Constipation - #9786

**Patient Name**: Ash K **Age**: 28 years **Date**: 12-04-2025 Ash presents with a history of chronic constipation spanning over 10 years, with notable worsening in the last 2 years. Each bowel movement reportedly takes up to half an hour, which significantly disrupts daily life. The patient avoids eating in the morning due to a sense of poor digestion and a tendency to need the toilet soon after, causing discomfort. There is a strong desire for a cleaner digestive system, more efficient bowel habits, and an overall healthier lifestyle. This longstanding constipation may be due to a combination of factors, such as low fiber intake, inadequate hydration, a sedentary lifestyle, sluggish bowel movement (slow colonic transit), or functional gastrointestinal disorders like irritable bowel syndrome with constipation (IBS-C). In some chronic cases, there may also be issues like pelvic floor dysfunction or incomplete evacuation, which would require a tailored approach. To manage the condition, the first step is to adopt dietary and lifestyle modifications. The patient should increase fiber intake to at least 25–30 grams per day through whole grains, fruits like papaya, pears, prunes, and vegetables like spinach and broccoli. Adding soaked raisins or figs to the morning routine and taking a spoon of psyllium husk (Isabgol) with warm water at night can help soften stools and promote regularity. At the same time, fluid intake must be increased to 2.5 to 3 liters daily. Including probiotic foods like curd or buttermilk will support healthy digestion. Physical activity is key. A brisk morning walk, light stretching, or yoga postures like Pawanmuktasana, Vajrasana after meals, and Malasana (yogic squat) can naturally stimulate the colon. These practices help create a morning rhythm for digestion and bowel movement. In addition to lifestyle changes, mild laxatives can be introduced if required. Lactulose syrup (15–30 ml at night) or polyethylene glycol-based powders can be used short-term to ease stool passage. A probiotic capsule (e.g., Sporlac or Vibact DS) once daily after meals for 2–3 weeks may also support gut health. Stimulant laxatives should only be used occasionally and under medical guidance. If symptoms persist, it is important to consider further evaluation. Investigations like a thyroid profile, abdominal ultrasound, vitamin B12 levels, or even colonoscopy may be warranted to rule out structural or metabolic causes. A structured morning routine, including drinking 2 glasses of warm water upon waking and using the toilet at the same time daily, can help train the body to adopt a healthier rhythm. With consistent dietary, physical, and lifestyle practices, along with occasional medical support, long-standing constipation can be significantly improved. Follow-up every 4–6 weeks is advised to track progress and adjust treatment as needed. Please give your valuebale rating and comment. Dr Shayeque Reza MD 9800280276