Regulated digestion
At least one in three and possibly even one in two adults suffers from constipation from time to time or persistently. For some people this condition is no more than a minor annoyance, but in others it assumes a highly disagreeable form with abdominal pain, sensations of fullness and general unwellness. That can be put right, and without too much difficulty. However, it is essential that you should know the causes of this disorder so that you can modify your lifestyle accordingly. It's also a good thing to know that there are medicines which can make it easier for you to make a smooth changeover to a well functioning bowel. There are, of course, other medicines which certainly have a strong laxative action but in the long term are more likely to make your condition worse. Our aim is to help you to restore your bowel to health and hence to recover your general well-being.
Digestion - what's really going on there?
The processes of digestion begin in the mouth, where the food is chewed and mixed with saliva. After you swallow each mouthful it passes down the gullet into the stomach, where the gastric juice continues the process of digestion. It is then transported onwards into the small intestine. That is where the most important digestive processes take place, because it is there that nutrients are absorbed and passed into the bloodstream. The indigestible residues then continue their journey into the large intestine, where water and salts are extracted from the liquid material and it becomes semisolid. After some fifteen hours the bowel contents pass into the rectum, where their arrival stimulates the urge to open the bowels.
There are many causes of constipation
Constipation is quite correctly described as a typical "disease of civilisation", as the causes of this deviation from normal health are to be found mainly in the mode of living adopted in modern times. Lack of exercise undoubtedly plays a major role. Many people spend most of their lives sitting down: in their car, at their desk, in front of the television. This unnatural way of living makes the bowel lazy as well. Other factors that cause digestive problems are the stress and hectic pace of modern living, which often cause people to suppress the urge to open the bowels. As a result the intestine becomes accustomed to functioning irregularly. Worse still, because of their prolonged stay in the intestine, its contents become unduly condensed; the outcome is a hard, solid stool which may even be painful to pass.
An incorrect diet is another important cause of constipation. Many people have become accustomed to a refined diet; though rich in nutrients it provides too little in the way of roughage or residue. These indigestible components of the diet are nevertheless important, because only when the bowel is sufficiently filled will it be stimulated to continue the onward transport of its semiliquid contents.
In elderly people weakness of the abdominal muscles is a frequent cause of constipation. And there is another reason why elderly people are frequently affected: when fluid intake is inadequate the motions are likely to become hard. This leads to difficulty or delay in opening the bowels.It is unfortunately true that elderly people tend to drink too little fluid.
Last of all, pregnancy is all too often accompanied by digestive disorders. Many different factors are involved, for example hormonal changes.
Self help: do the right things and forget the nonsense!
Because constipation so often has several causes, a measure directed against only one of them is unlikely to be successful. But there are lots of things that you can do not only to get rid of your constipation but indeed to feel better all round.
It seems nonsense - eat more.
Of course "more" certainly does not mean that you should eat (still) more high calorie foodstuffs such as sugar, alcohol, cakes and pastries made from highly refined flour. On the contrary, you should increase your consumption of foodstuffs which contain more roughage. This term refers to the indigestible components of the diet, chiefly vegetable fibres. These materials help to fill up the bowel, and this filling is absolutely necessary for regular bowel motions. Furthermore, they provide nutrition for the bacteria of the intestine, which are essential for complete utilisation of your food. Medical research has proved the importance of roughage or vegetable fibre. It has protective effects against many diseases such as appendicitis, intestinal polyps, gallstones and bowel cancer. In addition, a generous intake of roughage tends to normalise the uptake of fat into the blood and even the blood sugar concentration. Insufficient intake of these "unusable" components of the diet, if continued over many years, can be directly responsible for diseases such as calcification of the arteries (arteriosclerosis) or narrowing of the blood vessels of the heart (coronary heart disease), though these might seem to have nothing to do with bowel function. Vegetable fibre or roughage is found principally in fruits, potatoes and vegetables, pulses such as beans and peas, and wholemeal bread.
Drink more - but without calories and percents!
The most suitable drinks for increasing your fluid intake are mineral water, tea or coffee. A daily intake of at least 1 1/2 litres of fluid is essential if the intestinal contents are to remain soft.
Exercise makes the bowel get a move on, too.
There are some special techniques for promoting bowel activity. For example, intestinal massage often proves helpful. This can be done by lying flat and massaging the abdominal wall below the navel for about five minutes, first on the right side from below upwards and then on the left side from above downwards. Targeted training of the abdominal muscles by gymnastic exercises will also contribute to better bowel function. General physical exercise is of great importance. We should all walk or run for at least 15 minutes every day. This will help to stir up a sluggish bowel.
We are all creatures of habit ...
... and there are certain useful habits which can go a long way towards restoring properly regulated bowel function and which can be adopted without too much trouble. For example, a glass of water or fruit juice can be a useful device for persuading the bowels to move. And there is another such reflex which you can use: make a regular habit of visiting the lavatory at a fixed time every day - preferably in the early morning of course - even though you have no urgent "call". In conjunction with other measures, a regular visit will in time become more and more successful. Of course this doesn't mean that you must disregard a call to empty the bowels if it occurs at some other time of day. In any case, you cannot expect your bowel to function as regularly as clockwork, because it depends partly on your diet. For example, the time required for digestion varies from 1 - 2 hours for light meals (e.g. boiled fish) to 9 hours (e.g. for peas or beans).
Hints for the "smallest room"
It might be a good idea to try the effect of giving up the practice of reading or listening to the radio while visiting the lavatory, because these distractions often tend to discourage bowel activity. Especially for patients with weak abdominal muscles, putting the feet on a footrest may be useful. This is astonishingly effective in persuading the bowels to move.
For and against laxatives
A dose of laxative might seem the easiest way of solving the problem of constipation. And yet we are always hearing dramatic stories of the dangers of laxative medicines. As so often, the truth lies somewhere in the middle. First of all, it is in principle unwise to take any medicine regularly and for long periods without asking your doctor or pharmacist for advice. Laxative medicines, especially those with a drastic action, do really have their dangers. One of these is that the bowel may become accustomed to the powerful stimulation "from outside" and will practically cease to function on its own accord. Another danger is the loss of minerals from the body, most importantly potassium. If bowel transit is speeded up by laxatives, the uptake of potassium from the food may be seriously reduced. However, as the proper functioning of our muscles - including the intestinal muscles - is dependent upon potassium intake, the bowel may become "self-paralysed": constipation can be made even worse. Caution is also necessary during pregnancy, when constipation is particularly common. It is important to consult your doctor before starting to take laxatives. In many cases it is advisable to employ laxatives of plant origin having a gentle action which supports the natural activity of the bowel. On the following pages we shall introduce one of these to you.