Understanding Constipation: Causes and Types

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Questions and Answers

A bowel movement frequency of less than three times a week is the sole indicator of constipation, regardless of stool consistency or ease of passage.

False (B)

Constipation arises primarily from the slowing down of digestion and food transportation throughout the entire digestive system.

False (B)

The frequency of bowel movements is considered a more accurate measure of constipation than the difficulty experienced during bowel movements.

False (B)

Temporary constipation experienced during travel is primarily due to changes in the types of food consumed and has little to do with the disruption of the gut's usual routine.

<p>False (B)</p>
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Experiencing constipation occasionally while traveling indicates a severe, long-term digestive issue that needs immediate medical attention.

<p>False (B)</p>
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The nerves in the gut are unaffected by travel and maintain their regular function regardless of changes in diet, hydration, and schedule.

<p>False (B)</p>
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Increasing water intake and maintaining a consistent diet are insignificant factors in preventing constipation while traveling.

<p>False (B)</p>
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Experiencing a satisfying feeling of emptiness after a bowel movement is a typical symptom associated with severe constipation.

<p>False (B)</p>
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If constipation arises abruptly or persists for an unusually short duration, consulting a doctor is unnecessary.

<p>False (B)</p>
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The primary goal of using laxatives is to alleviate pain, not necessarily to facilitate bowel movements.

<p>False (B)</p>
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Osmosis describes the process where water moves from an area of lower solute concentration to one of higher solute concentration until equilibrium is achieved.

<p>True (A)</p>
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Soaking lettuce in pure alcohol will crisp it up due to the osmotic pressure.

<p>False (B)</p>
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Osmotic laxatives function by decreasing the amount of water in the large intestine, resulting in a more comfortable bowel movement.

<p>False (B)</p>
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Diarrhea indicates that an insufficient amount of osmotic laxatives have been ingested.

<p>False (B)</p>
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Jetlag can negatively impact the nerves in the gut, leading to digestive issues during travel.

<p>True (A)</p>
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Suppressing the urge to use the toilet while traveling has no effect on bowel function.

<p>False (B)</p>
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Sodium sulfate is a gentle salt that can be taken regularly without affecting the body's electrolyte balance.

<p>False (B)</p>
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Lactulose helps retain water in the large intestine and inhibits the growth of beneficial gut flora.

<p>False (B)</p>
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The 'not my toilet' syndrome primarily affects individuals who are comfortable using public restrooms without any hesitation.

<p>False (B)</p>
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Lactulose is diminished when milk is heated to high temperatures, therefore raw milk contains more lactulose than pasteurized milk.

<p>False (B)</p>
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Psyllium seed husks and plums are beneficial for constipation because they solely contain fiber, which stimulates the gut wall.

<p>False (B)</p>
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Consuming a high amount of dietary fiber guarantees immediate relief from constipation, regardless of fluid intake.

<p>False (B)</p>
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Sorbitol is a non-milk laxative sugar that is poorly absorbed by the body and is often used as a sweetening agent and can be found on food labels as E420.

<p>True (A)</p>
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Insoluble fiber is generally more gentle on the digestive system than water-soluble fiber.

<p>False (B)</p>
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PEG-150 chains are preferred in laxatives due to their ability to affect the gut wall.

<p>False (B)</p>
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PEG-150 is used in skin creams for its moisturizing effects, similar to its potential effect on the gut.

<p>True (A)</p>
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Even if a person drinks sufficient fluids daily, drinking more during air travel will further improve bowel function.

<p>False (B)</p>
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Laxatives with longer molecular chains (e.g. PG-3350) are safe for long term usage.

<p>True (A)</p>
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Air travel can cause dehydration, which can lead to harder stools and constipation.

<p>True (A)</p>
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Consistently suppressing the urge to go to the toilet does not affect the nerves and muscles involved in bowel movements.

<p>False (B)</p>
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Using osmotic laxatives increases, by sheer mass, the motivation for the gut to move.

<p>True (A)</p>
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Osmotic laxatives work solely by increasing moisture content in the feces, without affecting gut motility otherwise.

