Constipation: Causes, Prevention, and Treatment

Introduction

• Common sayings about constipation being exaggerated (e.g., "20 pounds of toxic poop").
• Focus on extreme cases vs. common experiences with constipation.
• Discussion on prevention, home remedies, lifestyle changes, and medical interventions.
• Cases where people try dangerous DIY methods to relieve constipation.

Transit Time

• Definition: The time it takes for stool to move from the beginning of the large intestine to the end.
• Importance: Stool absorbs water as it passes through, becoming more solid. Too much water absorption can lead to hard-to-pass stools.
• The rectum stretching sends a signal to the brain to trigger the need for a bowel movement.
• Holding stools can lead to further water absorption and harder stools.

Fluid Intake

• More fluid intake = softer stools that are easier to pass.
• Encouraged to maintain consistent bowel habits and not hold stools.

Fiber Intake

• Benefits: Increases stool bulk and helps stimulate contractions in the intestinal wall, improving transit time.
• Bulky, fibrous stools are softer and easier to pass because they retain more water.
• Recommended Intake: 20-35 grams per day.
• Gradual increase advised to avoid bloating, gas, and discomfort.
• Fiber also stimulates growth of gut flora, which can improve stool bulk and transit time. Prebiotics and probiotics can aid as well.

Exercise

• Improves gut motility and frequency of contractions in the gut wall, helping stool pass more quickly.

Medications That Cause Constipation

• Common types: Antihistamines, antidepressants, iron supplements, opiates, and opioids.
• Note: Opioids paired with laxatives to prevent constipation.

Fecal Impaction and Disimpaction

• Definition: Stool becomes so hard and built up that it can't pass.
• Procedure: Manual removal using a gloved, lubricated finger in a scissor motion, followed by a mineral oil enema.
• Importance of avoiding this situation by using lifestyle changes and proper medication adjustments.

Types of Laxatives

1. Bulk-forming: (e.g., Metamucil) Increase bulk and water content in stool.
2. Surfactants/Stool Softeners: (e.g., Docusate sodium) Soften the stool.
3. Osmotic Laxatives: (e.g., Miralax) Draw water into the large intestine.
4. Stimulatory Laxatives: (e.g., Dulcolax) Stimulate intestinal contractions.
5. Suppositories: Manual insertion to soften and lubricate stool.

DIY Methods Warning

• Extreme Case: Individual tried using a nail for disimpaction - highly discouraged. Use safer methods like suppositories.

Extreme Case: Hirschsprung's Disease

• Case Study: 22-year-old male with lifelong constipation due to Hirschsprung's disease.
• Surgery: Removed 76 cm of colon weighing 28.6 pounds.
• Disease: Lack of nerve cells in the intestinal wall causes severe constipation.

Conclusion

• Actions to take for preventing and treating constipation.
• Encouraging healthier bowel habits and avoiding dangerous DIY methods.
• Information on dietary supplements for gut health.