Brief Answer:
Details of long term solution are incorporated. Be patient, it will take time.

Detailed Answer:

Hi,

Initially, I would say that you should have a practical approach as there is no magical formula. Things will take time but they will help in the long term.

A drastic change in lifestyle is required to cure constipation. Not exercising enough, not drinking enough water and delaying a bowel movement can worsen constipation symptoms. The most important factor in curing constipation is a natural and simple diet. This should consist of unrefined food such as whole grain cereals, bran, honey and lentils; green leafy vegetables, like spinach, beans, lettuce, celery, asparagus, carrot.

Adding some fat to meals or increasing the size of a meal such as breakfast can help create the urge to defecate. Individuals suffering from constipation should increase the amount of plant foods they consume to get more fiber in their diet. Constipation can be treated by changing diets.

Secondly, human gastrointestinal tract is colonized by 1013-14 bacteria of 400 different species and subspecies. They are responsible for proper digestion of food. Depletion of this flora due to surgery can lead to severe constipation and digestive problems.

Intestinal flora are types of microorganisms known as probiotics that live normally as part of the intestinal tract. These organisms have several functions that help the body. The most plentiful and important bacteria in the small intestine is the Lactobacillus species. Lactobacillus helps ferment indigestible carbohydrates. It also helps to stimulate the digestive process and aid the absorption of nutrients, as well as increase the motility of the gastrointestinal tract. I would suggest her to start taking probiotics regularly. Probiotics are live bacteria and yeasts that are good for digestion. As her gut flora will improve, her constipation would be relieved and well formed stools will pass.

Apart from this other recommendations are:-

-Linseed: is extremely useful in difficult cases of constipation. One teaspoon of linseed with warm water should be taken at night for bulk and lubrication.

-Proper chewing: The diet alone is not enough. Food should be properly chewed-each morsel for at least 20 times.

-Taking a short walk is a good way to get some light exercise. Walking time should be gradually increased until it reaches 20 minutes.

-She should drink at least eight glasses of water daily. Water helps push the food through the intestines and also helps lubricate intestinal tissues. When the body is dehydrated, the intestines absorb the fluids from the food waste, which in turn leads to hardened stools

- Avoiding alcohol and caffeine is also important as these substances contribute to dehydration.

-Use fish oil and castor oil-Fish oil is believed to encourage healthy digestion and castor oil produces a laxative effect when ingested

-Fruits and vegetables: which contain high amounts of fiber, aid in alleviating symptoms of constipation,Whole-grain bread, bran, oatmeal, beans and lentils can also relieve the problem so use it Instead of highly processed rice, eat brown rice, millet or bulgur.

-Eat 2 cups of fruit 3 cups of vegetables and about 35 grams of fiber per day
* fruits: Generally all fruits, except banana and jack fruit, are beneficial in the treatment of constipation.
* Pears are beneficial in the treatment of constipation.
* Guava fruit when eaten with seeds, gives roughage to the diet and helps in the normal evacuation of the bowels.
* Grapes: have also proved highly beneficial in overcoming constipation. The grapes have the cellulose; natural sugar and organic acid make them a natural laxative fruit. Not only they clean the bowel, but also tones up the stomach and intestines to relieve the chronic constipation

All these things will increase the bulk of your stool, they will soften it and will clear your ileum of the compacted fecal material.

-While sitting on the toilet, support the feet on a small stool in order to achieve a normal position that aids in bowel movement.

Don't stop laxative, initially start following all this advice, then gradually taper the doses of laxatives she is on.

-Take Fybogel husk - Fybogel sachets and Fybogel Hi-Fiber sachets both contain the active ingredient ispaghula husk, which is a type of medicine called a bulk-forming laxative. Ispaghula is a type of fiber. It swells when it comes into contact with fluid in the gut and thus increases the volume of the feces. It increases the bulk in your stool, an effect that helps to cause movement of the intestines. It also works by increasing the amount of water in the stool, making the stool softer and easier to pass. Psyllium, one type of bulk-forming laxative.

Overactive adrenals can precipitate the problem, but most likely it is not her case.

Initially follow the above mentioned advice for 1 month, if not relieved, an MRI of the abdomen can be done along with serum cortisol levels to see if adrenals are normal or not.

Don't panic, be hopeful and keep the patient motivated.

I hope I have answered your query. Good luck.

Regards,
Dr. Ramesh Kumar
Gastroenterologist

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