Bowel movement in middle of night

Nocturnal diarrhea: Causes, treatment, and symptoms

Nocturnal diarrhea refers to diarrhea that happens at night. Chronic nocturnal diarrhea can be a sign of a more serious health condition, such as diabetes, a bowel disorder, or an infection.

Persistent diarrhea can also interrupt sleep and affect the quality of life. Treatment depends on the severity of the symptom and its underlying cause.

Diarrhea is defined as loose, watery stools. It may be acute and last for a few days, or it can be chronic and continue for 4 or more weeks. In this article, we discuss the possible causes of nocturnal diarrhea and how to treat them.

Share on PinterestSymptoms of nocturnal diarrhea may include fever and stomach pain.

Nocturnal diarrhea symptoms commonly includes the following:

bloating
fever
interrupted sleep
nausea
stomach pain
the urge to pass stool

Symptoms range from mild to severe, and they will also typically be present during the day. People with mild diarrhea often experience symptoms for just a few days, and these can usually be managed with home remedies.

Serious cases of diarrhea can cause additional symptoms, such as:

blood in the stool
severe pain
otherwise unexplained weight loss

Diarrhea that occurs several times a day for a month or longer is classed as chronic.

Long-term nocturnal diarrhea may also lead to sleep problems, which can affect mood and energy levels.

Diarrhea may be caused by:

allergies
foods
infections
medications
stress

If any of these factors are responsible, nocturnal diarrhea typically clears up once the infection is treated or the trigger is eliminated.

However, chronic nocturnal diarrhea is likely to have a more serious underlying cause, such as:

Secretory diarrhea

Share on PinterestCauses of diarrhea may include foods, infections, and stress.

Secretory diarrhea occurs when the intestine cannot properly absorb electrolytes. This is a common cause of both acute and chronic diarrhea.

Secretory diarrhea can result from:

alcoholism
bacterial toxins
medications
intestinal surgery
other medical problems that interfere with intestinal function

Irritable bowel syndrome (IBS)

IBS is a functional disorder, which means that the digestive tract seems to be regular but does not function correctly.

Symptoms include:

bloating and gas
diarrhea
constipation
mucus in the stool
stomach pain and cramping

Most people with IBS do not experience nocturnal diarrhea or severe symptoms. Typically, watery stools occur during the daytime, often after eating.

Nocturnal diarrhea is considered an “alarm symptom” in people with IBS. This means that it requires prompt medical attention.

Other alarm symptoms include:

blood in the stool
progressive pain
unexplained weight loss

Inflammatory bowel disease (IBD)

IBD refers to several chronic conditions that cause inflammation of the gastrointestinal tract. Up to 1.6 million people in the United States experience IBD.

IBD causes inflammation, unlike IBS. It also leads to changes in the gut that can increase the risk of bowel cancer.

Some people with IBD experience nocturnal and daytime diarrhea. Other symptoms include:

blood or mucus in the stool
fatigue
fever
loss of appetite
nausea
pain during bowel movements
stomach pain and cramps
vomiting
weight loss

The exact cause of IBD is unknown, though risk factors include having a family history of bowel conditions, being a smoker, and taking certain medications.

Most people with IBD are diagnosed before the age of 30.

Microscopic colitis

Microscopic colitis causes inflammation of the large intestine and leads to persistent diarrhea. The inflammation associated with this condition can only be observed using a microscope.

Older adults are more commonly affected by microscopic colitis, but anyone who continues to experience nocturnal diarrhea, even when fasting, should be tested for this condition.

Other symptoms include:

fecal incontinence
nausea
stomach pain and cramping
weight loss

The cause of microscopic colitis is unknown, but taking nonsteroidal anti-inflammatory drugs for 6 months or longer may increase the risk of developing it.

Diabetes

Diabetes affects the way the body uses glucose, which is sugar in the blood. Unless treated, it causes high levels to build up in the blood, which can lead to several complications.

Individuals with poorly controlled diabetes and insulin-dependency are at risk for nocturnal diarrhea. It may also affect those with nerve damage caused by diabetes, which is known as diabetic neuropathy.

