Constipation results from the accumulation of faeces in the large
intestine. The longer they remain, the more water is extracted and the
harder they become. This accumulation may be caused by a reduction in the
rhythmic bowel contractions that normally push food through the system or by
a bowel obstruction. It may be associated with pregnancy, an under active
thyroid gland, irritable bowel syndrome and depression, as well as the use
of painkillers and a diet that is low in fiber. In children, it may be
caused by emotional disorders. The elderly are more prone to constipation
because they tend to eat smaller quantities of less bulky foods, and
exercise less.

Symptoms of constipation include pain on defecation and a feeling that the
bowel has not been completely emptied. Persistent constipation in older
people may indicate a growth in the large bowel, especially if this is
accompanied by pain and bleeding. In the case of children, it may be due to
a congenital malformation of the bowel. Sudden constipation together with
pain and distension of the abdomen indicates an obstruction in the bowel and
requires emergency treatment.

All constipation benefits from an increased intake of fiber and fluids.
Laxatives may also provide occasional relief although they should not be
used regularly. There are three types:

   - Stimulants, which affect the muscular movements of the bowel and
   spend up the passage of the faeces. These may lead to cramps.
   - Fluid retainers, which draw water back into the faeces.
   - Suppositories stimulate the bowel quickly, while enemas will wash
   out the contents of the bowel.

In 1990, the Journal of the American Medical Association reported on a man
who on his doctor's advice ate a bowl of bran every morning to relieve
constipation. Ten days later he had to undergo major surgery for the removal
of a clump of bran that had completely blocked his gut. The man had been
taking diuretics, and not drinking enough fluids. This unusual episode
highlights the dangers of eating too much bran, the importance of having an
adequate fluid intake.

*Dietary measures*
 In most cases, constipation is largely a result of eating a diet that
includes a lot of refined and processed foods and relatively small amounts
of fiber and water.

   - Make changes in your diet and include a high fiber diet gradually so
   that your digestive system and your taste buds have time to adapt. Fiber is
   an important component of a healthy diet because it adds bulk to the stools
   and accelerates the progress of waste material through the digestive system.
   You may suffer from wind initially if your body is not used to fiber.
   - Gradually increase consumption of fruit, vegetables and salads. You
   can then move on to introduce complex carbohydrates, such as whole meal
   bread/grain/brown rice instead of white pasta, rice, potatoes, lentils,
   pulses and whole meal cereals including oats. As you get used to such a way
   of eating, try to base all your meals around such high fiber foods.
   - Rather than treating meat and breads as the main component of your
   meal with an odd vegetable as an accompaniment. Reverse this habit.
   - Fiber absorbs a lot of water as it passes through your system, so
   make it a point of drinking more fluid than you normally would.
   - Pure water, coconut water, herbal teas, juices, fruits are healthier
   choices than tea, coffee, colas and alcohol.
   - Try some traditional remedies to combat constipation by adding figs,
   mangoes, papaya, brown rice, guavas, grapes, bananas (avoid the over ripe
   ones), carrots, beet root and prunes/dried prunes. They really do work but
   remember to treat them as a part of a varied balanced diet rather than as
   the occasional 'instant fix' when your constipation is troubling you.
   - Constipation leads to piles, hemorrhoids and many other ailments.
   Hence, it should not be treated lightly.
   - It is important to include at least 30 minutes of cardiovascular
   exercises and pranayama to help combat constipation.

Just incorporate these simple measures and you will not face the problem of
constipation again.


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