Constipation, its causes, its side-effects and treatment procedures

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bikidas2060

     Well, from blogs to vlog most people talk about food. People love the taste and devour them like crazy. Nature’s law is body retain whatever we put in it and whatever can’t be retained by body has to be discarded by the body. So, food and poop are both of utmost importance to people. Sadly because of lack of education proper discussion on the topic of poop is usually frowned upon. Somebody said, a person’s way of life can be determined from cleanliness of his toilet. Similarly a person’s poop is mirror reflection of status of his/her health. 🙂 Today we will discuss about constipation. 

Definition

     Constipation is a condition in which you may have fewer than three bowel movements a week; stools that are hard, dry, or lumpy; stools that are difficult or painful to pass; or a feeling that not all stool has passed. You usually can take steps to prevent or relieve constipation. Copied from https://www.niddk.nih.gov/health-information/di....

Importance of dietary fiber

     They can’t be fully digested by acid and enzymes secreted by human body. It’s also known as roughage. There are two types of fibers that we eat in our food. 

  • Water Soluble Fiber   It is soluble in water. It becomes a gel like substance. In the large intestine it gets semi digested by bacteria and release few gasses and some calories. It lowers the rate at which we digest the food. It lowers the absorption of fat and cholesterol, stabilizes blood sugar.
  • Water Insoluble Fiber Since this type can’t be disolved by water, our body (human body) can’t digest the same. And it gives our poop the desired base. It allows water retention in the poop, which allows the poop easy to pass. It speeds up the process of digestion. 


Side Effects Of Constipation

     Constipation might lead to blockage in the intestine. Constipated person usually put a lot of strain of rectal muscles and rectum, which might give rise to painful problems like piles (inflamed hemorrhoids) and anal fissure (a tear in the outer anal orifice). Fistula is a different type of disease. But sometimes constipation can cause fistula.

Home remedy for prevention of Constipation

      Poop consists of a putty (plasticine) like material and 75% of its weight is because of water. Rest of the constituents of poop are fiber, sterols, lipids etc. Naturally a healthy person has to drink plenty of fluids. And one has to take control of one’s diet too.

  • 8 servings of 8 ounce of water/ day keeps the constipation at bay. Metric conversion shows 8 ounce of water is equivalent to .236 lt of water. That is min 8 X 8 glasses of water every day.
  • Colon’s job is to absorb water and other nutrients. In constipated people the poop is usually dry. That is because intestine is absorbing too much water. It is very much possible that diet of the person lacks dietary fibers. A constipated person has to take min 30 grams of dietary fiber along with food. It will retain water in the poop and it will make the poop pass easily.
  • 30 mins of physical exercise and reducing weight if one is obese. 
  • Yoga and Pranayam work like magic.

Steps to be taken after getting constipated

     If it is once in a while then it should be alright. It is your body and you know it better. Some people including me go to toilet twice a day, once in the morning and once in the evening and some people go to toilet once in every 3 days. Body is a flexible machine and there are certain ranges. When you feel like that you are missing your natural call and facing issues while relieving yourself then most probably the issue is temporary and with proper lifestyle choice should fix the issue. If the problem is persisting then you need to get worried. Here are few steps you need to take. 

  • Visit a doctor Why is it necessary to visit a doctor? Lack of water and dietary fiber can cause constipation for sure but Crohn’s disease, colon cancer, rectal cancer, certain medications, certain food allergens, some drinks like coffee, opioid narcotics and other sort of substance abuse can also trigger chronic constipation. A trained physician can diagnose the condition and give the proper treatment plan. After reaching 40 one must undergo a colonoscopy at least once a year. A doctor can identify any abnormalities in the abdomen and intestine using colonoscopy.
  • Religiously follow the diet regimen prescribed by your prescribing doctor.
  • Regularly communicate with your doctor. Your doctor might prescribe you a laxative. Some laxatives can form a habit and you can’t pass a bowel movement after stopping the laxative. Take good care of that situation. Doctors know it and please don’t extend the usage of those laxatives. 

Further complication of Fissure, Piles and Fistula

      Now the constipation situation has aggravated into a physical injury situation which might be  piles/fissure/fistula. What to do? First know the symptoms.

  • Bloodied stool
  • Frequent anal abscess, foul smelling discharges (signs of fistula)
  • Painful bowel movements while defecating
  • Pain while sitting
  • Fever along with pain while defecating
  • Pain while farting

Steps to be taken and what to expect?

