Q&A: Constipation

Bowel Bother

Question: I have been suffering from constipation for the past year. My bowel movements only take place about once a week, and even then, it is a painful experience. I drink a lot of water, eat a lot of greens, have taken over-the-counter medication (i.e. laxatives), and even tried acupuncture, but the problem persists. What could be wrong? Are there treatments, massaging techniques or exercises to adopt to help with my bowel movement?

Answer: Constipation can occur because of various ‘mechanisms’ in the body and it is helpful to understand what these are. The bowel has regulated contractions that work to propel its contents along.

These contractions are mediated through the autonomic nervous system and can be impaired by lack of physical activity, medications, ageing, an under-active thyroid gland, or on rare occasions, by diseases that damage the autonomic nervous system.

Related: Chronic Constipation

The bowel also needs to secrete mucous and fluid to maintain a lubricated surface and to prevent the contents in it from becoming hardened. Again, certain medications can impair this function, as can diseases of the autonomic nervous system. The fibre-content of food, as well as the amount of liquid ingested, also play a role. The bowel passage itself can be narrowed by tumours or by inflammation which causes stricture. When assessing the cause of constipation, the role of each of these mechanisms needs to be considered. Many cases may be caused by more than one factor.

Medications that can cause constipation are iron and calcium supplements, and anticholinergics like Amitriptyline (used for anxiety disorder and the prevention of migraines) in higher doses. Thyroid function and Parkinson’s disease (in advanced cases) can affect the body’s autonomic function. A search for tumours or stricture usually requires a colonoscopy or imaging. The possibility of tumours increases with age and should be especially considered if you are above age 50 or if there is a family history of colorectal cancer.

Read these next:

• More Fibre for a Fit and Fabulous You
• Understanding Health Supplements
• Screening for Colorectal Cancer