Diabetes symptoms include:

blurred vision
fatigue and irritability
frequent infections
increased hunger
increased thirst
unexplained weight loss
slow-healing wounds
urinary frequency

The cause of diabetes varies and depends on the type. Type 1 diabetes is linked to an overactive immune system, while type 2 occurs when the cells become resistant to insulin, a hormone.

Gestational diabetes affects some people during pregnancy.

Mild diarrhea can clear up on its own within a few days. During this time, the focus of treatment is to alleviate symptoms and keep a person hydrated.

Severe or chronic diarrhea should be reported to a doctor, who will investigate the underlying cause and formulate a treatment plan.

Some treatment options may include:

taking medications, such as antidiarrheal drugs and antibiotics
avoiding problematic foods, medications, or allergens
changing the diet, for example by eating more bland foods and avoiding high-fiber and fatty foods
managing stress through relaxation techniques and a healthful lifestyle
staying hydrated, with water, juices, and clear broths
reducing the intake of caffeine and avoiding alcohol

Underlying conditions that contribute to nocturnal diarrhea will also require treatment.

What if it is IBD?

IBD cannot be cured, so treatment aims to reduce symptoms and achieve and maintain periods of remission.

Medications for IBD include anti-inflammatory drugs, immune suppressors, and therapies that target inflammation.

In some cases, surgery is needed to widen a narrow bowel or remove damaged parts of the digestive tract.

How is microscopic colitis treated?

Discontinuing medications that cause problems and making dietary adjustments can treat persistent or severe cases of microscopic colitis.

If these approaches do not work, anti-inflammatory drugs and medicines that block bile acids can be used.

In rare cases, a surgeon will need to remove part or all of the colon.

Share on PinterestTo prevent mild diarrhea., it is recommended not to eat for 2 to 3 hours before bed.

Mild diarrhea is a common experience. It may be possible to reduce the frequency and severity of diarrhea episodes by trying the following:

making dietary adjustments and eliminating problematic foods
avoiding IBS or IBD triggers
not eating for 2 to 3 hours before bed
quitting smoking
establishing a healthful sleep routine
managing stress with meditation, exercise, and deep breathing techniques
maintaining a healthy weight
following the treatment plan prescribed for chronic conditions, such as diabetes

Type 1 diabetes is treated with insulin injections or an insulin pump. A person must also check blood sugar levels frequently and monitor their intake of carbohydrates.

Type 2 diabetes can be managed with lifestyle changes, blood sugar monitoring, and medications.

Untreated diarrhea can lead to complications, including dehydration.

Dehydration can cause:

loss of electrolytes
muscle weakness
abnormal heart rhythm
lightheadedness
nausea
kidney failure
shock
coma

When an underlying disorder is responsible for nocturnal diarrhea, additional complications can arise. For example, untreated diabetes may lead to vision loss or nerve damage.

Nocturnal diarrhea may clear up in a few days or become chronic. The outlook typically depends on the underlying cause.

A person should see a doctor right away if they also have any of the following:

symptoms of dehydration
blood or mucus in the stool
a high or persistent fever
other symptoms that suggest a more serious condition

If symptoms persist for more than a few days, it is important to see a doctor for a diagnosis.

Causes of Nighttime Bowel Movement And What You Can Do About It

Often we associate only one thing with our gut health - food. It turns out that food is only one of the many components of a healthy digestive system.

How you sleep affects your bowel movement and digestive health to a great extent. If you have been waking up at 4 AM with stomach pain, something might be wrong with your sleep. It goes without saying that sleeping well has a plethora of benefits. Complete sleep is not a choice or option, it is an absolute necessity. Every aspect of your physical and mental health will suffer without the right quality and quantity of sleep.

The relationship between sleep and digestive health

If you notice yourself over a long period where you go through phases of sleep deprivation, you will notice that your appetite either increases or decreases drastically with the quality of sleep. Sleep is essential for gut health. From ancient times, people have associated sleep with healing. Modern medical research shows that sleep helps in healing wounds, both internal and external. All restorative processes occur in our bodies when we sleep.

