Constipation is a common condition described by inability to pass stool regularly (less than 3 times per week) or to completely empty one's bowel. Constipation can also cause your stools to be hard and lumpy, as well as unusually large or small.
Constipation is a very common digestive problem faced by many Malaysians and can affect anyone; young and old, men and women alike. Constipation can have severe side effects such as bleeding haemorrhoids and damage or tearing of the anus.
What Causes Constipation
The intestinal transit time (ITT) is the time it takes for the food you eat to travel from your mouth, through your digestive system and finally removed as stool at the rectum. The longer the ITT the more likely you will suffer from constipation. Frequency of bowel movements varies widely from person to person. However, not having one for more than 3 days straight is usually too long and it constitutes constipation.
The function of the colon (also known as the big intestine) is to absorb fluid and transport waste to the rectum, where it is stored until it is ready to be removed. Hence, stool that remains in the colon longer than 3 days will become dry, which can lead to pebble-like stools or the stool becomes too large and hard to be passed out.
Assoc Prof Dr Raja Affendi Raja Ali, a Consultant Physician and Gastroenterologist at Hospital Canselor Tuanku Muhriz, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) explained that constipation can be caused by many reasons, most notably the foods that we eat or don't eat or eat less of (i.e. foods that are high in fibre). "Other causes of constipation may include having a certain medical condition such as irritable bowel syndrome or IBS, hypothyroidism, certain medications such as antidepressants, antacids, pain killers such as opiates, iron supplements and high levels of calcium in the blood."
Other possible causes of constipation includes pregnancy, lack of exercise, lack of drinking water or dehydration, having a stroke, old age, narrowing of the bowel such as in Crohn's disease, diverticular disease, long standing diabetes which affect the nerves, depression, problems with the nerves and muscles of the digestive system and resisting the urge to have a bowel movement. Chronic constipation can also be a symptom of colon cancer!
Constipation; A Prelude to More Serious Problems
Though considered a normal occurrence in most people, prolonged and frequent constipation may expose you to problems. For example, constipation might lead to or increase the risk of more serious complications such as bleeding haemorrhoids and urologic disorders such as urinary retention in elderly patients. Moreover, chronic pushing and hard stools increase the risk of damaging your colonic tissue. Chronic constipation can also lead to tearing of the anus (anal fissure).
Furthermore, the volume of stool held inside the colon during constipation can stretch the colon, irritate the lining of the colon, and produce toxins (and it can make patients with liver cirrhosis becoming seriously ill very quickly) as it waits to be expelled from the body.
Research has also found links between chronic constipation and colorectal cancer, diverticulitis (severe infection or inflammation of bulging sacs found in the lining of the large intestine), and ischemic colitis (inflammation of the large intestine as a result of insufficient blood supply).
Probiotics for Constipation Relief
Research into a viable treatment to relieve constipation has uncovered the potential of consuming probiotics. Probiotics are essentially live microorganisms that, when consumed in adequate amounts, can have beneficial effects to the person consuming it.
Many types of different bacteria have been tested and experimented on but one study conducted at our very own Pusat Perubatan Univerisiti Kebangsaan Malaysia (PPUKM) by Assoc Prof Dr Raja Affendi Raja Ali, who is also the Chief Researcher of the study, explained that the ongoing research focused on two particular strains of probiotics which are Lactobacillus acidophilus and Lactobacillus casei. Researchers sourced the bacteria from a popular cultured milk drink and so far many subjects (targets for 180 subjects) have been tested over a period of time. The objective was to determine whether consuming the cultured milk drink would help alleviate the symptoms of constipation, in both IBS sufferers and healthy adult subjects.
The results of this landmark Malaysian study revealed that drinking 3 bottles of cultured milk drink per day for 30 consecutive days could indeed help shorten the ITT of IBS patients and that of healthy subjects. Symptom of constipation improved, patient's stool samples were found to be of softer consistency and patients reported reduced pain and discomfort during defecation.
Assoc Prof Dr Raja Affendi Raja Ali also added that research also showed that both L. acidophilus and L. casei positively influenced the immune response in certain subjects. Other research elsewhere in the world has also confirmed that certain bacterial species are able to strengthen our immune system by helping the body keep harmful invaders out and assist or influence the production of certain immune cells.
More to Learn from Probiotics
It is evident that the bacteria in our gut play an essential role in the digestion of our food, the motility of intestines, and ultimately the development of constipation. As research continues, more information will emerge regarding the benefits of probiotics and how it can be used as an alternative for treating or preventing symptoms of digestive tract disorders such as constipation.