Constipation

Constipation is a common gastrointestinal condition in Singapore that causes infrequent bowel movements or incomplete emptying of the bowels. It can also cause hard and lumpy stools that are too large or too small. It can affect anyone at any age and has many causes. 

Although constipation is usually temporary and resolves independently, it may sometimes progress and require medical intervention. It can be a side effect from medication, a lack of fibre in the diet, a symptom of chronic disease, or an underlying health condition such as colon cancer. If left untreated, chronic constipation can cause more serious problems such as haemorrhoids, anal fissures, rectal prolapse, and impacted faecal matter (accumulated stool stuck in the intestines).

There are many factors and reasons for why constipation happens; they include:

• Diet and lifestyle: a sedentary lifestyle coupled with a low-fibre diet and minimal physical activity can result in constipation. 
• Medications: certain medications such as opioids, sedatives, and anti-depressants may cause constipation. 
• Dehydration: dehydration can cause the large intestines to absorb more water from food waste, leaving you with dry and hard stools, thus leading to constipation. 
• Medical conditions: conditions such as irritable bowel syndrome (IBS), diverticulitis, Parkinson’s disease, lupus, and other conditions may cause constipation. Endocrine conditions like hypothyroidism, diabetes, and hypercalcaemia may also cause constipation. Colorectal cancer can also cause constipation.
• Hormonal imbalances and changes: pregnant women often experience constipation due to hormonal changes. During menstruation and menopause, the drop in hormone levels may also cause constipation.

Symptoms of constipation include: 

• Less than three bowel movements a week
• Dry, hard, and lumpy stools
• Difficulty and pain during bowel movements
• Abdominal cramping
• Nausea 
• Bloating
• A feeling of not completely emptying the bowels

Yes, constipation can be painful and uncomfortable. It may cause straining in the rectum, leading to tearing and bleeding. It may also cause stomach cramps and bloating. Seek treatment if you are experiencing constipation often or if symptoms do not resolve after a few days. 

Constipation is a common problem affecting people of all ages and backgrounds, including those in Singapore. The risk factors of constipation include:

• Diet and lifestyle: a diet low in fibre and fluids can increase the risk of constipation. A sedentary lifestyle with limited physical activity can also be a risk factor. High levels of stress that is left unaddressed may also lead to constipation. 
• Age: as we age, gut motility (gut movement) decreases. This, in addition to other factors such as a sedentary lifestyle and changes in hormone levels, contributes to constipation in older individuals. 
• Medications: certain medications, such as some opioid pain relievers, antidepressants, and steroids, can cause constipation. 
• Medical conditions: those with chronic medical conditions like irritable bowel syndrome (IBS), diabetes, and neurological disorders may be more susceptible to constipation. 
• Pregnancy: pregnant women are more prone to constipation due to hormonal changes and the pressure of the growing uterus on the intestines.
• Dehydration: dehydration can cause constipation if not enough fluids are consumed.
• Travelling: changes in routine and diet during travel can also lead to constipation.