Constipation: Causes and Long-term Solutions for Relief

Constipation

I would like to ask about my bowel movements.
I often experience difficulty with stool getting stuck in my lower abdomen, and I can only pass it with the use of a suppository, even though my stool is not hard.
I am unsure whether this is a problem of reduced gastrointestinal motility or an abnormal defecation reflex.
Additionally, I have experienced nerve damage due to a ruptured arteriovenous malformation.
However, I had issues with bowel movements even before this condition arose, and doctors have consistently told me that my gastrointestinal motility is too slow, prescribing laxatives.
Am I going to have to rely on laxatives or suppositories for the rest of my life?

Xiao Rou Zong, 20~29 year old female. Ask Date: 2019/10/26

Dr. Chen Shidian reply Gastroenterology and Hepatology

If the rectal/colonic examination is normal, it may indicate insufficient bowel power or poor coordination.
Laxatives or specialized assistance for training bowel coordination can be utilized.

Reply Date: 2019/10/26

More Info

Constipation is a common gastrointestinal issue that can significantly affect one's quality of life. It is characterized by infrequent bowel movements or difficulty passing stools, which can lead to discomfort and distress. In your case, it seems that you are experiencing a combination of symptoms that may be related to both gastrointestinal motility issues and possibly neurological factors due to your history of vascular malformation and nerve damage.

Causes of Constipation
1. Gastrointestinal Motility Disorders: The slow movement of food through the digestive tract can lead to constipation. This is often referred to as slow transit constipation, where the colon takes longer than normal to move stool through the digestive system.

2. Neurological Conditions: Given your history of vascular malformation and nerve damage, it is possible that your constipation is exacerbated by neurological factors. Nerve damage can affect the signals that coordinate bowel movements, leading to difficulties in the reflexes necessary for defecation.

3. Dietary Factors: A diet low in fiber can contribute to constipation. Fiber helps to bulk up the stool and promotes regular bowel movements. Insufficient fluid intake can also lead to harder stools, making them more difficult to pass.

4. Medications: Certain medications, especially those that affect the nervous system or gastrointestinal motility, can lead to constipation as a side effect. If you are taking medications for your vascular condition or any other health issues, it is worth discussing with your healthcare provider.

5. Lifestyle Factors: Sedentary behavior, lack of physical activity, and stress can also contribute to constipation. Regular exercise can stimulate bowel function and improve overall digestive health.

Long-term Solutions for Relief
1. Dietary Modifications: Increasing your intake of dietary fiber can be beneficial. Foods such as fruits, vegetables, whole grains, and legumes are excellent sources of fiber. Aim for at least 25-30 grams of fiber per day. Additionally, ensure you are drinking plenty of fluids, as hydration is crucial for softening stool.

2. Regular Exercise: Engaging in regular physical activity can help stimulate bowel movements. Even simple activities like walking can be effective in promoting gastrointestinal motility.

3. Scheduled Bathroom Time: Establishing a routine for bowel movements can help train your body. Try to set aside time each day, preferably after meals, to sit on the toilet and allow your body to relax and facilitate a bowel movement.

4. Medications: While laxatives and suppositories can provide temporary relief, relying on them long-term is not ideal. Discuss with your healthcare provider about the possibility of using medications that promote bowel motility or other treatments that may be more suitable for your condition.

5. Biofeedback Therapy: If your constipation is related to a dysfunction in the pelvic floor muscles or the reflexes involved in defecation, biofeedback therapy may be beneficial. This therapy helps you learn how to control the muscles involved in bowel movements.

6. Consult a Specialist: Given your complex medical history, it may be helpful to consult a gastroenterologist or a specialist in pelvic floor disorders. They can provide a more comprehensive evaluation and tailor a treatment plan specific to your needs.

7. Consider Psychological Factors: Sometimes, psychological factors such as anxiety or stress can contribute to constipation. If you feel that this may be a factor for you, consider speaking with a mental health professional.

Conclusion
Constipation can be a multifaceted issue, especially in the context of underlying medical conditions. While it may seem daunting to manage, there are various strategies and treatments available that can help improve your symptoms and overall quality of life. It is essential to work closely with your healthcare provider to develop a personalized plan that addresses both the gastrointestinal and neurological aspects of your condition. Regular follow-ups and open communication about your symptoms and treatment efficacy will be key in finding a long-term solution.

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