How can constipation be treated?

How can constipation be treated?

Simple measures, such as increasing fluid and fibre intake, may be sufficient. Fibre helps digestion by increasing the amount of water in the bowel content. One gram of fibre will increase the motion weight by 5grams because of the additional water that is retained. The lubrication within the bowel is improved and the peristalsis of the bowel is more effective in moving the contents along. There are two types of fibre: Soluble fibre is broken down in the large bowel whereas insoluble fibre is passed out in the stools. Soluble fibre is found in figs, apricots, tomatoes, oats, barely and rye. Insoluble fibre is found in wheat, rice, pasta, lettuce, spinach, peas, lentils, strawberries and rhubarb. Cereals, particularly bran, are rich in fibre. Soluble fibre has an important role in the stomach and upper intestine. It slows down digestion and absorption allowing the body to deal with nutrients at a relatively steady rate. Insoluble fibre is more important in the large bowel as it bulks up the stool and assists with excretion.

If a healthy diet does not overcome constipation problems, laxatives may be considered. There are laxatives that increase the bulk of the stool, soften the stool or stimulate the bowel action. Bowel stimulants may increase IBS pain. With time, laxatives may become less effective so that stronger agents may be required. It is, therefore, recommended that they be used only when necessary and that every effort to control the bowel by dietary means be explored. Bulking agents may relieve constipation. Fibre supplements such as a tablespoon of natural bran two or three times a day may be ade quate. Ispaghula (Fybogel Reckitt and Colman; Regulan Procter and Gamble) are fibre supplements; one or two sachets in water each day is the usual dosage. Lactulose (Duphalac - Solvay) 2 or 3 teaspoonfuls once or twice daily is an osmotic laxative, which increases the fluid in the stool; this is a relatively gentle first choice agent. Bulking agents may relieve symptoms when there is either diarrhoea or constipation. It takes a while for these to help establish a normal bowel pattern so you should not give up too quickly.

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