By Dr Sujit Singh Gill

CONSTIPATION, one of the most common abdominal complaints, generally refers to a change in bowel habits. However, it can have varied stages: Stool may be hard, difficult to pass or bowels may move infrequently (less than three times a week).

There are many factors that can lead to constipation though frequently no cause is found. Low dietary fibre intake, inadequate fluid intake, decreased physical activity, a side-effect of some medications, hormonal or metabolic problems or tumours such as colorectal cancer are some.

Most people will experience constipation at some point in their lives. The type that does not persist is generally due to changes in diet. The persistent type could be due to more serious issues, even cancer or hormonal problems.

There is usually no need to seek medical help if you experience a single episode of constipation. In most cases, all you need to do is consume more dietary fibre and liquids.

When increasing dietary fibre, do so gradually as the sudden increase in fibre can lead to abdominal bloating and excess gas formation.

So when should one seek medical help? In general, if the constipation persists for more than three weeks, is associated with warning signs such as blood on toilet paper, fever and weight loss, or if the constipation is so severe that worsening abdominal pain and bloating occurs in association with no passage of stool or even air.

Those aged 50 years and above should seek advice earlier as colon cancer risk rises in this age group.

Generally, when medical opinion is sought, the doctor will take a full history and conduct a physical examination. Sometimes a colonoscope is recommended to examine the colon from the inside.

Laxatives may be required to improve bowel movement over the short term, but these are not prescribed over extended periods of time as some patients become dependent on these drugs. tabla@sph.com.sg

Dr Sujit Singh Gill is a vascular and general surgeon in private practice. He can be contacted at sujitsinghgill@me.com