Constipation

By Dr. Bimal Chhajer

Our stool contains about 75% water. It is estimated that on an average about 200 ml water is lost in the stool from the body which prevents hardening of the stool. In constipation, the opposite occurs. More water is removed in the small and large intestine leading to hard stool. Constipation occurs in many reasons if people do not drink adequate amount of water or fluid. Fibres are food which are not absorbed in the intestine and have a tendency to retain water. So, taking foods high in fibre makes the bulk of the stool and keeps the stool soft. Another problem that causes constipation is unnecessary holding of stool. This leads to more absorption of water as stool stays there for more time and the reflex which leads to passage of the stool in the last part of the large intestine (sigmoid colon, rectum) is also inhibited. Usually, as the rectum is filled up such reflex called mass peristalsis occurs which drives the whole stool down towards anus. The opening of the anus is under our control. But, if we ignore this reflex again and again, the reflex does not work well in future. This results in chronic constipation as more water is absorbed from stagnant stool.

• Language: English
• Publisher: Diamond Books
• Release date: Apr 15, 2021
• ISBN: 9789385975271

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Introduction

Our stool contains about 75% water. It is estimated that on an average about 200 ml water is lost in the stool from the body which prevents hardening of the stool.

Let us count how much water is handled by the intestine per day. On an average, we drink about 4-5 glasses of water which is about one and a half litre (1500 ml). In addition we consume 1500 ml more in the form of tea, coffee, juices, milk and moisture present in the food. So, total intake is about 3000 ml/day. All this goes in the stomach first and passes on to the intestine. About 7000 ml of water is poured (in the form of secretions) in the gastrointestinal system by way of saliva, gastric juices, liver juices (known as bile), pancreatic juices (to digest mainly proteins) and intestinal juices. So, all together about 10,000 ml or 10 litres of water is received by the gastrointestinal tract, (which extends from mouth to rectum—anus).

This system needs so much water to digest the food. While absorbing the digested food (carbohydrate broken into glucose, proteins into amino acids, fats into fatty acids), minerals and vitamins, the intestines reabsorb most of this water for reuse. About 98% of this water is reabsorbed. The first part of the small intestine (Jejunum) absorbs about 6 litres, the second part of the small intestine (ileum) absorbs about 2-3 litres. The large intestine reabsorbs about 1.5 litres of water. Only 200 ml or so goes out mixed with the stool. The whole passage time is 8 hours to 24 hours. (See Table)

If due to any reason the intestine fails to reabsorb this water loose