English for PTA

Constipation

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Constipation may not only be caused by medication, it may also be caused by a certain lifestyle. Stress is also a factor to be considered.

Defining the term constipation is not easy, as it means different things to different people. For some people constipation means having hard bowel movements, for others it means straining when passing stools and for still others it is the feeling of something still to come. Finding a definition is as individual as the person defining it. There are also lots of myths connected to constipation and digestion in general.

From a medical point of view constipation is defined as being severe if there are fewer than three bowel movements per week and may be caused by a variety of things. In medical conditions such as irritable bowel syndrome (IBS), for example, constipation can alternate with diarrhoea. As the number of bowel movements generally decreases as we get older – most adults have between three and 21 per week and it is considered normal – it is essential to change not only our nutritional habits but also our lifestyle as well. One of the most common myths is that it is essential to have a bowel movement every day. There are no medical grounds for this! Going without a bowel movement for two or three days is not a problem for most people. About the only thing it causes is emotional distress which doesn’t help either.

Commonly held misapprehensions are that not „going“ regularly causes a build-up of toxins in the bowel and may even cause cancer. There is no medical evidence for this. It is extremely important to distinguish acute constipation, i.e. recent onset constipation, and chronic constipation, which is of a longer duration. One of the first things to establish is the cause of the constipation. It is, of course, very comfortable to simply go to the pharmacy and get something to deal with the problem. On the other hand, it is essential to examine the causes.

Some of the medications that are frequently overlooked when seeking the cause of constipation include: pain medication such as codeine, antidepressants, anticonvulsants, iron supplements and antacids containing aluminium. According to recent studies here in Germany, quite a high proportion of adults would rather take the easy way and have a quick bite at the local fast food chain instead of going to the trouble of preparing fresh food. Quite a few people also argue that it is sometimes cheaper getting a take-away than buying the ingredients for the evening meal.

Eating fresh fruit and vegetables, and whole-wheat cereals, pasta and bread belong to the first step towards regular bowel movement. Light to medium sporting activity, such as taking a thirty-minute walk every day or every second day also helps. Avoiding foods that constipate is obvious. Many people may not realise that their constipation problems may be caused by eating too much cheese at the evening meal, not drinking sufficient quantities of fluid and basically not getting enough fibre in their diet. Although most national institutes for health and nutrition recommend the “5-aday” rule, i.e. five portions of fresh fruit and vegetables per day, going from zero fruit to large portions in a short period of time, may in fact have an adverse effect. So, it is necessary to start off with smaller portions and gradually change your eating habits before finally reaching this “ideal”.

Pharmacy customer: Hello.

PTA: Good morning. How may I help you?

I have been having problems with going to the loo the last two weeks or so.

Do you mean that you have been having irregular bowel movements?

Yes.

Do you mind me asking you a few questions? I’d like to see if there may be a reason for the problem.

Not at all. Go ahead.

Are you taking any medication such as pain medication at the moment?

No, not at the moment.

I see. And you are not pregnant, are you? You see, sometimes during pregnancy constipation may occur completely unexpectedly.

No, as far as I know I’m not pregnant!

And you are not suffering from some type of thyroid gland disorder?

Well, I do take 125 microgram of thyroxin every day, but I haven’t experienced any problems up to now.

What about irritable bowel syndrome?

What are the symptoms?

The symptoms vary from person to person, but it’s not unusual to alternate between constipation and diarrhoea.

I don’t think that I have irritable bowel syndrome either. Do you think I should take laxatives? I heard that taking them too often may cause dependency. Is this true?

Laxatives, for example preparations with senna, used correctly, are gentle and very effective.

Someone told me about putting wheat bran and linseed in my breakfast cereal. How do they work?

Wheat bran and linseed are an excellent natural means of stimulating peristalsis. They do so by increasing their volume to such a degree that the transport of food speeded up. Just as you have to go by the book when taking senna preparations, you should also be careful when using high-fibre foodstuffs. Firstly, you should make sure that you drink sufficient amounts of fluid when taking bran and linseed as they need liquid to increase their volume and stimulate the movement of food.

Do you have linseed and wheat bran here? I think I’ll try them straight away!

Okay! But just one more piece of advice: Start off gradually, if you take lots of high-fibre at once, it may cause more problems than it solves. Gentle laxatives such as teaspoon of psyllium seeds in water help at the beginning.

You’re very kind for giving me such good information, thank you so much!

Not at all, you’re welcome. Goodbye!

Den vollständigen Artikel finden Sie auch in Die PTA IN DER APOTHEKE 07/09 ab Seite 19.

Vocabulary

constipation Obstipation, Verstopfung
considered in Betracht gezogen
bowel movements (med.) Stuhlgang
straining (hier) pressen
stool (med.) Stuhl
digestion Verdauung
medical condition Krankheit
irritable bowel syndrome Reizdarmsyndrom
nutritional habits Essgewohnheiten
distress Elend
commonly held misapprehension weit verbreiteter Irrtum
toxins Giftstoffe
distingiush unterscheiden
recent onset seit kurzem angefangen
establish feststellen
anticonvulsants Antiepileptika
iron supplement Eisenpräparat
antacids Antazidium, gegen Magensäure wirkendes Mittel
fast food chain Fastfoodkette
takeaway (hier) Schnellimbiss
whole-wheat Vollkorn
fluid Flüssigkeit
fibre Ballaststoff
adverse ungünstig
going to the loo (ugs.) auf die Toilette gehen
pregnant schwanger
pregnancy Schwangerschaft
thyroid gland Schilddrüse
laxatives Abführmittel, Laxanzien
senna Sennesblätter
wheat bran Weizenkleie
linseed Leinsamen
peristalsis Peristaltik
to go by the book (ugs.) genau befolgen
high-fibre foodstuffs Lebensmittel reichan Ballaststoffen
psyllium seeds Flohsamen