Constipation is a problem that most people do not see as a big problem because they think taking laxatives will help them to excrete. However, they never know that regularly take laxatives do not treat constipation, it may cause other serious illness too. So, it is better to search for serious treatment of chronic constipation before serious illness occur.
What is considered as normal excretion?
Many people believe that normal excretion means to excrete every day. In fact, each individual’s body is different, so it is not necessary to excrete every day. As long as they can excrete comfortably without having to strain to stool so much as well as the stool is soft and well-formed. Even if they cannot excrete every day, it never been to consider abnormally.
Normally, people will excrete at least 3 times a week. Whenever, we excrete less than 3 times a week or have difficulty excrete such as hard stool, having to strain more than usual or feeling like unable completely excrete, having to use finger to help to excrete or having to spray water into anus to excrete. It may be considered as chronic constipation.
What symptoms should be suspicious as chronic constipation?
Currently medical practice and the use of Rome IV criteria for chronic constipation diagnosis, symptoms must interfere with daily life and be continuous for at least six months. The abnormal of chronic constipation must include at least two of the following:
- More effort than usual to strain the stool.
- Hard stool.
- Incomplete the stool.
- Feeling of obstruction in the anus
- Using the finger insert into the anus to help excrete.
- Fewer than 3 excretion per week.
Therefore, if anyone has at least 2 of these symptoms and the said symptoms still to be continued, it may be a sign that you have chronic constipation. So that you should ignore it, it is better to see a doctor for a diagnosis.
What are the effects of chronic constipation?
The patients may feel stressed, non-fresh, unenergetic, to have a headache, back pain, abdominal cramps, or even have acid reflux or heartburn because of chronic constipation. In addition, often to strain the stool is able to have adverse effects to some patients, such as, heart disease patients, hemorrhoids patients, hernia patients, etc. Significantly, constipation can also be a warning sign of colon cancer.
Constipation may be a sign of colon cancer.
Constipation may be a warning sign of colon cancer, especially when constipation is accompanied with the other warning sign. Patients should go to see a doctor proper diagnosis and treatment. These warning signs should always be observed, as follows:
- Black stool with blood in it or blood is found in the stool.
- Iron deficiency anemia.
- Unintentional or unexplained weight lost.
- Alternating constipation with diarrhea.
- Smaller stools.
- Symptoms of intestinal obstruction.
- Family history of colon cancer or chronic enteritis
Chronic constipation can be completely cured with proper treatment
For the chronic constipation, the doctor will initially ask about your medical history, associated symptoms, and perform a general physical examination, along with a rectal examination, to find treatable causes of the constipation, such as, stopping certain medications that cause constipation, or giving thyroid hormone replacement therapy in patients with hypothyroidism.
If the doctor cannot find the evidence cause of constipation, he will recommend for behavioral changed by giving the patients food with high fiber, drinking more water, having regularly exercise, and recommend good hygiene for excretion. At the beginning of treatment, laxatives may also be given. When the symptoms improved, the laxatives using will be gradually reduced until the patients can stop taking it.
Importantly, the patients should not buy and take the laxative regularly without the recommendation from the medical specialist, because sometimes the patients’ intestines may become accustomed for laxatives using all the time. At the end, the constipation will become more severe and will be harder to completely cure.
If some patients adjust their behaviors as well as taken laxatives, but the symptoms have not been improved. It may be because they have an anatomical abnormality, such as, having an abnormal angle between the rectum and anus during excretion, an abnormal prolapse of the rectum, an abnormal perineal descent or there may be a physiological abnormality from the mismatch of the rectal and anal muscles. These problems can be solved it they receive a correct diagnosis from a specialist with expertise, including the use of special equipment to perform a specific examination. When the real cause is found, they will receive the correct treatment and have a chance to recover.
Dr.Natthida Sribyangthong
Gastroenterologist and Hepatologist and Liver Center, Phyathai 2 Hospital