<p>False (B)</p>
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Waiting a week to overcome a fear of communal toilets will not affect bowel habits.

<p>False (B)</p>
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Probiotics and prebiotics are not useful for restoring balance to a tired gut.

<p>False (B)</p>
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Engaging in mild exercise, such as a leisurely stroll, is usually enough to significantly improve gut movement and alleviate constipation.

<p>False (B)</p>
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Increasing fiber intake without increasing fluid intake will help soften the stool.

<p>False (B)</p>
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If one usually has a bowel movement in the mornings, it is best to suppress this urge while traveling.

<p>False (B)</p>
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The rocking squat technique is a proven, universally effective method for relieving constipation.

<p>False (B)</p>
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Flashcards

Constipation

Infrequent bowel movements (less than 3 times a week) and/or hard stool that's difficult to pass.

Cause of Constipation

A disconnect between gut nerves and muscles, leading to difficulty in expelling waste.

Best Assessment Parameter for Constipation

The difficulty of passing stool, not just the frequency of bowel movements.

Temporary Constipation

Constipation caused by changes in routine, diet, and environment during travel.

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Gut's Creature of Habit

The gut's sensitivity to regular eating times, food types, hydration, and daily routines.

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Travel's Effect on Gut

Changes in diet, timing, hydration, and activity levels disrupt the gut's normal function.

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Dehydration and Constipation.

Drinking too little water leads to dehydration which can lead to constipation.

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Stress and Constipation

Stress impacts digestion and bowel regularity, as the gut-brain connection is strong.

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Laxatives

Substances used to stimulate bowel movements and relieve constipation.

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Perfect Little Pile

The goal of using laxatives: to produce well-formed stool.

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Osmosis

The diffusion of water from an area of low solute concentration to an area of high solute concentration, until equilibrium is reached.

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Osmotic Laxatives

Laxatives that work by drawing water into the large intestine to soften stool.

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Lactulose

A common laxative sugar that draws water into the large intestine and feeds gut flora.

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Lactulose Side Effects

Side effects of lactulose due to bacterial fermentation in the gut.

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Sorbitol

A sugar alcohol found naturally in some fruits, used as a sweetener and osmotic laxative.

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PEG Laxatives

Polyethylene Glycol; osmotic laxatives that are well-tolerated and don't disrupt electrolyte balance or cause wind.

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PEG Chain Length

Numerical value indicating the molecular weight of PEG chains; higher numbers are less absorbable.

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Peristaltic Reflex

Refers to the involuntary contractions of muscles in the digestive tract that move food and waste.

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Electrolyte Balance

A balance of electrolytes in the body, which can be disrupted by certain salts.

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Pasteurization

Process of heating milk to kill harmful bacteria.

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UHT Milk

Ultra-high temperature processed milk.

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Constipation Medical Consultation

A reason why you must see a doctor if symptoms come on suddenly.

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Travel Constipation Causes

Travel constipation can be triggered by the gut's nerves getting confused due to changes in routine and suppression of the urge to go.

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How Fiber Helps Constipation

Dietary fiber stimulates the gut wall, promoting bowel movement by adding bulk and drawing in fluids.

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Fiber-Rich Foods for Constipation

Psyllium seed husks and plums contain both fiber and agents that draw extra fluids into the gut, aiding bowel movement.

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Types of Fiber

Insoluble fiber stimulates movement, while soluble fiber softens gut contents; fruits often have insoluble fiber in the skin and soluble in the flesh.

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Importance of Fluids with Fiber

If you don't consume enough fluids, fiber will bind together in solid lumps.

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Air Travel and Dehydration

Air travel can cause dehydration due to the dry air in the plane, leading to constipation.

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Dangers of Ignoring the Urge

Suppressing the urge to go can train the gut to operate in reverse, leading to constipation.

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Probiotics and Prebiotics

Living, beneficial bacteria (probiotics) and their food (prebiotics) can revitalize a tired gut.

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Exercise and Constipation

A sudden decrease in exercise can slow down the gut, but extra movement may not help if you already get enough exercise; strenuous exercise is needed for a measurable effect.

