Constipation is often misunderstood and sometimes dismissed as a minor concern. As a senior consultant surgeon specialising in colorectal and pelvic floor disorders, I’d like to share some insights into constipation that may differ from common perceptions. Let’s explore some widespread assumptions and discuss why proper medical attention can be crucial.

Common assumption: constipation is a minor annoyance

While occasional constipation may not be cause for alarm, persistent constipation can be a sign of underlying health issues. If left untreated, it may lead to complications such as haemorrhoids, anal fissures, or, in rare cases, bowel obstruction. It’s important to understand that constipation isn’t just about infrequent bowel movements; it can also manifest as:

• Hard stools that are difficult to pass

• The need to strain excessively

• Requiring manual manoeuvres to pass stool

• A sense of incomplete bowel movement

• Excessive time spent on the toilet

These symptoms can significantly affect your daily life and overall well-being, which is why it’s important to take them seriously.

Common assumption: over-the-counter remedies are the only treatment options

A broader perspective shows that although lifestyle changes and over-the-counter remedies are often effective and usually the first line of treatment, medical professionals have additional options for managing persistent constipation:

• Prescription medications: these include osmotic laxatives, stimulant laxatives, and newer drugs that increase intestinal motility or affect bile acid absorption.

• Biofeedback therapy: this technique helps retrain the muscles involved in defecation, which can be particularly useful for pelvic floor dysfunction.

• Advanced diagnostic tests: these include transit studies to assess how quickly food moves through your digestive system, and defecation studies to evaluate pelvic floor muscle function and rectal emptying.

• Surgical interventions: in rare and severe cases, procedures like mesh rectopexy may be considered for structural issues contributing to constipation.

Understanding the causes

Constipation can result from various factors, including:

• Slow transit constipation

• Obstructed defecation (often due to pelvic floor dysfunction)

• Medications

• Medical conditions (e.g., hypothyroidism, diabetes)

• Lifestyle factors (poor diet, lack of physical activity)

Understanding the underlying cause is crucial for effective management, which is why a thorough evaluation by a specialist is so valuable.

Management strategies: a personalised approach

Effectively managing constipation often requires a multi-faceted, personalised approach:

• Lifestyle modifications: including dietary changes, increased hydration, regular exercise, and improved toilet habits.

• Medications and supplements: from bulking agents to prescription drugs, there are numerous options available under medical supervision.

• Advanced treatments: for severe cases, biofeedback therapy or surgical interventions may be considered.

The importance of seeking medical attention

Don't wait until constipation becomes debilitating to seek help. Early intervention can prevent complications and improve your quality of life. A specialist can:

• Accurately diagnose the underlying cause of your constipation

• Provide a personalised treatment plan

• Monitor your progress and adjust treatments as needed

• Address any related health concerns

Looking to the future

Ongoing research in areas such as microbiome modulation, neuromodulation techniques, and personalised medicine offers hope for even more effective and tailored constipation treatments in the future.

Conclusion

Constipation is a condition that deserves proper medical attention. Don’t let embarrassment or misconceptions prevent you from seeking help. As a specialist in colorectal and pelvic floor disorders, I’ve seen firsthand how proper management can transform patients’ lives. Whether through dietary adjustments, medication, or more advanced treatments, there’s a solution out there for you.

Remember, your digestive health is an integral part of your overall well-being. By taking proactive steps to manage constipation, you’re investing in your health and happiness. If you’re experiencing persistent constipation, don’t hesitate to reach out to a colorectal specialist who can guide you through the process of reclaiming your digestive health.