Constipation is a gastrointestinal condition characterised by fewer bowel movements or difficulty passing stool. How often people pass stool varies from person to person, but when a person finds it difficult to defecate at least two to three times a week, it is considered constipation and should be treated. 

If constipation is chronic or long-term, it may be a symptom of an underlying condition or a side effect of a medication. However, if it is short-term, it may be from a diet that does not contain enough dietary fibre and fluids. 

Causes

There are many possible causes of constipation, including medical conditions, lifestyle factors and medications. 

The medical conditions that can cause constipation include:

• Irritable bowel disease.
• Colorectal cancer.
• Endocrine conditions like uremia, diabetes, and hypercalcemia.
• Diverticulitis.
• Obstructed defecation syndrome.
• Outlet dysfunction constipation. 
• Lazy bowel syndrome.
• Intestinal pseudo-obstruction.
• Neurological disorders like multiple sclerosis, stroke, spinal cord injury, and Parkinson’s disease. 
• Intestinal obstruction.
• Pregnancy.
• Structural defects in the GIT.
• Multiple organ diseases such as lupus, amyloidosis, and scleroderma. 

Some medications that can cause constipation include:

• Antidepressants like tricyclic or fluoxetine antidepressants.
• Pain medications like codeine, hydromorphine, and so on. 
• Allergy medications like antihistamines.
• Nonsteroidal anti-inflammatory drugs like naproxen and ibuprofen.
• Antacids containing aluminium or calcium.
• Certain blood pressure medications like diltiazem, verapamil, nifedipine, and so on.
• Iron pills.
• Anti-nausea medications.
• Psychiatric medications like olanzapine and clozapine. 
• Antiseizure medications such as gabapentin and phenytoin.

The lifestyle factors that can cause this condition include:

• Lack of exercise.
• Not eating enough fibre.
• Stress.
• Not drinking enough water.
• Resisting the urge to have bowel movements.
• Consuming large amounts of milk or cheese.
• Changes in your routine, such as travelling, sleeping or eating.

Symptoms of Constipation

• Hard, dry or lumpy stools.
• A feeling that not all stool has been passed.
• Fewer than three stools a week.
• Straining or pain when passing stools.
• The need to use a finger to pass stool.
• A feeling that the rectum is blocked.
• Feeling bloated and nauseous.
• Loss of appetite.

Treatment

Constipation may not need medical treatment in some cases; it resolves on its own. However, for quick relief, the use of laxatives is the best option, but you shouldn’t take laxatives for more than a week. If the condition doesn’t improve after one week, you may need to seek other treatment options or take care of all underlying conditions that may be causing it. A doctor will recommend certain medications or surgery, as the case may be.

Aside from laxatives, some natural remedies can also help relieve constipation, such as:

• Drinking enough water.
• Getting enough dietary fibre, aiming for 22–34 grams per day.
• Choosing the same time each day to try and have a bowel movement.
• Getting enough physical activity or exercise.