Sushil Dhital

Kathmandu:

Gastro-intestinal disorders are recognised as "constipation". Constipation is accompanied by headache, coated tongue, foul breath, and lack of appetite. These symptoms disappear when satisfactory evacuation takes place. Generally daily elimination is considered a normal habit but in some individuals elimination every second or third day can be normal. However, regular toilet habits must be established for avoiding inconvenience and proper evacuations.

Causes Fasting, inactivity, lack of sleep or rest produces constipation. Similarly lack of exercise, poor personal hygiene in maintaining regular habits of evacuation, limited intake of fluid, consumption of refined and concentrated foods with less fibre are prone to increase constipation problem. Deficiencies of fats and Vitamin B1 (thiamine) in diet are also causative of constipation problems. Nervous disturbances such as tension, anxiety, excitement or worries and excessive use of laxatives or regular enemas (for bowel evacuation) also affect the normal muscular contraction and evacuation inducing constipation problems. Constipation is more common in children and older persons who prefer soft and smooth food but consume

an inadequate amount of water or liquid.

Effects Constipation is accompanied by headache, coated tongue, foul breath, and lack of appetite. These affect the normal activity, metabolism and bodily functions generating other numerous disorders. Hard and drier stool some time scratch and damage the anal passage. Chronic constipation may also lead to piles and colon cancer. Dietary measures The objective of dietary treatment is to encourage bowel movement and bowel evacuation. Diets that are rich in B vitamins and fibre are regarded best to avoid constipation. Coarse cereals, whole grain with bran, pulses, fresh fruits, salads, green leafy vegetable, roots and tubers are rich in both B vitamins and fibres. Fibres increase the bulkiness of stool by absorbing water and prevent it from being harder and drier thus promoting laxation. On top of that fibre is very helpful in preventing heart diseases and diabetes. It reduces the deposition of cholesterol in arteries and controls over blood sugar. Fatty foods such as butter, ghee, cream and oils stimulate the muscular movement with in the intestine for proper evacuations of bowel. Large amounts of fluids in the form of liquids or high fluid foods such as soups or vegetable curry are beneficial. Tea and coffee may be taken but in moderation.

Non-dietary measures Some people even prefer smoking before going to toilet thinking that smoking favours bowl evacuation and reduces constipation problem. However, smoking has nothing to do with constipation and evacuation problem instead it generates the problem.

Regular exercise, adequate sleep or rest with routine and timely toilet habits are necessary for avoiding constipation. Tensions, worries and unenthusiastic thinking disturb hormones secretion and general metabolism, accelerating gastrointestinal problem like constipations.