Constipation: Causes, Symptoms, and Solutions

Constipation issues?

Hello Dr.
Ke, I apologize for bothering you.
I have never had issues with constipation before, but since mid-May, although I feel the urge to have a bowel movement every day, it takes a long time to sit on the toilet.
The stools that come out are like rabbit pellets.
In terms of diet, I have been following the 211 plate method and eating fruits like bananas, apples, and guavas.
Previously, I used to eat whatever I wanted, including fried foods, sweets, and snacks, but I have eliminated those now.
I drink about 2000 ml of water daily and exercise five times a week, yet I still spend a long time in the bathroom and have to strain to pass stools, although there is no bleeding and no pain in the anal area.
I would like to ask what might be the problem.
Thank you.

Miss Yan, 10~19 year old female. Ask Date: 2021/07/04

Dr. Ke Fangxu reply Surgery

Young, underweight women often experience stubborn constipation.
Patients in this category usually find that increasing their intake of dietary fiber is effective.
If their daily dietary intake is insufficient, they can ask their physician to prescribe fiber supplements.
Additionally, taking a mild laxative can also be helpful.

Reply Date: 2021/07/04

More Info

Constipation is a common gastrointestinal issue that can significantly affect one's quality of life. It is characterized by infrequent bowel movements, difficulty passing stools, or the sensation of incomplete evacuation. Understanding the causes, symptoms, and potential solutions for constipation is crucial for effective management.

Causes of Constipation
1. Dietary Factors: A diet low in fiber is one of the most common causes of constipation. While you mentioned following a 2-1-1 plate method and consuming fruits like bananas, apples, and guavas, it’s essential to ensure that your overall fiber intake is adequate. The recommended daily fiber intake is about 25 grams for women and 38 grams for men. If your diet lacks whole grains, vegetables, and legumes, it may still be insufficient.

2. Dehydration: Although you reported drinking 2000 ml of water daily, it’s important to consider the overall hydration status. Factors such as caffeine intake, which can have a diuretic effect, or excessive sweating during exercise can lead to dehydration, exacerbating constipation.

3. Physical Activity: Regular exercise is beneficial for digestive health. You mentioned exercising five times a week, which is excellent. However, the type and intensity of exercise can also play a role. Activities that promote abdominal muscle engagement, such as walking, jogging, or yoga, can help stimulate bowel movements.

4. Medications: Certain medications, including opioids, antacids containing aluminum, and some antidepressants, can lead to constipation. If you are taking any medications, it may be worthwhile to review them with your healthcare provider.

5. Psychological Factors: Stress and anxiety can affect bowel habits. If you have been experiencing increased stress, it could contribute to your symptoms.

6. Underlying Health Conditions: Conditions such as hypothyroidism, diabetes, or irritable bowel syndrome (IBS) can also lead to constipation. If your symptoms persist, it may be beneficial to consult a healthcare professional for further evaluation.

Symptoms of Constipation
The symptoms you described, such as the need to spend a long time in the bathroom and producing hard, pellet-like stools (often referred to as "sheep droppings"), are classic signs of constipation. Other symptoms may include:
- Abdominal discomfort or bloating
- A feeling of fullness or pressure in the abdomen
- Straining during bowel movements
- A sensation of incomplete evacuation after a bowel movement

Solutions for Constipation
1. Increase Fiber Intake: Aim to incorporate more high-fiber foods into your diet. Foods such as whole grains, beans, lentils, fruits, and vegetables can help soften stools and promote regular bowel movements.

2. Stay Hydrated: Continue to drink plenty of water, and consider increasing your intake if you consume high-fiber foods, as fiber absorbs water and can help form softer stools.

3. Regular Exercise: Maintain your exercise routine, and consider adding activities that specifically target the abdominal area. Even simple activities like walking can stimulate bowel function.

4. Establish a Routine: Try to set a regular time each day for bowel movements, ideally after meals when the digestive system is most active. This can help train your body to have more regular bowel movements.

5. Consider Probiotics: Probiotics can help balance gut bacteria and may improve bowel regularity. Foods like yogurt, kefir, and fermented vegetables are good sources.

6. Consult a Healthcare Provider: If your symptoms persist despite these lifestyle changes, it’s important to consult a healthcare professional. They can help identify any underlying issues and may recommend treatments such as laxatives or other medications.

In conclusion, while constipation can be frustrating, understanding its causes and implementing lifestyle changes can often lead to improvement. If the problem continues, seeking professional advice is essential to rule out any serious conditions and to receive tailored treatment.

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