Functional constipation

What is functional constipation?

A gastrointestinal condition that predominantly affects the large bowel of the colon. It is characterised as an irregular bowel habit or problem with bowel motions that occurs for no apparent structural or organic reason. It's a chronic issue, which indicates the problem has been present for at least 6 months. Young children and older persons are more likely to be affected.
As opposed to occasional constipation, everyone may experience it when they change their lifestyle. Travelling, eating specific foods, and taking certain drugs are just a few examples. When you return to your regular schedule, it will go away.

Symptoms

Pain in the abdomen
Bloating
Feeling like you need to have a bowel movement but can't
Feeling like you haven't entirely emptied your bowels
Push (strain) very hard in an attempt to pass stools
Small, hard lumps of stool
Feeling of blockage in the intestine
Using fingers to help passing stools
Less than 3 bowel movements per week

If you suffer night-time constipation, severe stomach discomfort, fatigue, bloody stools, weight loss, or a sudden onset of symptoms, you should seek immediate medical attention.

Causes

Functional constipation can be caused by a variety of factors. These include:

Nerve and muscular disturbances in the rectum that prevent bowel motions from exiting your body. Defecation dysfunction is defined as the occurrence of disorganised muscular contractions in your pelvic floor to excrete stool out of your body.
Nerve and muscular problems in the lower intestine that control feeling. This might result in a sluggish digestive tract, often known as slow transit constipation.
Concerns with the brain-digestive system communication: The gut-brain interaction is disturbed, resulting in irritable bowel syndrome with constipation.

How is functional constipation diagnosed?

There are no specific tests for functional constipation. When no other reason for the symptoms can be established, functional constipation is diagnosed by a process of elimination of other medical conditions. Your doctor may ask you questions related to your bowel movement, therefore keeping a record of your bowel movement would be helpful. Your doctor may also undertake some routine blood and stool tests to rule out other possibilities.

Before a diagnosis of functional constipation can be made, a set of criteria based on Rome IV must be met:

Fewer than three natural bowel movements per week.
Pushing or straining during defecation attempts.
Lumpy or hard stools
During defecation efforts, there is a feeling of blockage

Why is treatment important?

It's critical to recognise that FC is not to be overlooked. Functional constipation does not go away on its own in the vast majority of situations. The longer faeces sit in the colon, the more difficult it is to evacuate from the body; therefore FC symptoms typically make the issue worse.
Constipation that goes untreated can expand the colon to the point that it takes months or years to go back to normal.

How can functional constipation be treated?

To treat functional constipation, it's crucial to first figure out what's causing your symptoms and triggers. There are three elements to which we may go further:
i) Diet: The way we eat, what we consume, and when we eat all have a significant impact on our bowel movements. It is important to eat regular, well- balanced, moderately sized meals. Regular, well-balanced, modestly sized meals are essential. Drinking plenty of water and eating high-fibre meals including fruits, vegetables, and whole-grain breads are recommended. To avoid gas and bloating, gradually increase your fibre intake.

ii) Psychological: Functional constipation is not a psychological disorder, but negative thinking has been found to interfere with gut-brain communication. When you feel anxious, the gut receives a signal from the brain that the body is in danger. As a result, symptoms of functional gastrointestinal diseases may get worse.

Regular exercise and sufficient rest can help reduce stress and alleviate symptoms.
Good quality of sleep should not be ignored.
You may seek help from healthcare workers who will be able to provide treatments such as cognitive behavioural therapy, hypnotherapy techniques, and relaxation breathing techniques.
In certain cases, functional constipation happens when the rectum and anus muscles do not coordinate effectively together. If this is the case, a physiotherapist may be able to help you with biofeedback therapy. It trains you to contract one set of muscles while relaxing the others.

iii) Medications: There are medications that can assist reinstate the bowel contracting mechanism, however adults and children treatment plans may differ. As a result, it's critical to discuss your options with your doctor.
Fibre supplements, commonly known as laxatives, can help with bowel movement. Osmotic laxatives and stimulant laxatives are the two main forms of laxatives. Osmotic laxatives draw water into the bowel to soften the stool while stimulant laxatives stimulate the nerves in your digestive system to get your bowel moving.
Probiotics may also help alleviate some of the symptoms. It enriches your digestive tract with beneficial bacteria. However, there is no evidence that probiotics can aid with functional constipation.

Takeaway message from My Gut Brain Centre

Functional constipation is a prevalent and important issue. You're not alone in your struggle with the symptoms. It may take some time to find the best treatment, but it is critical to be patient along the progress to avoid further issues. Regular visits to your doctor can help in the development of a strategy that is close to perfect.