Constipation: Tips for Healthy Bowel Movements - Gastroenterology and Hepatology

My intestines feel strange..?

Due to my constipation issues, I visited a traditional Chinese medicine doctor before the Lunar New Year this year.
The doctor told me that my intestinal function was very weak, which likely refers to poor gastrointestinal motility.
He advised me to eat smaller, more frequent meals and to increase my intake of fruits and vegetables.
He also prescribed me medication.
Since I already enjoy eating fruits and vegetables, and after taking the medication for a month, my constipation improved.
I also developed a habit of having a bowel movement at a fixed time every day without needing medication.

However, I tend to have a large appetite and often unintentionally consume excessive amounts of food, which can lead to constipation for two to three days.
Usually, I would return to normal afterward.
Recently, during Mother's Day celebrations, I overindulged again and started experiencing constipation.
This time, however, it did not return to normal.
Although I have a bowel movement every two to three days, the stools are hard and dark, resembling rabbit droppings, regardless of how many vegetables I eat.

I decided to see the traditional Chinese medicine doctor again.
After taking the prescribed medication, I had several bowel movements, and my abdomen became flatter, but I still felt like there was more to expel.
I didn't want to rely on traditional medicine anymore, so I stopped taking the medication, and my constipation returned.
I began to wonder if the medication had disrupted my intestinal motility.
How can I restore normal bowel movements?
Even though I now have bowel movements daily or every other day, the stools remain hard and dry.
I drink plenty of water every day and make sure to eat high-fiber foods like fruits and vegetables, but why is this still happening? I also control my portion sizes to avoid overeating.
What can I do to return my stools to a normal consistency? Additionally, why do my calves swell whenever I experience constipation? When I was having regular bowel movements, my calves felt much lighter.
Does irregular bowel movement affect circulation in the lower body?
My questions are lengthy, but they are causing me significant distress, so I kindly ask the doctor to answer them thoroughly.
Thank you!

MIMI, 10~19 year old female. Ask Date: 2006/06/13

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello,
(1) There are many causes of constipation, including dietary habits (abnormal intake of fluids and fiber).
Additionally, there are structural issues in the intestines (such as diverticula, tumors, intussusception, hemorrhoids, and anal fissures) and functional problems of the intestines.
Furthermore, some non-intestinal causes, such as medications, psychiatric disorders, endocrine diseases, and neuromuscular disorders, can also lead to constipation.

(2) Certain medications can affect intestinal motility.

(3) For the treatment of constipation, non-pharmacological approaches are recommended, such as maintaining adequate fluid and fiber intake, keeping a positive mood, engaging in moderate exercise, and practicing bowel training.
It is suggested to attempt bowel movements 15 to 36 minutes after breakfast, utilizing the gastrocolic reflex to aid in defecation.

(4) If constipation persists, it is important to investigate for any underlying diseases that may be causing it or to seek pharmacological assistance.

Sincerely, Dr.
Lin Ming-Hui, Internal Medicine.

Reply Date: 2006/06/13

More Info

Constipation is a common issue that can significantly affect one's quality of life. It seems that you have been experiencing a cycle of constipation and relief, which can be frustrating. Let's break down your concerns and provide some strategies for improving your bowel health.

Understanding Constipation
Constipation is generally defined as having fewer than three bowel movements per week, or experiencing hard, dry stools that are difficult to pass. It can be caused by a variety of factors, including inadequate fiber intake, insufficient fluid consumption, lack of physical activity, and even certain medications. In your case, it appears that your bowel function may be affected by dietary habits and possibly the medications you've taken.

Dietary Recommendations
1. Increase Fiber Intake: While you mentioned that you consume a lot of fruits and vegetables, it’s essential to ensure that you are getting a variety of fiber types. Aim for both soluble fiber (found in oats, beans, and fruits) and insoluble fiber (found in whole grains and vegetables). A daily intake of 25-30 grams of fiber is generally recommended for adults.

2. Hydration: Drinking plenty of water is crucial for softening stool. Aim for at least 8-10 cups of water daily, and consider increasing this amount if you are consuming high-fiber foods, as fiber absorbs water.

3. Regular Meal Patterns: Eating smaller, more frequent meals can help stimulate bowel movements. This approach can also prevent overeating, which you noted can lead to constipation.

4. Limit Processed Foods: Foods high in fat and sugar can contribute to constipation. Try to minimize processed foods and focus on whole, nutrient-dense options.

Lifestyle Modifications
1. Physical Activity: Regular exercise can promote bowel motility. 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 a regular time each day for bowel movements, ideally after meals when the gastrocolic reflex is strongest. This can help train your body to have more regular bowel movements.

3. Avoid Straining: When you feel the urge to go, don’t delay. Straining can lead to hemorrhoids and worsen constipation. If you find it difficult to pass stool, consider using a footstool to elevate your feet while sitting on the toilet, which can help align the rectum for easier passage.

Medical Considerations
1. Medication Use: If you have been using laxatives or herbal remedies, it’s important to understand that over-reliance on these can sometimes lead to decreased bowel function. If you feel that your bowel movements have worsened after stopping medication, it may be worth discussing this with a healthcare provider to explore other options.

2. Consult a Specialist: If your constipation persists despite making these changes, consider consulting a gastroenterologist. They can evaluate for any underlying conditions that may be contributing to your symptoms, such as irritable bowel syndrome (IBS) or other gastrointestinal disorders.

Addressing Swelling in the Legs
You mentioned experiencing swelling in your calves when you have constipation. This could be related to fluid retention or changes in circulation due to prolonged sitting or straining during bowel movements. When bowel movements are regular, the body may be better able to manage fluid balance and circulation. If this swelling continues or worsens, it would be advisable to consult a healthcare provider for further evaluation.

Conclusion
Improving bowel health often requires a multifaceted approach that includes dietary changes, lifestyle modifications, and possibly medical intervention. By focusing on a balanced diet rich in fiber, staying hydrated, maintaining regular physical activity, and establishing a routine for bowel movements, you can work towards achieving more regular and comfortable bowel habits. If issues persist, do not hesitate to seek professional medical advice to rule out any underlying conditions. Remember, taking care of your digestive health is crucial for overall well-being.

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