Change in bowel habits and disorders are highly prevalent in today’s society. It may occur differently and with varying intensity in people of different ages.
Its etiology is varied, but dietary habits, environmental factors, anxiety episodes, lifestyle, etc., are factors that influence its appearance and evolution.
The most frequent symptoms of change in bowel habits are diarrhea and constipation. Normal clinical studies allow a diagnosis to be made and the appropriate treatment to be established.
When you poop and the amount of stool expelled are as individual aspects as defecation frequency, some people defecate once a day, regularly.
Others defecate 3 to 4 times per week. The patterns individuals usually follow greatly depend on early education and how your organism got used to it.
Most people develop bowel habits after breakfast when gastrocolic and duodenocolic reflexes produce mass movements within the large intestine.
The quantity of stool will depend on the amount of food eaten, particularly on the diet’s volume and drinks.
Constipation refers to the passage of small, dry, hard stools or the absence of stools for a certain time. It is important to define constipation concerning a person’s regular elimination pattern.
Causes of constipation:
- Irregular change in bowel habits
- Laxative abuse
- Increased psychological stress
- Improper diet
- Insufficient exercise
- Disease processes
Tips to combat constipation:
- Try to designate a specific time of the day for going to the bathroom
- Drink plenty of healthy fluids, at least 2 lts water daily
- Eat more fiber (bran)
- Increase physical exercise
Types of constipation
Constipation can be classified by its etiology into:
- Constipation of organic origin: secondary to a pathological process whether digestive or not
- Functional constipation: is linked to an unbalanced diet, poor fiber, residues, or a low intake of fluids. Constipation linked to irritable bowel syndrome is also considered functional. It is caused by a mixture of factors such as stress, anxiety, emotional disorders, and certain eating disorders
- Iatrogenic constipation: is caused by the chronic or eventual ingestion of certain drugs, like antibiotics
Depending on its duration and intensity, constipation is classified into 2 types:
- Acute or simple: it appears occasionally, its duration should not exceed three months, and it’s of a mild nature. It occurs in situations of changing habits such as travel, medication for illness, etc.
- Chronic: its duration exceeds three months and affects the quality of life of the patient. It is usually related to incorrect hygienic and dietetic habits, consumption of certain drugs, and/or with some specific disease that causes it
Establishing a diagnosis of constipation should evaluate multiple factors such as family history for possible risks of colon neoplasms, type of diet for possible low fluid intake, lifestyle, drug intake, previous bowel rhythm, etc.
In general, the diagnosis should consider 3 factors:
- Psychological assessment– Constipation can be caused by an anxiety disorder, depression, eating disorders, etc.
- Physical examination– It must be complete to look for signs that point to a systemic or abdominal cause. Anorectal manometry includes a detailed visual examination of the rectal area at rest, as well as a rectal examination to assess the competence of the anal sphincter
- Complementary explorations– Necessary in case of complications. It’s vital to perform a blood test and detection of hidden blood in the stool
Fecalomas can be defined as a big mass or collection of hardened or cement-like stool in the rectum’s folds. Fecalomas result from prolonged retention and accumulation of fecal material.
Signs and symptoms:
- Continuous liquid excretion from the rectum
- Rectal pain and abdominal cramps
- “Uncomfortable” desire to defecate
- Abdominal distention
- Hard, palpable mass in the lower abdomen
- Prolonged periods without defecating
Fecalomas are recognized by the passage of filtered stool fluid (diarrhea) and abnormal stools. The liquid portion of the stool leaks out and around the stool mass.
Fecalomas can be assessed by digital rectal examination, during which the hardened mass can often be felt.
The causes of fecalomas are usually due to a negative change in bowel habits and constipation. Certain medications can also contribute to the formation of fecalomas and the barium meal used for certain radiological tests.
In older adults, a combination of factors contributes to fecalomas: poor fluid intake, insufficient mass in the diet, lack of activity, and weakened muscle tone.
Theoretically, fecalomas can be prevented; however, sometimes therapeutic measures are necessary to remove the fecaloma, such as digital extraction.
Laxatives promote bowel movements by facilitating the passage of stool through the digestive tract.
They can act through one or more of the following mechanisms:
- Softening the stool
- Increasing the stool volume
- Lubricating the stool
- Stimulating peristalsis
Occasionally, geriatric patients may need laxatives to compensate for their abdominal and rectal muscles’ flaccidity, which slows down the expulsion of the stool.
Difficulty in maintaining proper muscle control is favored by the lack of physical activity, typical of the elderly.
Laxatives should be used only when other alternatives, such as increasing fluid and fiber intake, have proven ineffective.
Likewise, laxatives should be prescribed by your physician. It is advised never to provide laxatives to a patient with unrated abdominal pain.
Types of Laxatives
They stimulate evacuation by increasing stool volume. These are the least risky laxatives because they act slowly and gently compared to others.
They soften the feces by allowing water to enter the fecal mass. They’re suitable for patients who must avoid excessive straining when defecating, such as those affected by hemorrhoids or myocardial infarction.
These are heavy mineral oils and glycerin suppositories, which soften the stool and decrease the friction between the stool and intestinal wall. They’re also suitable for patients who must avoid straining during defecation.
Just like milk of magnesia. They produce an increase in the volume of water in the intestine, which raises stool volume and stimulates peristalsis and evacuation. Usually has a rapid action, around 3 hours after administration.
Much like the senna plant and cascara sagrada (rhamnus purshiana), they often cause cramping and expulsion of semi-solid stool within 6-8 hours of administration. They’re inadvisable because of their irritating power on the intestinal mucosa.
