the car or even using the stairs instead of
the escalator on the metro or London
underground. It doesn't mean joining a
gym!
Other interventions - gentle massage,
using aromatherapy oils in the bath,
relaxing music, yoga, pilates - can all
help to make life less stressful.
Tailored treatment
Any dietary and lifestyle advice should
be tailored to suit individual circumstances,
re-enforced by simple written
care plans. Dietary modifications should
be introduced gradually, over a period of
months (one diet change, one fluid intake
change and one exercise/relaxation
change at each stage of the process is a
realistic strategy).
Taking time to go to the toilet is
extremely important for those with a
sensitive bowel. Time needs to be put
aside so the experience can be relaxing,
allowing the muscles in the bowel to
relax. In addition, putting off the urge to
defecate can make matters worse so this
should be avoided when possible.
Another useful suggestion is to advise
sufferers to raise their legs, perhaps by
using a footstool or a pile of books, which
will encourage movement due to the
increased abdominal pressure.
Make sure this kind of approach to the
management of constipation becomes a
part of long-term lifestyle changes.
There is always the danger that as soon
as an acute episode of constipation is
resolved, there is a perception that the
immediate danger is over. Then it occurs
once more, often resulting in a vicious
cycle of continuing episodes of constipation
that can carry on for months, even
years.
It is also important to take into account
that constipation may be a symptom of
another underlying bowel disorder, such
as Irritable Bowel Syndrome (IBS). IBS is
characterised by abdominal pain, altered
bowel habit (diarrhoea or constipation),
and abdominal bloating. IBS affects up to
20 per centof the general population, and
it is estimated that 14-24 per cent of
women and 5-19 per cent of men have
irritable bowel symptoms (Kennedy,
2006).
IBS is often dismissed as just being a
nuisance, rather than anything more
serious, but its symptoms can seriously
diminish a patient's quality of life. Stress
exacerbates IBS, so it is advisable for
patients to try to avoid stressful situations.
This could be planning ahead
when doing something new or perhaps
when they are travelling, as well as
explaining to their work place the symptoms
that they suffer with as a result of
the IBS. Identifying triggers is vital to
helping the patient manage their IBS,
including tbe effect of certain foods and
life events.
Patients will respond differently to
different treatments, so it is best to treat
one symptom at a time, starting with the
one that most bothers them. Constipation
is a frequent and distressing
symptom of IBS, as is abdominal pain.
The combination of Ispaghula husk and
Mebeverine (anti-spasmodic) in Fybogel
Mebeverine can be extremely useful in
relaxing spasms of the gut, whilst at the
same time helping to restore and maintain
bowel regularity.
Suffering from constipation, especially
when combined with other IBS symptoms,
is far from pleasant. At worst, it can
have a significantly adverse impact on
quality of life, productivity at work and
enjoyment at home. By adopting some of
the proposals outlined in this article,
much of the stress, anxiety and discomfort
associated with constipation and IBS
can be avoided.