Unveiling insights and strategies during constipation awareness month

December is the Constipation Awareness Month. The International Foundation for Gastrointestinal Disease (IFFGD) launches a campaign to address the dilemmas that so many people face each day when living with constipation and to increase public knowledge of a common yet often misunderstood condition. Constipation Awareness Month is a global healthcare event that has been observed annually by various organisations, both global and local, throughout December with the aim of educating people about the condition, its complications, and preventive measures for constipation.

Constipation is a frequent gastrointestinal condition that affects people of all ages, with a prevalence of around 10–11% in the general population. Constipation is more common in the elderly than in the younger population. Elderly women suffer from severe constipation more frequently than their male counterparts. People who are constipated may experience one or more of the following symptoms: reduced stool frequency, hard stools, difficulty passing stools, straining, painful bowel movements, and a feeling of incomplete emptying after defecation.

The North American Society for Paediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) defined constipation as delay or difficulty in defecation, present for 2 or more weeks, and sufficient to cause significant distress to the patient. The most common type of constipation is normal transit, where the passage of the stool through the colon and its frequency may be normal, but patients nevertheless feel constipated.

Women mostly face slow-transit constipation, where a reduction in colonic motor activity combined with significantly diminished colonic responses are observed following a meal and on awakening in the morning. Pelvic floor dysfunction is another type of constipation where the person is unable to correctly relax and coordinate the muscles in the pelvic floor in order to have a bowel movement.

There are many factors that contribute to constipation, which might include a low-fibre diet, excess intake of caffeine, overuse of alcohol, certain medications, thyroid disease (hypothyroidism), and several neurologic and psychological issues.

Most children benefit from medical treatment, but adults' constipation has a poor prognosis; it seriously affects the quality of life. Factors that are associated with a worse prognosis are: female gender, old age, longer time between onset of symptoms and initiation of treatment, and longer colonic transit time.

The preventive suggestions are to be followed on a regular basis to reduce the chance of developing constipation as well as relieve it. They include increasing daily water intake; reducing the intake of excessive meats and dairy products; eating a diet rich in fibre; not ignoring the urge to defecate; staying active throughout the day to improve gut movement; increasing physical exercise; trying medication or other techniques to manage stress; avoiding consuming alcohol and caffeine; maintaining a regular schedule for bowel evacuation; and taking your last meal at least two hours before bed.

The writers are respectively Asst Prof of Neonatology Department at Abdul Malek Ukil Medical College, Noakhali and Asst Director at Civil Aviation Authority of Bangladesh.