Constipation and IBD edited
What is Constipation and IBD
Constipation is where a person can’t empty their bowels as often or as easily as they would like. Constipation can be associated with abdominal pain and bloating. Some people with constipation have a feeling of not having completely passed stool after defecation.
Constipation can be due to a variety of causes, including certain drugs and medications, metabolic disorders, neurological disorders, inflammation within the bowel, and bowel cancer.
Most people with these symptoms do not have bowel cancer, but is important to have further assessment to rule this out.
Diagnosis will involve having a detailed history taken and physical examination. To help identify a cause, your healthcare provider may recommend you undergo a colonoscopy.
Treatment of constipation depends on the cause, but could include –
- Improving your toilet routine. You should go to the toilet to defecate when the urge is there. Postponing having a bowel motion when the urge is there may lead to worsening constipation by stretching the bowel.
- Try making it easier to defecate by resting your feet on a low stool while going to the toilet. If possible, raise your knees above your hips to get the best position.
- More exercise can improve your bowel movements significantly.
- Having a healthy diet with adequate fibre and fluid intake is very helpful to soften stool. The recommended fibre intake in Adults is 25 to 30g daily, equivalent to two slices of wholemeal bread. Fibre supplements can be used in those unable to increase fibre intake from dietary changes. Excess fibre intake however may cause abdominal discomfort, bloating and flatulence, and can even aggravate the problem.
- It’s important to restrict the intake of diuretic drinks such as coffee, tea and alcohol.
- There are many laxative products available, ranging from bulking agents (including fibre supplements), stool softeners and lubricants, as well as bowel stimulants. It is important to follow the instructions given by your healthcare provider on their use, as over use of some of these agents can lead to problems and unwanted side effects.
You should seek medical attention to make sure there is no underlying cause for the constipation. It is important not to over-treat constipation with laxatives in place of seeking medical advice.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) is an autoimmune condition that causes inflammation within the gastrointestinal tract. Common symptoms can include cramping abdominal pain and diarrhoea, sometimes mixed with blood, mucous and pus. Other symptoms may include fatigue, weight loss, anaemia and mouth ulcers, among many others.
About 1 in 1000 Australians will be diagnosed with inflammatory bowel disease in their lifetime.
Crohn’s disease and Ulcerative colitis are the two main forms of inflammatory bowel disease.
Ulcerative colitis is a condition where inflammation and ulceration occurs mainly in the inner lining of the colon and rectum (the large bowel). Ulcers and inflammation in the bowel lining can result in diarrhoea and passage of blood and mucous.
Crohn’s disease can affect any part of the gut (from the mouth to the anus), but is most likely to develop in the last part of the small intestine, or the colon. Areas of inflammation are often patchy, with sections of normal gut in between.
Inflammatory bowel disease is a chronic condition that is ongoing and lifelong, although people may have periods of good health and good disease control, known as remission, as well as relapses or flares in disease when symptoms are more active.
The exact cause of Inflammatory Bowel Disease remains unclear, but a combination of complex factors including genetics, environmental triggers and microbiotic factors likely set off inflammation in the gut. About 1 in 5 people with inflammatory bowel disease have a family member with the condition.
Inflammatory bowel disease is diagnosed using a combination of endoscopy, colonoscopy and imaging (CT scans, MRI). Blood and stool tests are useful in looking for signs of inflammations within the gut as well as infections.
There is no cure for inflammatory bowel disease, but drugs, and sometimes surgery, can give long periods of relief from symptoms.
Depending on the severity of the condition, regular review with a healthcare provider is very important to check how well the disease is being managed by medications, try and prevent complications of IBD, and address the impact that the disease may have on day to day activities, overall health and wellbeing.
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