Constipation & diarrhea » Causes and treatment. Book online

What is constipation?

Constipation can be described as hard stools (sluggish stools), stools that are difficult to pass and/or where a long time passes between stools (infrequent stools). In constipation, the stool can also be lumpy. In many cases, it can take days and in rare cases weeks before the person is able to have a bowel movement. Physiologically, it is the large intestine that must ensure that the stool is shaped and delivered to the rectum. Various problems with the large intestine and/or the control of the digestive system can have an influence on the development of constipation. The duration of constipation can also vary individually.

Chronic constipation

The definition of chronic constipation is 3 or fewer bowel movements per week that have persisted for several weeks or months. Causes of chronic constipation are often the same as for common constipation, but pathology in the intestines such as cancer, neuritis of the autonomic intestinal supply, Parkinson’s, sclerosis, etc. must often be considered.

Acute and hidden constipation

Acute constipation is constipation that occurs quickly and usually lasts no more than a few days. Unlike latent constipation, acute constipation is uncomfortable and disruptive to daily life.

Causes of acute constipation are often drastic dietary changes where high-fiber foods and fluids are not consumed in large quantities.

Overuse of medications such as laxatives, etc. can also cause acute constipation. Disturbance of the body’s autonomic nervous system in the form of stress is always present during acute constipation. In addition, reduced activity levels and sitting for long periods can also cause acute constipation..

Hidden constipation is not always visible in everyday life and is often the cause of other types of stomach – intestinal problems such as bloating, nausea, stomach cramps or the like. Hidden constipation is not as noticeable as acute constipation where patients can in many cases go to the toilet every other day or sometimes every day.

Causes of hidden constipation are the same as those of acute constipation.

Symptoms of chronic constipation

Infrequent bowel movements (not every day)
Sluggish bowel movements and difficulty passing stool
Sensation of poor bowel emptying
Tears in the rectum, which can result in bloody stools
Distended and bloated stomach
Pressure downward in the abdomen

Constipation and nausea/vomiting

Nausea and vomiting are often symptoms of constipation. Constipation through the digestive system’s own nervous system, Auerbach and Meissner, can reduce the efficiency and peristalsis of the entire digestive system. This can lead to a delay in the passage of food from the stomach to the small and large intestines. According to Arthritis-Health, this can in some cases lead to both nausea and vomiting.

Constipation and headache

According to mayoclinic.org, there may be a connection between constipation and headaches. Studies show that this is the case. They write that treating digestion can ease and eliminate migraines and headaches. The reason may be that the brain’s tenth cranial nerve, the vagus nerve, through which neurotransmitters produced in the intestines are transported up to the brain. The vagus nerve is the link between the brain and digestion

The nerve’s primary function is to report to the brain the state of digestion 24/7. Malfunction in the gastrointestinal system can and will affect the biochemistry of the brain.

Constipation and back pain

Back pain associated with constipation is common. The autonomic nervous system controls and regulates the internal intestinal system. Constipation affects the areas of the intestinal system where the blockage has occurred. This effect causes irritation / overactivity of the body’s autonomic / vegetative nervous system, which originates from the spine itself.

Chronic constipation can therefore cause irritation of the areas of the spine that correspond to the autonomic nerve supply to the intestines.

In addition, constipation can also cause pain in the left side of the abdomen corresponding to the anatomical course of the colon and pain in the lower abdomen corresponding to the parasympathetic nerve supply of the colon and rectum.

Constipation and acid reflux

Constipation and acid reflux are two of the most common digestive problems. In some cases, these symptoms are caused by the same cause. Problems in the digestive regulatory system (the parasympathetic system) such as stress, anxiety, and the like lead to decreased peristalsis and constipation, as well as altered production of stomach acid. However, constipation is often caused by the intake of stomach acid-regulating medications.

Pain associated with constipation?

Pain does not have to be associated with constipation. The body’s internal organs such as the intestines are relatively poorly supplied with nociceptive pain receptors. This means that there must be a large pain activation of the intestines before the brain registers pain problems in the digestive system. Therefore, problems in the gastrointestinal system can go undetected for a long time.

Constipation and fever

Fever is an immunological product of the body’s internal organ system. Bacteria, viruses, and parasites are the most common causes of fever in the body related to digestion (healthline.com). In some cases, inflammation of large parts of the intestinal system can occur due to acute or chronic constipation.