Digestive health is one of the most important aspects of your overall health. In fact, every facet of physical well-being is related to digestion. Your gut health determines every aspect of your physical and mental wellbeing. What else has a similar effect on your overall well-being? Sleep.

Lack of sleep, stress, and gut health

Stress is not good for you. You will have a hard time recovering from injuries when you are stressed. You will be at a higher risk of suffering from mental health issues. Your digestive health will also suffer.

Stress alters our digestive system in a way that facilitates the leaking of toxins from the intestines to the bloodstream. It leads to stomach aches, bloating, acidity, and a host of gut issues. On top of that, stress can make you lose appetite. In that case, you would not be fighting as usual and will soon lose weight, muscles, and strength. Many people also report losing libido over stress.

The easiest way to mitigate stress is sleep. There is no stress buster like sleep. A good night’s sleep is all you need to keep your stress levels in check. However, we have the problem of sleep stress to deal with. In a nutshell, you feel stressed about the inability to sleep, ie, insomnia. As you keep stressing, you develop insomnia. It is a vicious loop that people with sleeping disorders and high anxiety levels suffer from.

If you can manage your sleep, you can manage stress. And when you can manage stress, you can enjoy great digestive health. You will eat healthier food, exercise more frequently, and digest what you eat better. Sleep is a one-stop solution for all your digestive and mental health issues.

However, sleep is more about reducing stress. There are many other factors associated with sleep that harm your gut health. One of the most taboo yet serious issues is nocturnal diarrhea.

What causes diarrhea in the middle of the night?

If you are suffering from nocturnal diarrhea, you would know the unpleasantness of the situation. However, it is not just an embarrassing and unpleasant experience. It hints at some serious underlying condition.

Nocturnal diarrhea is a huge problem for sleep continuity. If you keep waking up in the middle of the night, you can never have a good night’s sleep. In turn, it would affect your overall health. Everything from your gut health to your appetite depends on it. If you are suffering from nocturnal diarrhea, get in touch with your doctor at the earliest.

Anxiety poop

Anxiety poop is another embarrassing and uncomfortable problem associated with your gut health. Anxiety triggers certain hormone releases that give us the urge to poop. While it is common, many people suffer to a much larger degree.

According to Healthline, anxiety poop is a result of severe stress.

Severe stress, as we discussed earlier, can be a direct consequence of sleep deprivation. Unless you manage your stress, you cannot deal with anxiety poop. It can also be a result of medications or other gastrointestinal issues. It is also an issue that needs medical attention. But most importantly, you need to get better sleep.

Irritable Bowel Syndrome

40% of people suffering from irritable bowel syndrome also suffer from insomnia. The degree of insomnia varies, but a large number of people with Irritable Bowel Syndrome (IBS have difficulty in sleeping). Women are more likely to suffer from it than men. IBS affects roughly 15% of the population in both Europe and the United States of America. IBS is closely associated with sleep problems. Having trouble falling or staying asleep has been linked to an increased risk of developing IBS. The difficulty in falling asleep can come in various forms: stomach pain, bloating, heartburn, and so on. As a result, you would wake up feeling tired and sick.

Reports also suggest that IBS sufferers also tend to suffer from sleep apnea. Sleep apnea is a condition where a person has difficulty falling asleep because of shallow or obstructed sleep. They keep waking up in the middle of the night, often panting.

Both IBS and sleep apnea cause disruptions to our sleep patterns. Over time, they can make us chronically insomniac and have a lasting effect on how we sleep. To avoid this fate, it is very important to get these issues in check at their very onset. Waiting for a long time can have a detrimental effect on your health.

Does IBS make you tired? Yes, a lot. However, it is not good from a sleep perspective. Normally when you are tired, you tend to fall asleep faster. However, IBS does not cause physical fatigue. It makes us weak and tired on both physical and psychological levels. If you continue to suffer from IBS, you will have trouble falling asleep almost regularly. As a result of sleep deprivation, you would feel more stressed. That in turn would have an effect on your digestive health.

