Dealing with Constipation: Tips for Gastrointestinal Health

Bowel movement issues

I'm sorry, doctor.
Currently, I can only sit while using the toilet, but since mid-June, I have been experiencing difficulty with bowel movements.
I visited a colorectal surgeon who prescribed a laxative for me, but after taking it last night before bed, there was no improvement.
Today, my stool feels a bit hard and has an unpleasant odor.
I went to the emergency room at Yadong Hospital, where they took X-rays and examined my anus, but there were no significant issues found.
I would like to ask what I should do, as this is affecting my ability to sit comfortably while urinating.

Shu Wei, 20~29 year old female. Ask Date: 2023/08/13

Dr. Lin Minghui reply Gastroenterology and Hepatology

Constipation requires identifying the underlying causes, such as excessive intake of greasy foods, insufficient hydration and fiber intake, hard stools, and difficulty in bowel movements.
Inadequate physical activity can affect intestinal motility.
Dysregulation of the autonomic nervous system in the brain or intestines can lead to irregular bowel movements.
Certain medications and medical conditions can also cause constipation.
Abnormal rectal function, such as rectal prolapse, tumors, or issues with anal tissue, warrants follow-up and treatment by a colorectal specialist.
For those who experience difficulty urinating while sitting, it is advisable to consult a urologist to rule out other issues.
It is generally recommended to increase fiber intake, along with drinking plenty of water, engaging in moderate exercise, and establishing a regular bowel habit (preferably after breakfast or during stress-free times).
Wishing you good health!

Reply Date: 2023/08/13

More Info

Dealing with constipation can be a frustrating and uncomfortable experience, especially when it begins to affect your daily activities and overall well-being. Based on your description, it seems you are experiencing hard stools, which can be accompanied by a foul odor, and you have already sought medical attention without significant improvement. Here are some strategies and tips that may help you manage your constipation and improve your gastrointestinal health.

Understanding Constipation
Constipation is generally defined as having fewer than three bowel movements per week, and it can be characterized by hard, dry stools that are difficult to pass. It can result from various factors, including diet, hydration, physical activity, and underlying medical conditions. In your case, since you have already consulted with a healthcare provider and undergone imaging studies, it is essential to focus on lifestyle and dietary changes that can promote regular bowel movements.

Dietary Recommendations
1. Increase Fiber Intake: A diet high in fiber can help soften stools and promote regularity. Aim for a variety of fiber sources, including:
- Fruits (e.g., apples, pears, berries)
- Vegetables (e.g., broccoli, carrots, leafy greens)
- Whole grains (e.g., oats, brown rice, whole wheat bread)
- Legumes (e.g., beans, lentils, chickpeas)
Gradually increase your fiber intake to avoid gas and bloating, and ensure you are drinking plenty of water.

2. Stay Hydrated: Adequate hydration is crucial for preventing constipation. Aim to drink at least 8-10 cups of water daily. If you are active or live in a hot climate, you may need more. Herbal teas and clear broths can also contribute to your fluid intake.

3. Limit Processed Foods: Foods that are low in fiber, such as processed snacks, fast food, and sugary treats, can exacerbate constipation. Try to minimize these foods in your diet.

4. Consider Probiotics: Probiotics can help balance gut bacteria and may improve bowel regularity. You can find probiotics in yogurt, kefir, sauerkraut, and other fermented foods, or consider a probiotic supplement after consulting with your healthcare provider.

Lifestyle Modifications
1. Regular Physical Activity: Engaging in regular exercise can stimulate bowel function. Aim for at least 30 minutes of moderate exercise most days of the week. Activities like walking, jogging, or yoga can be beneficial.

2. Establish a Routine: Try to set aside time each day for bowel movements, especially after meals when the gastrocolic reflex is strongest. This can help train your body to have regular bowel movements.

3. Listen to Your Body: When you feel the urge to have a bowel movement, do not delay. Responding promptly can help prevent stool from becoming harder and more difficult to pass.

Medical Considerations
Since you mentioned that you have already been prescribed a laxative (便通樂), it is essential to use it as directed and not to rely on it long-term without consulting your healthcare provider. Overuse of laxatives can lead to dependency and worsen constipation over time.

If your symptoms persist despite these changes, or if you experience severe pain, bleeding, or other concerning symptoms, it is crucial to follow up with your healthcare provider. They may consider additional evaluations to rule out any underlying conditions, such as bowel obstruction or other gastrointestinal disorders.

Conclusion
In summary, managing constipation involves a combination of dietary changes, hydration, physical activity, and establishing a routine. By incorporating these strategies, you may find relief from your symptoms and improve your overall gastrointestinal health. If you continue to experience difficulties, do not hesitate to seek further medical advice. Your health is paramount, and there are many resources available to help you navigate this issue effectively.

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