Constipation is a very common problem that most of us have probably experienced at some point of time during our lives. To most, constipation means difficulty in passing motion, or a need to strain excessively. Struggling to pass hard pellet-like stools or infrequent bowel habit may also be interpreted as suffering from constipation. Frequent straining to pass motion may lead to other problems like piles and anal fissures.

What causes constipation?

Brief periods of constipation are normal and many people may have experienced it occasionally especially when they are travelling or during National Service in-camp training. Common causes include a change in diet, insufficient fibre and water intake, and sedentary lifestyle. Constipation may also be made worse by repeatedly ignoring the urge to pass motion.

Bowel habits are determined by what you eat. Exercise is also helpful for proper functioning of the colon.

Certain medications can cause constipation

Medications like cough syrups, painkillers and iron supplements can cause or worsen constipation. If you have constipation after taking a new medication, do check with your doctor.

Sometimes, constipation may be due to other medical conditions like thyroid disease, stroke or Parkinson’s disease. More serious causes of constipation include growths or areas of narrowing in the colon due to colon cancer.

When to seek help?

If you have persisting constipation as well as any of the conditions listed below, it may be indicative of a more serious underlying health problem:

  • Change in bowel habit
  • Fever
  • Blood in the stools
  • Weight loss
  • Low blood count
  • A hard lump in the tummy
  • Family member with colorectal cancer

Seek your doctor’s advice should you suffer from any of the above symptoms. In particular, if a person aged 50 years or above experience a new onset of constipation, colorectal cancer is a possible concern, and I would recommend that this person see his doctor for a check-up. Colorectal cancer is one of the most common cancers in Singapore. Your doctor may recommend a colonoscopy, performed by a specialist to check your large intestines internally before the treatment of your constipation.

How is constipation treated?

The important task of the doctor is to identify the cause of your constipation and to treat it specifically. It is not just about prescribing laxatives. Many patients with constipation can be successfully treated. Everyone should eat a well-balanced diet regularly. If you have not been eating much vegetables and fruits in your meals, take additional fibre. Foods high in fibre include vegetables and fruits, as well as bran, wholemeal bread and unpolished rice.

Drink about 8 glasses of water daily. Increase in exercise will also help bowel function. A short course of mild laxative may be required to regulate the bowel.

Do you know?

  • More than 1 in 10 persons in Singapore have constipation.
  • There is no definite ‘normal’ number of times you need to visit the bathroom to have a bowel movement. It can vary from person to person, anything from three times a day to three times a week may be consider alright.
  • You don’t actually need to have a bowel movement at least once a day. This false belief may lead to unnecessary use of laxatives.
  • Not passing motion does not result in ‘poisons’ retaining inside the body.
  • In a person with severe constipation, taking too much fibre can worsen the constipation!

Prevention is still the best

Dietary and lifestyle modification are usually all that are required to prevent constipation. A balanced diet with sufficient intake of fibre and plenty of fluids will go a long way in ensuring good general health. Regular exercise is also beneficial, not just for the heart, but also for constipation!