Why am I constipated?

When talking about constipation, it is important to look at the structure and control of the gastrointestinal system. Digestion is controlled by its own system, Auerbach and Meissner, a system that is constantly active. This system responds to mechanical pressure (food in the intestines pressing on the walls), chemistry and temperature. This system is active no matter what.

The overall control of Auerbach and Meissner is controlled by the body’s parasympathetic nervous system, more specifically the vagus nerve.

This nerve originates from the brain and controls everything that has to do with digestion; stomach acid, peristalsis of the stomach and intestines, secretion of bile and salts in the intestines, production of intestinal bacteria (intestinal flora) and the formation of the mucous membranes in the intestines.

Digestive control issues are the most important cause of constipation. Factors that can disrupt or cause problems with the vagus nerve include stress, depression, lack of joy in life, and physical problems with the vagus nerve.

Constipation and stress

Stress and constipation go hand in hand. Stress is a neurological response to stimuli that increases arousal (wakefulness) and tone (firmness) in the body.

To achieve this, the body’s sympathetic system opens up the blood vessels to the parts of the brain and skeletal muscles that need to be used during stress.

On the other hand, the sympathetic nervous system and stress hormones constrict the blood vessels to the body’s internal organs, especially the digestive system, which should not be active in stressful situations. Persistent stress therefore leads to decreased activity of most digestive functions, including peristalsis, which often leads to constipation.

Other causes of chronic constipation

Lack of or too little fluid
No or insufficient exercise
Too little fiber in the diet
Medicine – diuretics, psychotropic drugs, morphine, etc.
Diseases

Constipation in children and babies

Babies and children often suffer from constipation in the first months or years of their lives. Babies’ digestive systems do not secrete sufficient amounts of digestive enzymes until they are 6-9 months old, so their gastrointestinal system can sometimes be sensitive. Problems in the neck and back that occurred during a difficult birth can prolong this period.

Constipation and pregnancy

During pregnancy, the uterus grows larger and larger. This change in the uterus causes a change in the position of the body’s internal organs, especially the intestines. In the last trimester, the pressure on the intestinal system is very great, which in many cases blocks the passage of feces in large parts of the digestive tract. In addition, the hormonal changes during pregnancy will reduce the peristalsis of the intestines, which can also cause constipation – which is one of the more well-known pregnancy complaints.

Constipation and weight

Underlying diseases such as impaired metabolism and diabetes are frequent causes of chronic constipation due to changes in hormonal and biochemical levels in the body. Impaired metabolism will in most cases lead to weight gain or make it difficult to lose weight, whereas diabetes will cause the opposite as the body has difficulty getting energy from the glucose in the blood into the cells and will instead consume the body’s fat and muscle stores.

Treatment of chronic constipation

Osteopaths and physiotherapists are specialists in gastrointestinal problems including chronic constipation. We use our extensive knowledge of physiology, anatomy and pathology together with selected individual examination techniques to find the problems that have been there prior to the onset of constipation. Treatment of chronic constipation should include management of the vagus nerve and the body’s autonomic nervous system (sympathetic and parasystemic nervous systems), treatment of all parts of the gastrointestinal system as well as treatment of selected areas in the skeletal system that are related to digestion.

How long is it okay to be constipated?

It is not clear how long and how constipated you have to be before it can be considered dangerous or inappropriate. As a rule, it is said that 3 days without a bowel movement should lead to some form of treatment. However, underlying pathological causes such as intestinal torsion, etc. may mean that treatment of constipation must be initiated sooner.

Good advice against chronic constipation

Reduce stress in your everyday life – stress can be physical, but the most invasive is mental stress, which constantly stresses the physiology of the body
Do the things that make sense to you and that you enjoy. This helps strengthen your parasympathetic system, i.e. the digestive system.
Find activities and interests that you can engage in that will keep you inactive and your brain and thoughts from working. This will get you out of the sympathetic system (the stress system) and into the parasympathetic system (the digestive system).
Eat plenty of fiber. Fiber that you get through vegetables, among other things, ensures active digestion.
Chew your food properly. When food is broken down in your mouth, your stomach doesn’t have to work as hard to break it down and the entire system is relieved.
Drink plenty of fluids. The intestinal flora and intestinal walls need fluids to function optimally.
Get plenty of exercise. Cardio training heavily involves breathing, which is the engine for the organ system.
Pay attention to your body’s signals. If your body is tired and worn out, rest. If you need to go to the toilet, it is important that you do so immediately.