As you can see, lack of sleep traps us in vicious cycles where we suffer due to and as a result of sleeping poorly.

Now that you know that sleep and bowel movements are related, we will delve into ways to keep these issues in check. We will be primarily focusing on getting quality sleep and aligning your eating and exercise habits to assist your sleep. We will also talk about how to have good gut health.

How to sleep better

Instead of getting into nuances and minutiae, we must first focus on getting quality sleep every night. It is a simple solution to many of our most pertinent issues. Here’s how you can get good sleep every night for the rest of your life.

Have a fixed time to wake up

Ideally, you should be falling asleep and waking up roughly at the same time every day. However, reality does not work on idealism. It is unavoidable for most people to fall off schedule every once in a while. You might not be able to fall asleep at the same time every day. However, you should try to wake up at the same time every day.

If you happen to get less sleep due to sleeping late and waking up early, consider getting an afternoon nap. Naps are proven to be effective against fatigue, tiredness, depression, and many other issues.

Waking up at the same time every day fixes your body’s internal alarm. As our body moves in the circadian rhythm, waking up in the morning is very important. By having a fixed waking up time, you are setting yourself up for a disciplined approach to sleep.

Enhance your sleep environment

Nothing can be worse than waking up in the middle of the night due to discomforts. Be it temperature fluctuation, humidity, or excessive light, sleep is disrupted due to many reasons. Setting up your sleeping environment is very important to prevent these disruptions.

Since we are living in the 21st century, it makes a lot of sense to use technology to enhance sleep. Consider getting a fitness band that will also track your sleep. You can use the reports to better understand your sleep patterns and the problems in them. You can also get smart lights and shades. While you can snooze the alarm with one swipe, it is more difficult to turn off lights or draw shades. With smart household appliances, you can set them on an automatic schedule and forget about it.

Perhaps the most important part of good sleep is the physical bed you sleep on. Here again, you can use the latest tech in the form of electric blankets. These blankets let you control the temperature at a macro level. Instead of altering the temperature of the entire room, you get to decide the perfect state for yourself. It is a great solution when you are sharing rooms or if you live with a partner.

Having a good bedtime routine also helps greatly. Consider soothing yourself with a warm bath, an electric foot warmer, calming music, and some aromatics. Reading before bed is also great for falling asleep. Lastly, make sure you cut all screens at least an hour before bedtime. You can set up all your devices to this automatically on a schedule.

By doing these simple things with discipline, you can set yourself up for lifetime protection against insomnia and sleep apnea. Since we are talking about gut health and sleep, it is also important to talk about food. What you eat has a huge impact on your sleep and digestive health.

Food, gut health, and sleep

Consuming certain food items before bedtime can help you fall asleep easily. On the other hand, you must avoid certain ingredients before bedtime. There are also time windows within which you should eat to get the best sleep. Every food habit that helps with sleep will also help you deal with digestive and gut issues. Let’s find out more about it.

Food for sleep

Research has shown that a high-fiber meal with lean proteins can improve sleep quality. While food items with a high percentage of sleep carbohydrates make you feel drowsy, they are actually bad for sleep. Try to avoid sugary foods as much as possible. Instead, focus on getting green leafy vegetables, healthy fats, and lean protein in your meal. Removing (or lowering) salt and saturated fats will also have a beneficial effect on your sleep quality.

As you can see, a diet good for sleep is also good for your overall health. It goes on to show the deep connection between food, sleep, and health. With a plethora of insomnia treatments available, it can get very confusing to stick to any one treatment. We recommend prioritizing your mental and physical fitness and diet. Once these things are taken care of, other treatments would also be more effective.

If you exercise often (which helps you get good sleep), be cautious of working out late in the day. Working out at night will increase blood flow along with adrenaline and dopamine secretion. It makes you hyper-aware and falling asleep will be difficult.

Timing your meals

While timing meals is a very subjective issue, it is preferable to avoid anything right before going to sleep. When we lie prone, stomach acids tend to go up the esophagus. It can cause irritation in your bowel movement and wake you up at the night. Keep a window of at least two hours between your last meal of the day and sleeping time.

