Chronic constipation affects 15 - 30% of Canadians and is commonly found in young children and the elderly, occurring more frequently in females.
WHAT IS NORMAL?
It is normal to have a bowel movement (defecate) anywhere from three times a day to three times a week, as long as the stool (fecal matter) is soft and comfortable to pass. A person experiencing constipation has a hard or lumpy stool, which is difficult to pass.
WHAT IS TRANSIT TIME?
Transit time is the duration between when food enters the mouth and when leftover waste finally passes out as stool. A meal could take anywhere from 12-72 hours to travel through the digestive tract. Each person is unique; a normal bowel movement pattern for one person may be very different from those of family members or friends. Some individuals have an irregular pattern, never knowing what to expect. Usually, before food enters the colon, most of the nutrients have been absorbed into the body and the colon’s role is to remove water. If someone has a long transit time, meaning food passes slowly through the colon, then too much water is absorbed, hardening the stool.
WHAT CAUSES CONSTIPATION?
Factors that can contribute to constipation, often by altering transit time, include:
- Medication side effects (eg. some narcotics, antidepressants, codeine, calcium or iron supplements, and medications that affect the nervous system),
- Diseases in which there is a physiological change to some tissue or organ of the body (eg. radiation therapy, inflammatory bowel disease, colon cancer, diabetes, stroke, hypothyroidism, or Parkinson’s disease),
- Functional disorders, such as irritable bowel syndrome, intestinal obstructions or strictures resulting from surgery, and
- Diet and lifestyle choices, such as consuming a diet too low in fiber and fluid, insufficient physical activity
- Chronic use of laxatives, suppositories, or enemas.
HOW IS CONSTIPATION DIAGNOSED?
A panel of experts developed the main diagnostic criteria for constipation, and update them regularly. Currently, these criteria require that two or more of the following symptoms be evident for at least 12 weeks (not necessarily consecutive) within the past 12 months:
- fewer than 3 bowel movements per week, and
- one or more of the following, occurring more than 25% of the time:
- straining to pass stool,
- stools are lumpy or hard,
- sensation of incomplete evacuation,
- sensation of anorectal blockage, or
- facilitated manual manoeuvres (eg. digital evacuation or support of the pelvic floor muscles).
WHERE CAN I FIND OUT MORE?
An excellent resource about constipation and other digestive issues is the Canadian Society of Intestinal Research, a charitable organization dedicated to providing information and research funding for gastrointestinal diseases and disorders.
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