Constipation and diarrhea at the same time

This phenomenon often occurs in patients suffering from irritable bowel syndrome. Irritable bowel syndrome has many subtypes such as IBS-M (mixed irritable bowel syndrome), IBS-C (irritable bowel syndrome with constipation) and IBS-D (irritable bowel syndrome with diarrhea). The definition of IBS-M is; 25% of the stool is loose and liquid and 25% of the stool is hard and solid when no laxative is taken.

What is diarrhea?

Diarrhea is frequent bowel movements, more often 3 or more loose stools per day and/or stools that exceed 200 grams per day. Diarrhea is not a disease but a symptom and most often occurs acutely. Diarrhea can be divided into acute diarrhea or chronic diarrhea. Chronic diarrhea is 3 or more loose stools per day that have lasted for four or more weeks. The duration of diarrhea can vary individually, depending on the cause. Chronic diarrhea can be a sign of autoimmune bowel disease such as ulcerative colitis and Crohn’s disease.

Symptoms of chronic diarrhea

Defecation several times a day
Defecation several times a day for several weeks
Thin explosive stools – watery or mushy stools
Strong urge to defecate
Bowel movements that come quickly so you need to stay close to toilet facilities
Involuntary defecation
Stomach ache
Problems with the rectum

Why do I have diarrhea?

It is important to establish that diarrhea is a reflex mechanism controlled by the immune system itself. This means that diarrhea is a mechanism that has the function of excreting foreign viruses or bacteria that are in the intestinal system.

The intestinal system is highly prioritized in the body’s hierarchy because the intestinal system ensures that we get our nutrition for all processes in the body, the intestinal system excretes waste from our body and it is an integral part of our immune system.

Therefore, harmful bacteria and viruses are not welcome in the gastrointestinal system as they can damage the mucous membranes and intestinal walls.

Upon penetration of bacteria into the digestive tract, the immune system opens the 5 sphincters of the intestines, the immune system increases the secretory, inflammatory and osmotic processes of the gastrointestinal system, which results in dilution of the contents in the intestines and the contents can be excreted quickly and smoothly.

Bacteria, viruses and diarrhea

To get an overview of how external bacteria and viruses can enter the system, we need to look at where the gastrointestinal system has its barriers. The first barrier is the stomach acid itself.

The function of stomach acid in relation to the immune system is to kill and destroy these bacteria. Low stomach acid will therefore be a problem, as well as stomach acid-reducing drugs. The next barrier is bile and salts from the pancreas, which is why removal of the gallbladder and/or excessive intake of glucose (sugar, etc.) can become a problem.

The final barrier is the mucous membranes in the intestines, but these cannot do anything if the previous barriers are not effective.

Other causes of chronic diarrhea

Norovirus infection
Stomach infection (bacteria and viruses)
Bacteria; Campylobacter, Salmonella, Shigella, E. coli, Yersinia, protozoa.
Vibrio, enteroadherent E. coli, Yersinia and Aeromonas
Food intolerance
Irritable bowel syndrome

Osteopathic approach to chronic diarrhea

Treatment of chronic diarrhea involves physical treatment of the immune system and counseling for this, treatment of the vagus nerve (digestive nerve), the stomach (stomach acid), the liver and gallbladder, and the remaining parts of the gastrointestinal system. Osteopathy specializes in the management and physical treatment of chronic diarrhea.

We have over 12 years of training in the investigation, diagnosis and treatment of causes of chronic diarrhea.

Good advice for chronic diarrhea

- Reduce stress in your everyday life – stress can be physical, but the most invasive is mental stress, which constantly stresses the physiology of the body

- Do the things that make sense to you and that you enjoy. This helps strengthen your parasympathetic system, i.e. the digestive system.

- Find activities and interests that you can engage in that will keep you inactive and your brain and thoughts from working. This will get you out of the sympathetic system (the stress system) and into the parasympathetic system (the digestive system).

- Ensure good and proper hygiene. Wash your hands and use hand sanitizer. This reduces the chances of getting bacteria into the gastrointestinal system.