Constipation is a common condition where bowel movements become infrequent or stools are hard and difficult to pass. It can cause discomfort, bloating, and sometimes complications like haemorrhoids. In Uganda, understanding constipation is important, especially for the elderly, pregnant women, and children, because timely management can prevent more serious problems.
Hope Plus can support patients experiencing persistent constipation by connecting them with a licensed healthcare provider in minutes. You can get advice on diet, lifestyle, and medications, and find out when specialist care is needed. Learn more at Hope Plus.
Key Takeaways
- Constipation is when bowel movements are hard, infrequent, or require straining.
- Causes include low-fibre diet, inadequate fluids, lack of exercise, pregnancy, certain medicines, and medical conditions affecting the bowel, metabolism, or nerves.
- Symptoms include abdominal discomfort and small, hard stools; it may cause haemorrhoids or anal fissures.
- Severe or “alarm” symptoms like rectal bleeding, weight loss, or obstruction require urgent medical attention.
- Treatment involves lifestyle changes, dietary adjustments, and sometimes medications or specialist care.
Causes of Constipation
Common Causes
- Dietary: Low fibre intake and insufficient fluids.
- Infants: Concentrated formula feeds.
- Lifestyle: Lack of exercise, immobility, or being bedridden.
- Pregnancy due to hormonal changes and pressure on the bowel.
- Medicines: Narcotic painkillers, antidepressants, diuretics, antipsychotics, iron supplements.
- Bowel disorders: Stricture, fissures, cancer, proctitis, congenital bowel abnormalities, irritable bowel syndrome, volvulus, intussusception.
- Metabolic disorders: High blood calcium, diabetes, hypothyroidism.
- Neurological disorders: Stroke, spinal cord injuries, Parkinson’s disease.
Symptoms Patients May Notice
- Abdominal discomfort or bloating.
- Hard, small stools passed with difficulty.
- Straining during bowel movements.
- May lead to haemorrhoids or anal fissures.
Alarm Features (Require Urgent Medical Attention)
- Signs of bowel obstruction or acute abdomen (sudden severe abdominal pain).
- Confusion, disorientation, or abnormal vital signs.
- Iron deficiency or unexplained rectal bleeding.
- Rectal mass or haematochesia (blood in stool).
- Patients over 45 years with no previous colon cancer screening or a family history of colon cancer.
- Unintentional weight loss.
Diagnosis
Healthcare providers may perform:
- Physical examination, including abdominal and anorectal assessment.
- Stool examination.
- For patients with alarm features: abdominal X-rays, ultrasound, endoscopy, blood tests (blood count, calcium, kidney function, thyroid function, blood sugar), barium enema, or CT scan.
Treatment and Management
For Mild or Chronic Constipation (No Alarm Features)
- Eat a high-fibre diet with plenty of vegetables and fruits.
- Drink adequate fluids with meals.
- Bisacodyl (stimulant laxative):
- Adults: 10 mg at night until stool is passed.
- Children 5–12 years: 5 mg suppository (not for acute abdomen).
- Lactulose (osmotic laxative), orally or rectally, may provide faster relief than bisacodyl.
For Severe or Alarm Symptoms
- Immediate referral to hospital for specialist management.
Prevention
- Eat a diet rich in fibre, including vegetables, fruits, and whole grains.
- Drink plenty of fluids throughout the day.
- Maintain regular physical activity.
Frequently Asked Questions
1. What causes constipation?
Common causes include low-fibre diet, dehydration, lack of exercise, pregnancy, certain medications, and bowel or metabolic disorders.
2. How can I relieve constipation at home?
Increase dietary fibre, drink plenty of fluids, and exercise regularly. Mild cases may benefit from laxatives like lactulose or bisacodyl.
3. When should I see a doctor?
See a healthcare provider if there is rectal bleeding, severe pain, weight loss, vomiting, or if constipation persists despite home remedies.
4. Can children get constipation?
Yes, especially if they are on concentrated formula feeds or have low-fibre diets.
5. Are there long-term complications of constipation?
Yes. Chronic constipation can cause haemorrhoids, anal fissures, or faecal impaction.
6. Can Hope Plus help with constipation?
Yes. Through Hope Plus, licensed healthcare providers can guide you on diet, medication, and when to seek specialist care.
7. How can I prevent constipation?
Eat a fibre-rich diet, drink enough fluids, exercise regularly, and avoid delaying bowel movements.
