Human beings empty their bowels usually every 8–72 hours. In constipation the bowels move less often, or the contents become so hard that moving the bowels is difficult.  Constipation is caused by lack of exercise, too small fibre contents of food, and drinking too little.

After a day surgical procedure constipation may be caused by fasting, medication given during the day of the procedure, and the pain medication used. Especially strong painkillers, such as opiates (Tarqiniq ®, Oxycontin ®), and painkillers with codeine (Panacod ®) may slow down the bowel movement.

Preventing constipation

Food fibres reduce constipation, because they add to the volume, and bind water inside the intestines, thus making the contents softer. All plant products - cereals, vegetables, fruit and berries – contain fibres. The most efficient in increasing the bowel contents is the fibre in cereals that can be found in whole grain bread and porridges. The aim is to get a minimum of 30–50 grams of fibre per day.  Plums and figs contain - apart from fibres - ingredients that stimulate bowel function. A portion of 6–7 plums in the morning taken with the water used for softening the plums is sufficient.

You should drink plenty of fluids, a minimum of two litres per day, especially if you use brans or pharmaceutical products as additional fibres.

Exercise helps bowels move; abdominal muscles massage bowels, and make them work better. The quality of exercise is not important. For example brisk walking as separate longer walks, and shorter periods of walking as a part of daily chores, are both good alternatives.

Treating constipation with pharmaceutical products

Different constipation medication that contain fibre and add to the volume of the bowel contents can be purchased at the pharmacy (e.g., ViSiblin®, Agiocur®). They can be used for longer periods of time with no harm.

Lactilol, lactulose (e.g., Duphalac®), and macrogol increase stool water contents in the colon, and they can be used for more consistent constipation. The effect can usually be seen in a few hours, but may sometimes take 1–2 days to take place. These medicines are not meant for regular use.

Medicines that stimulate the bowel, such as sennosid (e. g., Exprep®, Pursennid®), and bisacodyl (e.g., Metalax®, Toilax®) are only meant to be used temporarily for a few days. They can be used as pills, suppositories, or mini enemas.

Especially after haemorrhoid and prostate surgery it is important that the bowels move regularly and with ease.

Reference:

Mustajoki, Pertti (2010): Ummetus, Lääkärikirja Duodecim

10/17/2017 päiväkirurgia 2