How do we deal with chronic constipation

Chronic constipation is an extremely common problem which is rarely discussed in social events and only reluctantly mentioned to the doctor during a checkup. The result is millions of people are not receiving the required medical care.
The reluctance is often due to misconceptions about the causes, treatment and its consequences, but the truth is that it’s usually manageable even with simple measures.
Chronic constipation can accompany many medical problems, from multiple sclerosis, the disease of Parkinson’s and the existence of a tumor to metabolic problems such as severe hypothyroidism, or low levels of magnesium in the blood. It can also be a side effect of medications, such as opioids, antidepressants, anticonvulsants, and antihistamines.
In a new combined analysis for this published last month in the “journal of the American Medical association” (JAMA), dr. Arnold Wald, a professor of Gastroenterology and Hepatology at the University of Wisconsin, presented a combination of newer data on the diagnosis and treatment of.
As noted in the article, many beliefs for chronic constipation are not based on medical data.
One of the oldest and most unfounded is that when the emptying of the bowel is not daily, the body absorbs the toxic by-products of metabolism, and poisoning himself.
The truth is that there is absolutely no scientific evidence that the presence of the residues of food in the intestine leads to the accumulation of toxins. In addition, constipation is not a man who shall not be daily, but whoever has fewer than three bowel movements a week or has hard, dry and small, painful bowel movements which often lead to pain in the abdomen or bloating.
The diet
The first step to deal with constipation is to follow a diet low in foods that promote constipation and high in foods that reduce.
In foods that promote constipation include white rice and other processed carbohydrates (white pasta to white grains), green bananas, tea, cheese and chocolate. On the contrary, those who restrict it and should be eaten daily include whole grains (particularly bran), wholemeal bread, legumes, vegetables, fruits (especially dried) and nuts.
It is also good to drink a large glass of water before sleep at night to soften the stool and another immediately after the morning rise in order to stimulate the intestine.
Laxatives
Those who need laxatives you need to know and these are surrounded by many myths, most notably that the stimulant laxatives such as senna and the δισακοδύλη can disrupt the normal functioning of the colon and can cause dependence.
As he notes, dr. Wald, this kind of stimulant laxatives may damage the nerves and muscles of the colon only when taken over a number of years and in doses ten times or greater than the recommended. In the recommended amounts does not have consequences in the intestine, while many doctors still wrongly, by dr. Wald – constitute a limited use.
In addition to the laxatives, and other measures that may help are regular exercise (the more intense the better), the establishment of a program of defecation and the immediate emptying of the bowel when someone feels the need to. It can also help the consumption of a hot cup of coffee for breakfast, the taking of laxatives that increase the volume of stool thanks to the fiber (such as psyllium, bran cereals, methyl-cellulose) and the receiving of a fabric softener of stools.
But when the cause of constipation is muscle weakness or problem in the nerves of the intestines, increased fiber intake can be harmful says dr. Wald. For these patients it is often best to reduce the consumption of dietary fiber and to replace it with drug taking, such as the λινακλοτίδη, add water into the colon and soften the stool.
The difficult cases
Sometimes, however, the usual medicines and methods for chronic constipation are not working. Such is l.x. the case of people with weakness of the pelvic floor muscles to relax when you have to, in order to allow the faeces to pass.
In these patients, the muscles around the anus instead of loose, clamped, with an “involuntary movement which the patients must learn to not do”, by dr. Wald. This can be achieved with the help of biofeedback – a complementary therapy which “when done correctly, is effective in about 80% of the cases,” he adds.
So, given that constipation is a complex issue with many possible solutions, the advice of a specialist doctor is required when the problem persists and is not responding to simple measures of self-help, like the careful diet.