Constipation is not actually a disease, but a symptom that can conceal various diseases and it is therefore important to understand the cause of constipation.

Professor Silvio Danese, Head of the Centre for Chronic Inflammatory Bowel Diseases at Humanitas, a guest in the All Health study at Rai3, spoke about constipation.

Women and the elderly are particularly affected: “As for women, it is thought that they have a hormonal involvement in intestinal motility and we also know that irritable bowel syndrome (of which constipation is one of the symptoms) is a predominantly female disease. The elderly, on the other hand, tend to drink less or take certain medications that can cause constipation”, explained Prof. Danese.


Different types of constipation

“There are various types of constipation: a first type is called colon inertia or a lazy intestine, which contracts very slowly. In other cases, however, in the final part, all the muscles of the pelvis dedicated to the act of defecation do not behave in a synergistic way and are therefore not coordinated. In other cases, however, both conditions may be present, while in irritable bowel syndrome the cause is not clearly identified.

Lifestyles are generally the main cause of constipation, including low-fiber nutrition, dehydration, sedentariness and certain medications. Constipation is also common in some conditions, such as pregnancy,” emphasized the specialist.


When to contact the doctor and tests for diagnosis

“In general, you should consult a doctor if there are less than three evacuations per week, tendency or need to make efforts during defecation, feeling of incomplete defecation, presence of hard or goat (ball) stools.

It is very important to understand if it is a transit problem and in this case the patient is subjected to the study of the intestinal transit times, or specific X-rays that observe the intestinal transit. Anorectal manometry, on the other hand, is very useful for understanding how the pelvis moves, in some cases defecography is indicated and finally colonoscopy is needed for certain patients”, explained Prof. Danese.


Advice on intestinal regularity

“It is important to maintain lifestyles, with a good diet (5 portions of fruit and vegetables or 20 grams of fiber per day), sufficient hydration (more than 1.5 liters of water per day) and physical movement. Where necessary, osmotic supplements or laxatives that attract water and facilitate intestinal activity can be taken.

As far as treatment is concerned, we must first understand the type of constipation. If it is a motility problem, insoluble fibers, osmotic laxatives or motility drugs may be used. If the problem involves low constipation, some enemas may need to be used. However, you should avoid do-it-yourself techniques and consult your doctor,” recommended the specialist.


Watch the full interview with professor Danese, click here.