Constipation during Ramadan

I will soon commence the Ramadan fasting. My problem is constipation. I wish to request for preventive measures to cope with the period.

Habashiyya V.

Before delving into possible solutions to your condition during fasting, let me provide a general information about constipation. It is a condition that many people have experienced.

Constipation occurs when bowel movement becomes difficult or less frequent. In many communities, women and the elderly are more commonly affected. Although not always serious, constipation can be a concern and a discomfort.

The normal length of time between bowel movement differs from person to person. Some people have bowel movement three times a day; others, only once or twice a week. Going longer than three days without a bowel movement is too long. After three days, the stool or faeces become harder and more difficult to pass.

One is considered constipated if she/he has two or more of the following for at least three months:

1. Straining during a bowel movement more than 25 per cent of the time.

2. Hard stools more than 25 per cent of the time.

3. Incomplete evacuation more than 25 per cent of the time.

4. Two or fewer bowel movements in a week.

Constipation is usually caused by a disorder of bowel function rather than a structural problem.

Common causes:

1. Inadequate water intake.

2. Inadequate fibre in diet.

3. Disruption of regular diet or routine such as when traveling or fasting.

4. Inadequate activity or exercise or immobility.

5. Eating large amounts of dairy products.

6. Stress.

7. Resisting the urge to have a bowel movement, this is sometimes the result of pain from haemorrhoids.

8. Overuse of laxatives (stool softeners) which, over time, weaken the bowel muscles.

9. Antacid medicines containing calcium or aluminum.

10. Medicines (especially narcotics, antidepressants, or iron pills).

11. Depression.

12. Eating disorders.

13. Pregnancy.

14. Colon cancer.

15. In some cases, lack of good nerve and muscle function in the bowel may also be a cause of constipation.

Symptoms:

1. Infrequent bowel movement and or difficulty having bowel movement.

2. Swollen abdomen or abdominal pain.

3. Pain.

4. Vomiting.

Majority of people with constipation do not have any obvious illness to explain their symptoms and suffer from one of two problems:

1. Colonic inertia: A condition in which the colon contracts poorly and retains stool.

2. Obstructed defecation. A condition in which the person excessively strains to expel stool from the rectum.

Recommendations to you as you commence fasting:

You can do the following early in the morning, as well as when you break your fast in the evening:

1. Eat a well-balanced diet with plenty of fibre. Good sources of fibre are fruits, vegetables, legumes and whole-grain bread and cereal (especially bran). Fibre and water help the colon pass stool.

2. Drink good amounts of water and other fluids (unless fluid restricted for another medical condition). Liquids that contain caffeine, such as coffee and soft drinks, seem to have a dehydrating effect and may need to be avoided until your bowel habits return to normal. You may avoid milk, if dairy products cause constipation for you.

3. Exercise in the morning.

4. Move your bowels when you feel the urge.

5. Try warm liquids, especially in the morning.

6. Add fruits to your diet.

7. Eat prunes and or bran cereal.

8. If needed, use a very mild stool softener or laxative. Do not use laxatives for more than two weeks without calling your doctor, as laxative overuse can aggravate your symptoms.