We seldom appreciate our gut as long as it is performing what it is programmed to do. But should it start to act up, it brings misery.

There is even a movie, ”Piku”, that depicts how constipation can lead to dysfunction in the family. Fortunately the movie had a happy and romantic ending. That often is not the case in real life. Constipation can stink (pun intended) up relationships. It can make life unbearable not only for the person suffering from it but also those around them.

What is constipation? It usually means difficulty in passing stools that are hard or a decrease in the frequency. The frequency and consistency of normal bowel movement varies with age and diet-an infant who is breast fed may pass stools several times a day to once in a few days. As one gets older the transit time for food from the mouth to the anus becomes more regulated. After you eat food, the nutrients are extracted by the gut and the waste is what makes “poop”. Normal poop is usually soft and does not cause discomfort during its transit from the gut to the outside world. The colour can vary-but clay coloured or black or red poop should raise a red flag and needs urgent consultation with your doctor.

What causes constipation? A number of factors can be at work -inadequate intake of fluid and fiber, physical inactivity, obstructive lesions in the gut (tumors, twisting of the gut), certain drugs, pregnancy, lifestyle (especially in children who are busy playing and hold their poop or the jet setting executive), diseases that affect your hormones (decrease in thyroid function) and other diseases of the muscles and nerves.

What is the treatment? To address this one should attempt to prevent it if possible-drink enough fluids and say hello to fiber.

Have a regular time to not only to meditate on, but also to process your bowel function. Your gut may call only once and if you do not listen to the call of nature, like an obstinate child the waste matter settles down and refuse to budge. The longer the waste matter stays in the large bowel, the harder and bulkier it gets as more water gets absorbed by the lining of the gut. A hard poop is hard to push and may cause a tear resulting in pain that culminates in children holding it back more, thus creating a vicious cycle of -hold the poop–hardening of the poop-painful poop-holding it further and making the constipation worse. Regular evacuation reduces the risk of constipation and its complications – encopresis where the stools leak out and soil the underwear. This destroys self esteem and often lead to being bullied by other children.

As a first line of treatment, I tell my patients to attempt to fart-yes, Fart! Fluid and fiber in diet to be optimized Avoid the triggers that result in constipation.

Reassess your lifestyle-increase your exercise, reduce inactivity and To see your health care provider if no improvement or if complications are observed.

If constipation recurs, becomes chronic or recurrent ofr if complications are seen, then further intervention would be indicated using stool softeners, gentle laxatives, glycerine suppositories, fleet enema,etc. Primary causes of constipation should be addressed if detected.

That my friends, is the scoop on poop!