If you feel hungry upon waking up, you should eat a healthy breakfast. Many people prefer to fast intermittently, which can also be good for sleep. Depending on your hunger levels you can space out meals across the day. As a rule of thumb, try to eat lighter as the evening closes in.

Conclusion

Sleeping well is one of the most underrated joys of life. Sleep is related to every aspect of our mental and physical well-being. Unfortunately, many of us fall into loops of bad habits that promote insomnia, sleep apnea, and other issues.

As you can see, everyone can get a good night’s sleep with healthy habits and discipline. If you frequently suffer from digestive issues, sleep should be your priority. Try getting at least 7 to 9 hours of sleep every day if you are an adult. Sleeping more than 9 hours may be counterproductive. However, focus more on the quality of sleep than quantity. Before you know it, all your physical and mental health issues will start taking care of themselves.

A warm bed is always great for a good night’s sleep. At Wellcare, our aim is to create gadgets that are both functional and comfortable. Our range of heating pads, cushions, and blankets are all you need to snuggle comfortably and sleep deeply.

how to have a bowel movement, how to avoid constipation and establish a regular bowel movement, is it harmful to push in the toilet

I don’t experience problems with bowel movements, but I constantly hear that there are some special rules on how to go to the toilet in a big way. Allegedly, they will help to avoid problems in the future. Is this true or, if nothing bothers you, these rules can not be followed?

Polina Kalmykova

also poops

Author profile

There really are such rules. They are based on human physiology, and it is useful for each of us to know them.

I will tell you exactly how a bowel movement occurs, how to facilitate bowel movements and why we need to think about it at all.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

How the mechanism of defecation works

Defecation is a process that allows you to remove feces from the human body, that is, all undigested food residues. We control defecation, unlike many other processes that accompany digestion, such as salivation or intestinal motility. Normally, feces leave the body only when a person is ready for it.

We begin to feel the urge to defecate when feces accumulate in the rectum

Defecation starts in the final section of the intestine - the rectum. When it fills with feces, the receptors react to the stretching of the intestine and transmit a signal to the brain that it is time to go to the toilet.

Textbook "Fundamentals of Human Physiology" edited by N. A. Agadzhanyan

To prevent the intestine from emptying as it fills, the rectum is closed by two circular muscles - sphincters: internal and external. The inner one opens involuntarily when the receptors transmit a signal to the brain about the need to defecate. But the man himself controls the outside. Even if the rectum is already full, the sphincter will hold back feces until the person gets to the toilet and gives the body the command to act.

When a person is ready to defecate and signals this to the body, the external sphincter opens and the walls of the rectum begin to contract, pushing the feces out.

Sometimes these contractions are not enough - then the person has to push: tighten the diaphragm and abdominal muscles in order to increase the pressure inside the abdominal cavity and use it to push out the stool.

Additional force is required due to the fact that the end of the rectum is at an angle. When a person is standing, this angle is approximately 90°.

Effect of Posture on Defecation Restraint - International Journal of Colorectal Diseases

To poop easily, the person should assume a position that makes this angle as blunt as possible: this will help the stool not get stuck in the bend. Otherwise, pooping will still work, but you will have to make extra efforts to feel relief.

The curved arrow indicates the anorectal angle. Fecal masses must overcome it in order to leave the body.

Source: Research Gate

How to poop properly

The sitting position helps smooth out the curve between the rectum and the anal canal, and the deeper the person sits, the easier it will be for the feces to descend to the anus.

Thus, the best position for defecation is squatting. Although this position may not be very comfortable, it allows you to empty your bowels quickly and without extra effort.

Comparison of strain during defecation in three positions: results and implications for human health - Pubmed

Despite the benefits for the body, many are not ready to give up the usual toilet in favor of a floor-standing structure. In this case, a footrest will help you to take the desired position.

Another way to soften the anorectal angle is to assume the thinker's posture by bending the upper body. Studies have shown that 11 out of 22 volunteers who experienced problems with bowel movements in a sitting position were able to completely empty their bowels in this position.

