Constipation is one of the most common digestive disorders, especially in women. Temporary, chronic and/or severe, it is painful. Here’s how to stop it.
Constipation would affect up to 35% of adults in France. Lack of physical activity, poor diet… or more serious health problems, it should not be ignored.
What is the definition of constipation?
Constipation is usually defined by a slowing of intestinal transitgenerating a decrease in the frequency of stool emission, who will appear dehydrated. “But the modern definition doesn’t just include stool frequency”, notes Professor Benoît Coffin, gastroenterologist at the Louis Mourier hospital (Colombes). Those are the criteria of “Rome IV” which offer a complete definition of constipation. Among these are:
- Small or hard stools to pass (which correspond to types 1 and 2 on the Bristol scale).
- The need to force to evacuate.
- A feeling of incomplete evacuation.
- A feeling of blockage or obstruction.
- The need to “maneuver” to allow evacuation.
- And finally, infrequent bowel movements (less than three per week).
In order to characterize functional constipation, the patient must present at least two of the above criteria.
Temporary, severe or chronic constipation?
► When constipation lasts only a few weeks (up to less than 3 stools per week), We are talking about transient constipation or occasional. The intestinal transit then resumes a normal frequency.
► The severe constipation : “There is no scientifically recognized definition, but it would correspond to patients who have less than one bowel movement per week, or even every 10 days, and who have complications”details the gastroenterologist.
► Constipation can be chronic. “This corresponds to constipation which lasts for more than 6 months“, says the practitioner.
What to do in case of constipation?
Enema. In cases of heavy stools found in the terminal part of the digestive tract (also called the “rectal ampulla”), a enema (Normacol©, evacuating enema) can be carried out in order to eliminate the stools and restore the transit.
Glycerin suppository. The use of glycerin (suppository) can also facilitate the elimination of stools.
Laxative medicine. Oral laxative treatment (Macrogol, Lactulose), to be taken for several weeks, may be prescribed to restore correct transit in cases of chronic constipation. Moreover, “there are drugs developed for the treatment of constipation which are not reimbursed in France by Social Security, because it does not consider this pathology as a public health problem”, laments the practitioner. These are the Resolor©, and the Constella©.
Belly massage. Abdominal massages can help stimulate a sluggish bowel. For this: lie on your back and breathe gently, use a natural oil, and gently massage your belly, touching it and applying moderate pressure… You can ask your partner to gently massage your belly.
Sport. A healthy lifestyle contributes to good transit and this requires movement. Being lying or sitting permanently does not promote intestinal transit. 2 to 3 one-hour sports sessions are enough per week. Regarding walking: 15 to 20 minutes are recommended each day. Take the stairs instead of the elevator, avoid taking your car, tinker, garden…
Drink more water? “There is no point in drinking large amounts of water, because the excess will be eliminated in the urine, and not in the stool, which will not be more hydrated”warns Professor Coffin.
What are the causes of constipation?
Once characterized, it is necessary to determine the origin of the constipation. “It should not be considered that it is something trivial”, warns Professor Coffin. Often transient and not serious, it can sometimes be a symptom of a serious pathology such as colon cancer.
Colon Cancer. “We have what are called red flags for this: we will be particularly attentive to the constipation of a patient if he is over 50 years old, has a family history of polyps or first-degree colon cancer, reports significant weight loss or blood in the stool…”, explains Professor Coffin.
Feed. The lack of fiber-rich foods in the diet (dried fruits, green vegetables, whole grains, legumes, etc.) would be a major risk factor for constipation, as well as a sedentary lifestyle. “Even if compliance with hygiene and dietary rules is important for everyone, there is no scientifically proven link between diet, or sedentary lifestyle, and constipation.. To cause constipation, dietary deficiencies must be very significant. And if regular physical activity promotes intestinal transit, its absence does not cause constipation” nuance Professor Coffin.
Medications. Some drug treatments also promote the onset of constipation, such as level 2 or 3 analgesics, antacids, antidepressants, neuroleptics, laxatives used in excess, anticholinergics, anticonvulsants, diuretics, antispasmodics, iron and calcium supplements, opiates, antiparkinsonians… “A third of the drugs listed in Vidal mention constipation as a possible side effect”, points out the practitioner. It can also come from anal fissure problems: the patient holds back because having a bowel movement is painful.
What exams to do?
The doctor will perform a clinical examination, abdominal palpation, and possibly a digital rectal examination. Following which, he may carry out additional examinations, such as colonoscopyA standard biological assessment (especially the TSH assay). “According to the patient’s profile, it is obvious that we are not going to have the same diagnostic approach”says the practitioner.
“There is no point in drinking large amounts of water”
What to eat in case of constipation?
“As with everything, you must adopt a normal, varied and balanced diet”, summarizes Professor Coffin.
- In addition, eating foods high in fiber helps fight constipation. Vegetable fibers, for example, fill with water during digestion, thus stimulating intestinal transit and increasing the volume of stools.
- Legumes, lentils, white beans, split peas, chickpeas or broad beans are particularly recommended.
- Dried fruits, prunes, dried apricots, figs, walnuts, hazelnuts or even almonds have a high fiber and mineral salt content. But they have the disadvantage of being very caloric.
- Whole grains, wheat bran and oats are also very high in fiber. Don’t hesitate to eat pasta, brown rice, wholemeal bread, bran bread…
- Green vegetables promote intestinal transit: choose spinach, peas, celery, fennel, endive…
- Fresh fruit, plums, kiwi, passion fruit, raspberry, blackberry, currant, grape, guava, orange, fresh walnuts and hazelnuts are also recommended.
On the health forum: discussions about constipation
To remember
► Less than 3 bowel movements per week: we speak of transient or occasional constipation.
► Constipation that lasts more than 6 months is considered chronic.
► Abdominal massages can help stimulate a lazy bowel.
► Consuming foods high in fiber helps fight constipation.
► Some drug treatments also promote the onset of constipation.