  • Immediately consult a general surgeon. Let the surgeon inspect the affected area with help of digits/ medical instruments. Please don’t be shy. The issue is both piles and fissure might be giving same symptoms. Uncle at home/ neighborhood aunty might solicit you into buying certain meds but unfortunately piles, fissure and anal fistula might have similar symptoms but the treatment is different. Fissure is a tear in rectal area often caused by hard lumps of stools. The outermost part and some inches inside of the end of GI tract (rectum) is super sensitive to touch. It can even sense air. Let’s not joke about fart. But one feels the fart while farting, no? So, imagine the pain one will feel while defecating if a part of the rectum is torn in the slightest amount. So, situation becomes very grim. Anal sphicters (sphincters are valves that regulates movement of substances in different orifices of human body. https://en.wikipedia.org/wiki/Sphincter#Functio... drink water, food all the time. Yet we can control the urge to defecate. Right? All credits goes to the sphicter muscles.) Hemorrhoids are blood vessels and act as a cushion which helps us to defecate peacefully without worry of injury. But constipation causes them to get swollen which in turn are known as piles. One can get an anemic condition from a severe case of piles. If anal glands get clogged/infected then abscesses are formed in/ around anal areas. It is so called fistula. Even Crohn’s disease, irritable bowel syndrome ( https://www.dda.net/blog/whats-the-difference-b...), colon cancer can cause those symptoms.
  • Treatment Plan  include meds, diet change, lifestyle change and surgery. 
  • Yours truly, bikidas2060, myself got affected by anal fissure. Actually I got it during covid. And I got it again couple of days ago. It is very difficult to confess to a thing like that in open but it is what it is. And I will definitely share my experience with you. Doctor prescribed me certain meds, which we will discuss later in the topic. They did wonders to me. We will discuss about them shortly. If meds can’t help then surgery will help definitely. Anal fistula can only be treated using invasive surgery methods. 
  • Acute Fissure goes away in 4-5 weeks. Chronic fissure opens and reopens again and again. Some piles get healed. Some piles dont require any attention. Serious cases of fissure, fistula, piles are treated in invasive surgical way. 
  • Fistula is the most dangerous situation. It might show a single opening but internally it might have many channels. MRI and Sonogram is performed to locate the affected areas. The test alone is very very expensive.  

Treatment Plan for Constipation and complications arising from it 

Alopathic Way

    Doctor will most likely prescribe a cocktail of pain relievers, local anesthetic gel, topical ointment, antibiotics and high fiber diet in case of anal fissure. Doctor might prescribe a hydrocortisone for piles. I don’t know much about piles treatment. Local anesthetic gel most likely contain Lignocaine Hydrochloride Gel. It literally takes the pain away. In my experience, I could still feel the tearing is getting stretched but the pain was 90% gone. The ointment part varies from doctor to doctor. I was prescribed Sucral-ano ointment. It is composed of lignocaine, metronidazole (antibiotic) and sucralfate (a complex of aluminum hydroxide. It coats the affected area and prevents further injury). Some might prescribe fisofine (lignocaine + Nifedipine). Nifedipine is a powerful calcium channel blocking vasodilator. It relaxes the sphincter muscles. Nitro glycerine is prescribed in chronic fissure. It is usually the last meds a physician would prescribe before preparing the patient for surgical method. For anal fissures, surgeons remove some portion of anal sphincter, Sphincterotomy. Some use a metal device to widen the anal canal. It is a non surgical procedure. Laser makes things easier but it is costly. Similarly for piles and fissure are effectively treated with appropriate surgical methods. Unfortunately I don’t have much idea about em. https://www.webmd.com/digestive-disorders/surge...). Side effects of Nifedipine/nitroglycerin are lowering of blood pressure. Lignocaine can make some people feel dizzy. Consult the physician immediately.  I was also prescribed some broad spectrum antibiotics and paracetamol. My sphincter went into a spasm. So, I had to take paracetamol to reduce the inflammation. Please dont self medicate. I was also advised to use Sitz bath. Basically you put warm water in a tub and sit in it for 10-15 mins. It relaxes the anal sphincter and spasmed muscles relax. It helps the healing procedure. I was prescribed liquid paraffin + milk of magnesia as a laxative. Some gets prescribed Pruease, some gets prescribed Loozpeg. Some gets prescribed some sort of fiber supplement like Lactifiber ( Lactitol + Ispaghula)

    Ayurvedic Way 

    After a while Sucral Ano did not properly healed my wound. My doctor prescribed me Pilon tablet and ointment. We had a Pilex cream at home, my father had bought it for me earlier, but I insisted upon seeing the doctor. Doctor said I can take Pilex tablets and apply Pilex ointment. I am aware of Triphala churna to ease the passing of stool. Boiled raw papaya is an effective food for this problem. I am having it everyday. It was super difficult to eat at first. But trust me, it helped me. Ispaghula has helped many since hundreds of years. The most impressive part is alopathic surgeons prescribe them because they work. Alopathy has no treatment for Crohn’s disease and Irritable Bowel Syndrome. (Please Google) And Ayurveda has effective surgical treatment for Piles and Fistula too. It is called Ksharsutra method. Researchers have effectively compared Ksharsutra treatment with open fistulotomy in https://www.ncbi.nlm.nih.gov/pmc/articles/PMC45.... A lot of people are not aware of Ksharsutra treatment. Nearest ayurveda practice center has it. And this effective treatment can be done in fraction of cost that is involved in laser treatment. People with monetary problem can opt for this procedure. A good friend of mine has recommended to use water stored in a  Copper vessel. It worked for me. 

    Conclusion and Mistakes done by me

    I was not using the narrow hollow applicator provided with Sucral ano. I was just applying on the outer area of the affected part. Stupid mistake was paid by painful spasms. I could not seat for days. I had to sleep 24X7. I did squatting and burpees, which further tore my internal tear. I had stopped taking laxatives in the middle of the treatment. My fissure was raw again. Take help immediately. Proper habits like Yoga, Pranayam, exercise, proper diet will keep one healthy.

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