If “love” is the most misunderstood word in society today, “constipation” cannot be far behind. A recent study revealed that 5-22% of the population across the world are unhappy with the ways their bowels move and they use the same word to describe a variety of symptoms.“Constipation” means different things to different people, from a feeling of incomplete evacuation (45%), straining at stools (30%), hard stools (10%), bloating and distention (20%) to several others. None of these meet the Western medical definition of “constipation” described as passage of less than 3 stools per week!
How bowel habits differ between peoples and regions, and the urgent need to redifine terms were highlighted during the recent Asia Pacific Digestive Conference in Kuala Lumpur, in which Asian doctors pointed out that the Western definition of constipation was inappropriate for Asians as hardly anyone would actually qualify while many feel they are constipated while passng stools quite liberally.
Bowel habits indeed vary widely not just between peoples and regions, but even between individuals. While many Indians believe that passing atleast one stool per day in the morning is crucial to health, the range could be considerable from 3 times a day, often after food or meals, to once on alternate days. Timing may not be so important after all as modern lifestyle may not often permit us to sit long on the pot before the early rush to school or work while evenings allowing more time to coax stressed bowels to relax and allow the passage.
Food and exercise are once again being thrown into center stage in debates on bowel habits. Our Indian diets of daal-roti-sabji have adequte amounts of fiber that absorb water and toxins, give volume to stools and stimulate the large intestine to move forward with regularity, keeping our constipation as well as our risk of colon cancer at bay. In USA, bowel cancer has become the commonest of cancers, making doctors advocate colonoscopic examination for screening in everyone above 45. If we change our food habits to burgers, sausage, ham and cheese, we will acquire the risks as well, just as Indian immigrants to western countries have started doing.
A few simple tips can be of use: If stools are hard or infrequent, green veggies, and fruits such as papaya, apple, pear or “bel” can help. If your stool tends to be loose and the frequencies high, try bananas and curd, and cut down on milk and cheese. If “gas” and bloating are your main symptoms, excess of gas forming foods such as sprouts, daals, peas, radish or milk could be the culprits; try cutting down on them and see if it makes a difference.
Unsatisfactory bowels movements however do compete with spouses, bosses, children and work place as a significant cause for unhappiness in life. The solution often lies in treating them as barking street dogs: if you heed them they bark more; if you ignore them, they often stop barking.
As published in HT City ( Hindustan Times) dated 26 september , 2010.
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