stools, difficulty with evacuation, abdominal discomfort, and pain. Patients with normal transit constipation tend to underestimate their bowel movements in the absence of a stool diary.
Successful treatment of constipation is achievable by combining both medication and lifestyle changes. According to Bae (2014), having a proper diet with a lot of fluids, fruits, and probiotics can help with the treatment of constipation. Fruits such as plum, bananas, kiwifruit, and persimmons, fluids including juice, water, milk products are vital in lessening constipation. Other fiber-rich foods to include in the diet include whole grain, cereals (corn, rice), potatoes, vegetables, and bread (Dhingra, Michael, Rajput & Patil, 2012). Bae (2014) highlights the fiber’s role in constipation as increasing stool bulk that accelerates colon transit, contains water, with the fermenting type of fiber producing short-chain fatty acids that increases the osmotic load. Therefore, medication and lifestyle changes are necessary for the treatment of constipation.
References
Bae, S. H. (2014). Diets for constipation. Pediatric gastroenterology, hepatology & nutrition , 17 (4), 203-208.
Dhingra, D., Michael, M., Rajput, H., & Patil, R. T. (2012). Dietary fiber in foods: a review. Journal of food science and technology , 49 (3), 255-266.
Portalatin, M., & Winstead, N. (2012). Medical management of constipation. Clinics in colon and rectal surgery , 25 (1), 12.
Sobrado, C. W., Corrêa Neto, I. J. F., Pinto, R. A., Sobrado, L. F., Nahas, S. C., & Cecconello, I. (2018). Diagnosis and treatment of constipation: a clinical update based on the Rome IV criteria. Journal of Coloproctology (Rio de Janeiro) , 38 (2), 137-144.
Tack, J., Müller ‐ Lissner, S., Stanghellini, V., Boeckxstaens, G., Kamm, M. A., Simren, M., ... & Fried, M. (2011). Diagnosis and treatment of chronic constipation–a European perspective. Neurogastroenterology & Motility , 23 (8), 697-710.
