Constipation in adults

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What is it about ?

Some people have a bowel movement three times a day, others three times a week. If you do not have regular bowel movements for more than three days or it is less frequent and more difficult, then we are talking about constipation. Because the stool stays in the large intestine for too long, it hardens and becomes dry.

There are many causes of constipation. Here are some examples :

  • Your lifestyle, for example:
    • Lack of physical exercise;
    • A diet low in fiber;
    • Insufficient fluid intake;
  • Not going to the bathroom when you need to (at work, at school);
  • Medicines, for example:
    • Iron preparations;
    • Opioid painkillers;
    • Antacids;
    • Certain antidepressants;
    • Medicines for urinary incontinence;
    • Medicines for Parkinson’s disease
    • Certain laxatives if you use them regularly. The intestine is then so used to the laxative that it cannot do without it;
  • A metabolism and hormonal problem, for example:
    • An underactive thyroid (hypothyroidism);
    • Diabetes;
  • A neurological problem, for example:
    • Parkinson’s disease ;
    • Multiple sclerosis ;
  • A psychological problem, for example:
    • Anorexia nervosa;
    • Depression ;
  • A ‘structural’ problem, for example:
    • A tumor ;
    • Diverticula;
  • Abnormal functioning of the digestive tract, for example:
    • Irritable bowel syndrome;
    • Too slow digestive transit.

In whom and how often does it occur?

Each year, general practitioners see around 6 men and 11 women constipated in 1,000 consultations. The problem is probably still seriously underestimated. About 1 to 3 in 10 people experience constipation problems at some point. Young children and the elderly (inactive) suffer from constipation more often.

How to recognize it?

Constipation is a problem that we have suffered most often for quite some time. If the only complaint is difficulty going to the bathroom and there is no other problem, you can have peace of mind that it is not an illness.

If, on the other hand, the rhythm of your transit changes rapidly and the stools become abnormal (for example regular diarrhea, presence of blood in the stool, pain during defecation, etc.), it is necessary to look for possible conditions. responsible for constipation.

How is the diagnosis made?

The doctor will first try to distinguish between ordinary constipation and constipation due to illness. He will ask you questions about the pace of your transit, your eating and exercise habits as well as your (family) history. Then he will examine your belly and, if necessary, perform a rectal exam. If necessary, he will order additional examinations such as an X-ray of the abdomen or a colonoscopy.

What can you do ?

Eat and drink
Drink at least 1.5 to 2 liters per day.
Healthy eating is important. By eating healthy, you are getting enough fiber. Fiber retains fluids in the gut and stimulates bowel function. Your stools then become more numerous and softer. Fiber is found especially in wholemeal bread and rye bread, potatoes, whole-grain pasta, brown rice, legumes (beans, peas, lentils), vegetables (including raw vegetables), fruits, wholemeal cookies, muesli bars and puffed rice cakes. 30 grams of fiber per day is sufficient. There is no dietary fiber in meat, eggs, cheese, and other dairy products.

Exercise
Move moderately to intensely each day for at least 30 minutes. Sessions of 3 times 10 minutes or 2 times 15 minutes are also possible. For example, go for a walk, run, cycle, swim or garden. These activities stimulate the bowels, which starts the bowel movement.

Going to the toilet
Go to the bathroom as soon as you feel the need. Don’t ignore it, even if you are very busy. If you constantly fail to relieve these natural needs, you will feel less inclined to satisfy them. The stool will stay in your bowels longer and become drier and harder. This is what causes constipation.
Deciding on a specific time of day to have a bowel movement (such as every morning after breakfast) can also help train your bowels.

What can your doctor do?

Treatment is only needed if constipation is causing symptoms.

If you have temporary constipation, your doctor will prescribe laxatives. The use of laxatives should be limited in time. Sometimes a mini enema relieves severe constipation.

In case of chronic constipation, your doctor will stress the importance of a healthy lifestyle. He will stop the drugs that cause constipation or reduce their dosage. It will also stop certain laxatives because they slow down the functioning of the intestine in the event of chronic long-term consumption. In this case, it is no longer possible to have a bowel movement without a laxative.

There are several types of laxatives. Bulking agents (ballast laxatives) and osmotic laxatives (eg lactulose and macrogol) increase the amount of stool by increasing the water content of the stool. The stools become softer and softer, and the intestines begin to “knead” better. These drugs often have to be used for several months and do not make the bowel “lazy”.

Medicines containing linaclotide or prucalopride may be tried if symptoms of irritable bowel syndrome persist.

If there are problems with the defecation mechanism, biofeedback or ‘biofeedback’ can help. You can contact a physiotherapist to find out more about this. It will teach you how to recognize and interpret your body’s signals, and how to respond to them correctly. Thus, you will learn to tell the difference between a real and a false urge to have a bowel movement.

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