They soften the stools, stimulate peristalsis, mitigate flatulence and abdominal distension, and induce immediate defecation.
There are currently commercial preparations that are sold in pharmacies. Their content is 250-300 ml. and they have a lubricated cannula.
It should be administered slowly and with the least amount of liquid possible to achieve a smooth evacuation.
The person should be placed in the left lateral position, with the right leg completely bent.
Administer the enema slowly, pause for 30 seconds if the patient complains of fullness or pain, and then resume the flow again at a slower speed.
After all the product has been instilled or when the patient cannot resist any longer and wants to defecate, remove the rectal cannula from the area.
Apply firm pressure to the anus with tissue to clean it and encourage the patient to hold the enema for 5 to 10 minutes.
Actions may vary depending on the factors that contribute to diarrhea and its severity. When there is an excessive loss of fluids, they should be replaced with oral electrolyte solutions.
Potassium losses can be large, and therefore, intake of fluids and foods containing potassium (banana, raw tomato) should be encouraged. Excessively hot or cold liquids should be avoided because they stimulate peristalsis.
To protect the anal region, it should be cleaned with soft tissue and dried properly. Protective creams such as Vaseline or zinc oxide can also be used in the perianal area to prevent excoriation. Diarrhea is prevalent with the change in bowel habits.
Incontinence refers to the loss of voluntary ability to control fecal and gaseous discharges through the anal sphincter. Incontinence can occur at specific times, such as after meals or irregularly.
Fecal incontinence is associated with impaired sphincter function, spinal cord trauma, or tumors.
- Many incontinent patients can be helped to regain bowel control with a planned bowel retraining program by establishing a regular schedule
- Meticulous skincare to reduce the risk of bedsores and excoriations is recommended
- Washing of the perianal area with warm water and soap when necessary and after scrupulous drying, application of zinc oxide ointments
- Prevent constipation and the formation of faecalomas by adopting a fiber-rich diet
- Unless it is contraindicated, make sure you drink 1,000 to 1,500 ml of liquids a day. (and at least 2 lts of water daily)
- Increase your physical activity level as much as possible
- Review your medications and consult with your doctor if any of them are the cause
- Consider the use of disposable diapers
Change in bowel habits: The importance of colon cleansing
Performing a good colon cleanse is beneficial in many ways; we all know that. However, it would be best if you took certain precautions to avoid unnecessary risks.
The main benefits of colon cleanse are:
- Energy increase: when the body is overloaded with cholesterol, toxins, or other intestinal waste, it can make us feel: tired with lack of energy or even depressed
- Optimizes nutrient absorption: if there is an excess of waste, the colon will not properly absorb the nutrients. Foods that can reduce the intestinal flora’s sensitivity are cheese, refined flours, fried foods, strong spices, and processed foods
- Contributes to weight loss: foods low in fiber remain in the intestine much longer. Thus, when performing a natural colon cleansing, this accumulation is eliminated, helping to lose weight
- Improves bad breath: by eliminating fermentation, constipation, excess stagnant waste, and parasites, bad odors from the body will also be eliminated
After doing so, you should rebalance the intestinal bacteria, as most of them will have been eliminated by cleansing the colon.
Natural remedies for colon cleansing
Boil a piece of fresh ginger in water. This way you will get the juice extract out of it.
Next, heat two cups of water and add a tablespoon of that “ginger juice” with a quarter of a cup of lemon juice. Make separate portions and drink it in two or three shots throughout the day.
Squeeze a lemon, add a pinch of sea salt and a little honey. Mix it all in a glass of warm water and drink it every morning before breakfast.
Cut a large leaf of aloe vera and squeeze out its juice. Add the juice of two lemons in half a liter of filtered water. Drink this preparation three times a day for 2 or 3 days.
With the help of a blender, prepare apple juice and drink it throughout the day. Half an hour after drinking it, take a glass of water; it will serve as a laxative.
Do this for three days, but during this time, you should avoid solid foods.
This is no different from making any other infusion. It’s better to consume it before and after breakfast to improve digestion.
Mix two spoonfuls of apple cider vinegar and two spoonfuls of honey in a cup of water. Mix well and drink it once a day.
Foods to cleanse the colon
Health changes and aging, along with a lack of colon cleansing, can interfere with your digestive tract.
Therefore, you must include these foods in your diet for optimal intestinal cleansing:
- Apple: apart from apple juice, as we’ve explained in the previous section, apples promote colon cleansing whether they are whole, in the form of vinegar, juice, or compote. This is due to the pectin present in this fruit, a substance that helps eliminate all the toxins from the colon while favoring the intestinal lining. Apples are also rich in fiber, so it helps to relieve the digestive tract from possible obstructions
- Fruit and vegetable juice: must be natural and processed in a blender. If you drink a glass regularly you will keep your colon clean. The enzymes and salts present in these juices will keep the colon toxin-free
- Avocado: eating avocados every day is one of the best ways to optimize digestion. It contains both soluble and insoluble fibers that promote bowel movements and help cleanse the colon. They also reduce the chances of suffering from colon cancer in the future
- Garlic: usually helps with most digestive problems and is also a superfood for colon cleansing. Garlic isn’t good only for colon cleansing, but also for other organs in our body such as the heart
- Spinach: all green leafy vegetables, and the more intense the color the better, offer great benefits to the body
Try to include some prebiotics in your meals: yams and other tubers, potatoes, ginger, leeks, fibrous fruits and vegetables, legumes, and beans.
And now that you know the importance of colon cleanse every few months, you are ready to enjoy its many benefits. Like making the change in bowel habits more “friendly.” Plus, it will make your entire body feel much better, not just your belly.