MANAGING CONSTIPATION

What is constipation?

Constipation is defined as having a bowel movement fewer than three times per week. 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. Constipation is a symptom, not a disease. Almost everyone experiences constipation at some point in their life, and a poor diet typically is the cause. Most constipation is temporary and not serious.

What causes constipation?

Constipation occurs when the colon absorbs too much water or if the colon’s muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry.

Common causes of constipation

   •  Not having enough fibre in the diet

   •  Lack of physical activity (especially in the elderly)

   •  Side effects of medication

   •  Irritable bowel syndrome

   •  Changes in life or routine such as pregnancy, aging, and travel

   •  Overuse of laxatives

   •  Ignoring the urge to have a bowel movement

   •  Dehydration

   •  Specific diseases or conditions, such as stroke (most common)

   •  Problems with the colon and rectum

   •  Problems with intestinal function (chronic idiopathic constipation)

How can I relieve constipation?

Although treatment depends on the cause, severity, and duration of the constipation, in most cases dietary and lifestyle changes will help relieve symptoms and help prevent them from recurring.

1. Diet

High-fibre foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, brussels sprouts, cabbage and carrots can help to prevent constipation.

2. Lifestyle Changes

Drinking enough water and other liquids, such as fruit juices, vegetable juices and soups, engaging in      daily exercise, and reserving enough time to have a bowel movement can help prevent constipation. In addition, the urge to have a bowel movement should not be ignored.

3. Laxatives/Enemas

For those who have made diet and lifestyle changes and are still constipated, use of laxatives or enemas for a limited time can help retrain a chronically sluggish bowel.

Types of laxatives/enemas/suppositories

1.  Bulk-forming laxatives generally are considered the safest, but they can interfere with absorption of some medicines. They absorb water in the intestine and make the stool softer.

2. Stimulants cause rhythmic muscle contractions in the intestines. They should not be use over a long period of time.

3. Osmotics retain fluid through the colon, stimulating bowel movement and resulting in relief of constipation.

4. Stool softeners moisten the stool and prevent dehydration.

5. Lubricants grease the stool, enabling it to move through the intestine more easily. Lubricants typically stimulate a
bowel movement within 8 hours.

   •  Drink plenty of liquids.

   •  Exercise regularly.

   •  Eat a well-balanced, high-fibre diet that includes beans, bran, whole grains, fresh fruits and vegetables.

   •  Set aside time after breakfast or dinner for undisturbed visits to the toilet.

   •  Do not ignore the urge to have a bowel movement.

   •  Understand that normal bowel habits vary.

   •  Whenever a significant or prolonged change in bowel habits occurs, check with a   doctor.

MANAGING INDIGESTION

What is indigestion?

Indigestion, also known as dyspepsia, is a term used to describe one or more symptoms of a feeling of fullness during a meal, uncomfortable fullness after a meal, and burning or pain in the upper abdomen.

How can I relieve indigestion?

Antacids are usually the first drugs recommended to relieve symptoms of indigestion.

Different brands on the market use different combinations of three basic salts—magnesium, calcium, and aluminum—with hydroxide or bicarbonate ions to neutralise the acid in the stomach.

Antacids, however, can have side effects. Magnesium salt can lead to diarrhoea, and aluminum salt may cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects. Calcium carbonate antacids can also be a supplemental source of calcium, though they may cause constipation.

H2 Receptor Antagonists (H2RAs) include ranitidine, cimetidine, famotidine, and are available from your pharmacist. H2RAs treat symptoms of indigestion by reducing stomach acid. They work longer than, but not as quickly as antacids.

Proton Pump Inhibitors (PPIs) include omeprazole lansoprazole, pantoprazole rabeprazole and esomeprazole, and are available by prescription. PPIs, which are stronger than H2RAs, also treat indigestion symptoms by reducing stomach acid. PPIs are most effective in treating symptoms of indigestion in people who also have GERD (gastroesophageal reflux disease).

Prokinetics such as domperidone may be helpful for people who have a problem with the stomach emptying too slowly. Domperidone also improves muscle action in the digestive tract. Antibiotics may be prescribed by your doctor to treat the condition, if tests show the type of bacteria that causes peptic ulcer disease.

Over-the-counter solution

We can recommend antacids or medication that reduce acid production, or medication that helps the stomach move food more quickly into the small intestine.

What else can I do to relieve indigestion?

Some people may experience relief from symptoms of indigestion by:

   •  Eating several small, low-fat meals throughout the day at a slow pace

   •  Refraining from smoking

   •  Abstaining from consuming coffee, carbonated beverages and alcohol

   •  Stopping use of medication that may irritate the stomach lining such as aspirin or anti-inflammatory medication

   •  Getting enough rest

   •  Finding ways to decrease emotional and physical stress, such as relaxation therapy and yoga