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Constipation is defined medically as less than 3 bowel movements per week. This is closely related to dys-synergic defaecation, which refers to the need for excessive straining to defaecate even when the person can have a daily bowel movement. A constipated person tends to feel bloated or suffer abdominal cramps. Constipated people may strain hard at bowel movement which can lead to haemorrhoids or anal fissures. However, many people who can have a bowel movement every two to three days may also suffer these symptoms. These patients can be treated in the same way as constipated patients.
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If the constipation is of recent onset, if you have abdominal or anal pain, bloating or anal bleeding, you should seek medical advice soon.
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A detailed history of your diet, lifestyle and medications is required. Blood tests are often used to rule out other medical conditions which may present as constipation. If your doctor suspects a growth or cancer in the colon, he may recommend a colonoscopy. When all secondary causes of constipation have been ruled out, your doctor may request a colonic transit marker study.
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Constipation is readily treatable. The aim of treatment is to relieve symptoms. Treatment may involve modifications to your diet and lifestyle. Medications (such as laxatives) may be helpful in some cases. In patients with dys-synergic defaecation, anorectal biofeedback (a form of pelvic floor rehabilitation physiotherapy) can provide dramatic improvement. Surgery is rarely required except for the most severe cases.
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Constipation is not associated with an increased risk of cancer. However, as the incidence of constipation is high among the average population, it is not uncommon to find a patient with colorectal cancer who has a preceding history of long-standing constipation.
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Laxatives used at the prescribed dosages by your doctor are safe. They are used to help constipated patients contract the bowel wall harder to push the stools toward the rectum and anus. Some laxatives also soften or liquefy hard stools so that it is easier to pass the stools. Please remember that laxatives are prescribed for patients with constipation or dys-synergic defaecation and not for people with normal bowel movements.
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