Are you aware of obstructed defecation syndrome? No? Please read what Dr. DILIP BHOSALE* writes.
“I wish that being famous helped prevent me from being constipated.” -Marvin Gaye.
Going to the toilet is our daily routine human experience. But, occasionally constipation strikes, and that causes back-up in the digestive system. The food you consume takes several days to exit your body. This constipation can become chronic, which means regularly passing lumpy, hard stools accompanied with straining. When this condition does not improve with medical and conservative management, it is known as refractory constipation. In this, it includes one anorectal condition, which is known as obstructed defecation syndrome.
In this, there is prolapse of the rectal wall into the anorectal region, producing this condition. Typically, patients complain of inability to pass the stools, even if it comes in the rectum. Careful examination shows that the stools get stuck in the lax inner lining of the anorectal region.
Normally, the fiber in the diet resolves the normal frequency of bowel movements, due to the increase in fecal mass, volume, and softness. Several trials show a lack of evidence regarding a direct effect of constipation on prolapse of piles, pain, and itching. A stimulant laxative is effective in reducing the symptoms like bleeding, but the problem is habit formation. You should avoid mobiles, laptops or reading newspapers in the toilet. There is a pneumonic TONE.
T stands for three minutes for defecation.
O stands for once daily defecation
N stands for no straining and no phone during defecation.
E stands for enough fiber in the diet.
Maintaining hygiene in the anal area is important. Never use tissue papers after passing the stools. You can use soft wet wipes or wash the anal area with water. Drink plenty of liquids, avoid alcohol and caffeine.
· Exercises and lifestyle modifications
· Stop eating spicy and fried foods.
· Eat plenty of fiber when you have non-vegetarian food.
· Drink buttermilk and eat yogurt as they help to maintain bacterial flora in the colon.
· Drink plenty of fluids to avoid hard stools.
· Prevent obesity and exercise daily.
· Toilet training: Insert your finger till the internal sphincter is relaxed. If you don’t pass stools, then repeat after 20 minutes.
· Bend forward and try to contract your abdominal muscles and bear down to release the stools.
· Kegel exercises: Strengthen pelvic and muscle tone. It controls maintenance in women after childbirth.
· Biofeedback is used to strengthen the rectal muscle sphincter in people with fecal incontinence. They are taught how to squeeze rectal muscles around the rectal plug. The changes are recorded on the computer.
· Prolonged straining should be avoided.
· In pregnancy, take stool softeners, a high-fiber diet, or laxatives, if necessary to avoid straining.
· Sitting for a long duration should be avoided, especially for people having jobs where they have to sit for a long time. Every 1 or 2 hours, you should stand and walk to avoid piles formation.
· Obese patients are advised to reduce weight.
The last word: If the conservative treatment fails, patients should take opinion of a specialist who is expert in treating your problem with necessary procedures preferably non-invasive. Generally, patients especially females are shy or embarrassed to express these problems, which causes a delay in the treatment. This should be avoided and timely treatment helps to ensure a healthy and pain-free life. (*The author is General Surgeon at Apollo Spectra Mumbai)