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Rocking Squat Technique

Bending your upper body forward as far as possible toward your thighs, then straightening up while on the toilet.

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Daily dose of fiber

One ounce (30 grams) is the commonly accepted daily amount of dietary fiber.

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Hydration During Travel

When traveling to maintain normal levels of liquids (since travel dehydrates easily).

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Training the System

If digested food pushes back repetitively, even a couple times may train your system.

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Feces Fluid Extraction

As feces stay in the gut longer, the more extraction happens turning product harder.

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Study Notes

  • Constipation affects 10-20% of people in the United States.
  • Diagnostic criteria include fewer than three bowel movements per week, hard stool a quarter of the time, difficulty passing stool without aid, and a lack of complete emptying.

Causes and Types of Constipation

  • Constipation arises from miscommunication between the gut's nerves and muscles.
  • Digestion speed is often normal until the final part of the large intestine.
  • The difficulty of bowel movements, not frequency, determines constipation.
  • Temporary constipation can be triggered by travel, illness, or stress.
  • Travel constipation affects almost half of travelers, especially in the early days of a trip.
  • The gut's sensitivity to routine (food, timing, activity, hydration, sleep) explains travel-induced constipation.
  • Travel disrupts the gut's routine via dietary changes, schedule disruptions, dehydration, and jetlag.
  • This disruption can cause the gut nerves to slow down function.
  • Suppressing the urge to go when traveling and discomfort with unfamiliar toilets worsen the issue.

Remedies for Mild Constipation

  • Eating fiber can stimulate gut wall action.
  • Psyllium seed husks and plums combine fiber with fluid-drawing agents for smoother bowel movements.
  • Effects typically appear after 2-3 days.
  • 30 grams of dietary fiber is an appropriate daily dose.
  • Insoluble fiber stimulates movement, but can cause stomachaches.
  • Soluble fiber softens stool, with fruits containing both types.
  • Adequate fluid intake is essential when consuming dietary fiber, to prevent solid lumps.
  • Increased fluid intake benefits those who are dehydrated.
  • Dehydration from air travel dries out feces in the gut.
  • One should heed the urge to go to the toilet, especially during travel, to maintain gut rhythm.
  • Delaying bowel movements trains the gut to retain, leading to harder stools.
  • Probiotics and prebiotics can revitalize gut flora.
  • Increased exercise is generally ineffective unless extremely strenuous.

Other Techniques and When to Seek Medical Advice

  • The rocking squat technique involves bending forward and straightening up while seated on the toilet.
  • Consult a doctor for sudden or prolonged constipation, as it may indicate underlying conditions like diabetes or thyroid problems.

Laxatives: An Overview

  • Laxatives aim to produce well-formed stools.
  • They are helpful for travelers, slow transporters, and those with toilet aversion or hemorrhoids.

Osmotic Laxatives

  • Osmotic laxatives use osmosis to draw water into the large intestine.
  • They contain salts, sugars, or molecular chains to increase water retention and ease bowel movements.
  • Overuse can lead to excessive water extraction and diarrhea.
  • Salts like sodium sulfate (Glauber's salt) are harsh and can disrupt electrolyte balance.
  • Lactulose retains water and feeds gut flora, potentially causing gas and cramps.
  • Lactulose forms from lactose when milk is heated. Higher temperatures result in more lactulose
  • Sorbitol, found in fruits like plums, pears, and apples, also acts as a laxative.
  • It is poorly absorbed and used as a sweetener (E420), with warnings about excessive consumption on sugar-free products.
  • Short molecular chains like polyethylene glycol (PEG) are the most easily tolerated.
  • PEG does not disrupt electrolytes or produce gas.
  • Higher molecular weight PEGs (e.g., PG-3350) are preferred over shorter chains (e.g., PEG-150) to avoid absorption by the gut wall.
  • PEG-based laxatives can be taken long-term without addiction or damage.

How Osmotic Laxatives Work

  • Osmotic laxatives increase stool moisture and mass, stimulating the peristaltic reflex.

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