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Jul 17

Preventing Constipation

The setting was the accident and emergency unit. The normal organized madness of the whole environment was playing itself out. There were broken heads that needed suturing; someone was rushed in unconscious; some people had beaten themselves up and wanted doctor’s report; groans and whimpers were intermittently uttered with a scream of agony now and then (imagine the soap  “ER” by Michael Crichton with just two doctors and two nurses and you’ll get the picture). Then this fine young lady walked in with pain and discomfort written all over her face. She could barely sit down. Her problem? Faecal impaction. Her faeces had become rock hard and she couldn’t pass it out. We had to go and remove it manually. It was a nasty, noisy procedure!

I picked up a terrible habit in secondary school. I went to a Federal Government College where going to poo poo, shit, delete, download, (…………. fill in the blank spaces) or simply put defecate was not a task to look forward to. I had the choice of either going to a road we called Jamaica to do the open-bush-attack-system or go to use a pit latrine where I might have to cross a sea of faeces to get to the hole. In short passing faeces was not an activity I looked forward to. I stayed put for as long as possible. I could stay a whole week without using the toilet.

Now don’t start laughing. I don’t think your own school was any much better. The truth is only 38% of our teeming population have access to sanitation. That means 62% simply have no option other than the open-bush-attack-system. So at least we had access. In fact we had some WC’s they were just not working. So don’t laugh.

After leaving secondary school, my body had become attuned to this schedule until one of my professors said to us, “…if you don’t use the toilet daily, you are dying instalmentally”.  I have had to examine his words and change my bowel habits.

Constipation is defined as having a bowel movement fewer than three times per week.  The normal range is 3 times daily to 3 times weekly. With constipation stools are usually hard, dry, small in size, and difficult to eliminate. Some people who are constipated find it painful to have a bowel movement and often experience straining, bloating, and the sensation of a full bowel.

The time it takes for what we eat to transverse the whole of our intestines (which is 25 feet or 8.5 meters long) and out through the anus is referred to as the transit time.   An increased transit time has been identified as one of the causes of intestinal cancer. This is because an increased transit time gives more time to carcinogens (i.e. cancer-causing substance or agents) to act.  Colonic cancer is the 2nd leading cause of cancer deaths worldwide.

Cancer is the end of the spectrum of complications of constipation. Others include haemorrhoids/piles (which is prominent part of the so called Jedi-Jedi syndrome which is not in any medical textbook!) caused by straining to have a bowel movement, or anal fissures (tears in the skin around the anus) caused when hard stool stretches the sphincter muscle. As a result, rectal bleeding may occur, appearing as bright red streaks on the surface of the stool. Sometimes straining causes a small amount of intestinal lining to push out from the anal opening. This condition is known as rectal prolapse.

Remember the lady at the beginning of this piece? Her problem stated with constipation. Constipation may also cause hard stool to pack the intestine and rectum so tightly that the normal pushing action of the colon is not enough to expel the stool i.e.  faecal impaction.

You have to visit the toilet often.

[notice]Every time you go to the toilet should not be a “major event”![/notice]

So what can we do to put constipation at bay? Let’s discuss four of the common causes of constipation.  These are:

Not Enough Fibre in the Diet

People who eat a high-fibre diet are less likely to become constipated. The most common causes of constipation are a diet low in fibre or a diet high in fats, such as cheese, eggs, and meats.

Fibre—both soluble and insoluble—is the part of fruits, vegetables, and grains that the body cannot digest. Soluble fibre dissolves easily in water and takes on a soft, gel-like texture in the intestines. Insoluble fibre passes through the intestines almost unchanged. The bulk and soft texture of fibre help prevent hard, dry stools that are difficult to pass.

Within the digestive system, dietary fibre assists the movement of faecal material along the large intestine, and affects the way the body absorbs and uses nutrients. A diet which provides around 20-30 grams of dietary fibre will help prevent constipation in adults. Fibre also helps in the lowering of blood cholesterol, reduction in hunger pangs (hence obesity and its sequelae), reduction in colon cancer.  Also by preventing constipation it helps prevent hiatus hernias and some other diseases I won’t bother you with.

Give yourself a treat this weekend. Buy some apples. Too expensive? Oya buy corn then! Buy some fruits for yourself today. Cook a vegetable soup.

Not Enough Liquids

We touched on this last time. Water is life. Research shows that although increased fluid intake does not necessarily help relieve constipation, many people report some relief from their constipation if they drink fluids such as water and juice and avoid dehydration. Liquids add fluid to the colon and bulk to stools, making bowel movements softer and easier to pass. People who have problems with constipation should try to drink liquids every day. However, liquids that contain caffeine, such as coffee and cola drinks, will worsen one’s symptoms by causing dehydration. Alcohol is another beverage that causes dehydration. It is important to drink fluids that hydrate the body, especially when consuming caffeine containing drinks or alcoholic beverages.

Lack of Physical Activity

A lack of physical activity can lead to constipation. This may be due to the fact that there is a reduction in the metabolic rate of the body. This can translate to a reduction in intestinal transit time and hence constipation. For example, constipation often occurs after an accident or during an illness when one must stay in bed and cannot exercise. Lack of physical activity is thought to be one of the reasons constipation is common in older people. So move about. Talk a walk. Ignore the elevator once in a while. Use the stairs.

Ignoring the Urge to Have a Bowel Movement

If you ignore the urge to have a bowel movement, you may eventually stop feeling the need to have one, which can lead to constipation. Some people delay having a bowel movement because they do not want to use toilets outside the home. Others ignore the urge because of emotional stress or because they are too busy. Children may postpone having a bowel movement because of stressful toilet training or because they do not want to interrupt their play.

The above list is by no means complete. Some causes of constipation will necessitate you visiting a doctor and obtaining treatment in a hospital. The above are those you can do something about. So, no more grunting, groaning, or panting in the toilet. No more pseudo-labour sessions in the bid to defecate.  If you eat right, you won’t spend more than five minutes in the toilet every time you go to do the major job. No more goat-like shit. You know those small round balls? No more of those.

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Concluding Tips

  • Don’t resist the urge to have a bowel movement
  • Eat more fibre
  • Exercise or move around more.
  • Set aside time to have a bowel movement. A good time may be after breakfast or any other meal or first thing in the morning.
  • Drink plenty of fluids–at least 8 glasses (i.e. 3 litres) a day. Fluids can include water, juices, soup, tea and other drinks that are non-dehydrating.
  • Don’t take laxatives too often. They are addictive and in themselves can cause constipation.

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1 comment

  1. Felix

    Hmm….,
    What a piece! Off course, to everyone especially me. I think a quick response to the call would do me good in other to avoid the usual strain in the white house(toilet).

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