In recent years, with the continuous improvement of living standards and increasingly refined foods, the incidence of constipation has been on the rise. According to epidemiological surveys, the prevalence rate of chronic constipation among adults in China is 4% to 6%, increasing with age; this rate reaches 22% in those over 60 years old, and up to 80% in bedridden or immobile elderly individuals with long-term illness. Some people may not consider occasional difficulty in bowel movements to be a serious issue and pay little attention to it, while others may suffer from chronic constipation but avoid medical consultation, opting instead to self-medicate. In fact, these behaviors are not advisable. What kind of constipation requires treatment? What are the potential harms behind constipation? Let's take a closer look.
Manifestations of Chronic Constipation
What are the manifestations of chronic constipation? Let's conduct a self-check for constipation to see if you have any of the following symptoms:
① Reduced bowel movements, fewer than three times per week; ② Hard stools that resemble sheep droppings; ③ Difficulty passing stool, where the stool is not necessarily hard but passage is strenuous, requiring significant effort like squeezing toothpaste, and sometimes manual assistance is needed; ④ Prolonged time spent in the bathroom, where immediate defecation does not occur upon entering the restroom, but rather takes several minutes or even longer; ⑤ A sense of incomplete evacuation, where after defecation, there remains a sensation of needing to go again, but no further stool is passed.
If you experience two or more of these symptoms continuously for over six months, you may be suffering from chronic constipation.
Causes of Chronic Constipation
Constipation is a symptom of various conditions and can be divided into organic and functional categories. Functional constipation is more common and may be related to poor dietary habits, prolonged sitting or bed rest, and irregular bowel movement habits. Lifestyle adjustments can often improve this condition. Organic constipation refers to constipation caused by structural changes or use of certain medications, such as diabetes, intestinal tumors, thyroid dysfunction, etc., which require prompt medical attention to treat the underlying disease.
The Many Hazards of Long-Term Constipation
(1) Who Should Pay Special Attention to Constipation?
Patients with cardiovascular diseases: If stools are hard and dry, straining during bowel movements can cause an increase in heart rate and blood pressure, potentially increasing the risk of acute cardiovascular events, such as cerebral hemorrhage, myocardial infarction, and cerebral infarction, which can be fatal in severe cases.
Patients with liver cirrhosis: If they experience constipation, straining during bowel movements can suddenly increase abdominal pressure, causing portal hypertension, leading to rupture of dilated esophageal-gastric varices and resulting in massive hematemesis and hematochezia, which can be life-threatening. Additionally, if stools remain in the intestines for extended periods, excessive toxins can be absorbed into the body, triggering hepatic encephalopathy, one of the primary causes of death in patients with liver cirrhosis.
Therefore, patients with cardiovascular diseases and liver cirrhosis should promptly address constipation to maintain regular bowel movements and prevent the above-mentioned complications.
(2) Does Long-Term Constipation Lead to Colorectal Cancer?
Long-term constipation does not necessarily lead to colorectal cancer, but it may increase the risk. When stools remain in the intestines for extended periods, harmful substances are repeatedly absorbed, stimulating the epithelial cells of the intestinal mucosa and potentially leading to dysplasia, which increases the risk of colorectal cancer.
(3) When Should You Be Alert?
If constipation persists for more than three months or if any of the following warning signs appear, immediate attention is necessary: sudden change in bowel habits, alternating episodes of constipation and diarrhea, change in stool consistency (e.g., pencil-thin stools), blood in stools, black tarry stools, positive fecal occult blood test, anemia, weight loss, abdominal pain, palpable abdominal masses, history of colorectal polyps, or a family history of colorectal cancer. Patients with these symptoms should seek medical attention promptly to rule out organic lesions.
(4) Is There a Link Between Hemorrhoids and Constipation?
Patients with long-term constipation may develop varying degrees of perianal diseases, such as hemorrhoids and anal fissures, causing bloody stools, anal pain, and perianal inflammation due to prolonged defecation times.
Constipation can also cause abdominal distension, nausea, and decreased appetite. Some patients may experience irritability, insomnia, anxiety, irritability, fatigue, and lethargy, which can affect work, study, and daily life.
(5) Can Laxatives Relieve Constipation?
Occasional constipation is relatively normal, and most people can improve through lifestyle adjustments. However, if constipation persists for a longer duration and lifestyle changes alone are ineffective, medication may be required. Some individuals may self-treat with drugs such as senna leaves or enemas, which can temporarily alleviate constipation symptoms but can lead to dependency with prolonged use. As the condition progresses, the dose-effect relationship of these drugs becomes inverted, eventually losing their effectiveness.
The pharmacological treatment of constipation should balance safety and efficacy. Due to significant individual differences, particularly in older adults who often have multiple comorbidities and concurrent medications, medication use should always be under a doctor's guidance, and self-medication should be avoided.
Traditional Chinese Medicine External Therapies for Constipation Relief
(1) Auricular Massage
The inner surface of the ear contains the auricular concha, which includes acupoints corresponding to the duodenum, small intestine, appendix, and large intestine. This area reflects information about the abdomen. In patients with constipation, the skin in this region may have small lumps or unevenness. Massaging this area can help regulate digestive system function, promote intestinal motility, and facilitate bowel movements.
To perform the massage, use the pads of your fingers to gently rub the auricular concha on both ears, moving from back to front. Apply gentle and slow pressure, continuing for approximately 3 to 4 minutes until the ear feels slightly warm. Perform this massage once or twice daily.
(2) Abdominal Massage
Abdominal massage can help relieve constipation and is simple to perform. Lie down on your back, place your hands on top of each other, and position the palm root over the right lower abdomen with slight pressure. Slowly massage the lower abdomen clockwise around the navel. Perform this massage once or twice daily, making 50 to 100 circles each time. Regular practice can effectively prevent and improve constipation.
Daily Management Strategies
(1) Proper Diet
Eat more whole grains, fruits, and foods rich in dietary fiber (such as celery and bamboo shoots), and less strongly stimulating, high-fat, and high-protein foods. Avoid spicy and aromatic foods, such as chili peppers, mutton, and five-spice blends.
(2) Adequate Hydration
Drink at least 1.5 to 2 liters of water daily. Drinking 1 to 2 glasses of lukewarm salt water or plain water first thing in the morning can stimulate gastrointestinal motility effectively. Consuming honey and yogurt in moderation can also help relieve constipation. Limit consumption of strong tea and coffee.
(3) Establish Good Bowel Habits
Develop a routine of daily bowel movements. The most active bowel activity occurs in the morning and within two hours after meals. Try to defecate during these times to establish a regular bowel pattern. Do not ignore the urge to go, as frequently delaying bowel movements can weaken the defecation reflex, leading to constipation. Focus solely on defecation while in the bathroom, avoiding distractions such as reading, watching TV, or using your phone.
(4) Moderate Exercise
Moderate exercise can promote intestinal motility and aid in bowel movements. Activities such as cycling, walking, jogging, practicing Tai Chi, doing Baduanjin, swimming, etc., can be beneficial. Choose exercises suitable for your physical condition.