Effect of Body Posture on Defecation: A Perspective Study of the Thinker Position - Pubmed

The more familiar way of sitting on the toilet does not smooth out the anorectal angle as much - it is more difficult to poop in this position than when the knees are raised above the pelvis. You can fix this with the help of a footboard - on Yandex Market it costs from 453 R

The "Genoa" bowl, or a toilet like a hole in the floor, allows you to take the most physiological position for defecation. Such a design on Yandex Market costs from 2710 R

The thinker's pose is named after Rodin's sculpture: this is what a pose looks like that facilitates defecation in a sitting position. Source: Wikipedia

The "Genoa" bowl, or a toilet bowl similar to a hole in the floor, allows you to take the most physiological position for defecation. Such a design on Yandex Market costs from 2710 R. The pose of the thinker is named after Rodin's sculpture: this is exactly what the pose looks like, which facilitates defecation in a sitting position.

Source: Wikipedia

Regardless of the position , doctors do not recommend sitting on the toilet for more than two minutes: this can aggravate hemorrhoidal disease if it already exists, or lead to its development.

After defecation, the anus area must be cleaned from the remaining fragments of feces. To avoid irritation and itching, doctors recommend giving up toilet paper and giving preference to cleansing methods that do not require rubbing the skin: rinsing with clean water without soap and other detergents, blotting with damp wipes without fragrance or a damp cloth. If you have to use toilet paper in a public restroom, it is best to flush your anus with water as soon as possible.

Anal Itching - Drugs.com

Basic Anal Care - Permanente Magazine

Flush the anus from front to back to prevent infection from the rectum into the urinary tract.

Why pushing is harmful and how to avoid constipation

Although the body has the ability to push stool, pushing often and hard is not safe: it can become one of the causes of hemorrhoids or rectal prolapse. Correct posture will help prevent severe straining only if a person has a normal stool, but with constipation this may not be enough.

Constipation: Symptoms, Causes and Complications - Mayo Clinic Article

Normal bowel movements are between three times a day and once every three days if the stools are soft and formed. If a person feels the urge to empty the bowels less than three times a week, and the stool is hard, dry and difficult to pass from the body, this condition is called constipation.

Stool types 3 and 4 are considered ideal. Types 1 and 2 indicate constipation.

Constipation forces a person to strain during bowel movements and also leads to complications: in addition to problems due to straining, hard stool can lead to tears in the anus or anal fissures. And this condition can make going to the toilet uncomfortable - too tiring or painful.

Community 11/14/22

What to do if you are constipated?

Constipation can occur for a variety of reasons: due to other diseases, such as diabetes, certain medications, dietary habits, pregnancy or age, one in two people over 80 suffer from constipation.

But sometimes constipation is caused by factors associated with the defecation process itself. So, frequent suppression of the urge to empty the intestines can lead to regular constipation.

To determine the cause of constipation and choose the right treatment, you need to seek help from a general practitioner. Perhaps, based on the results of the consultation, he will give a referral to a gastroenterologist and a proctologist. It can be difficult to figure out on your own which part of the digestive tract has caused constipation.

What else affects bowel movements

To ensure that bowel movements do not cause inconvenience, it is important not only to properly organize the process itself, but also to prepare the body for it in advance with the help of diet, sports and regimen.

Diet. The quality of stool is affected by the amount of fiber we consume. Its deficiency can cause both constipation and diarrhea. The more dietary fiber in the feces, the less stress is required during defecation, bowel movements occur more completely and with greater regularity.

/pochechuy/

How to Cure Hemorrhoids

Most fiber is found in vegetables, fruits with skins, and whole grains such as whole grain pasta or cereals with minimal refining. The normal amount of fiber per day for an adult is about 30 grams.

It is worth increasing the amount of fiber in the diet gradually: it can provoke bloating and increased gas formation.

Physical exercise. Sports activities increase muscle activity, including in the intestines - this helps the body to remove feces faster and more efficiently.

Mode. The habit of going to the toilet at the same time, without haste and stress, also contributes to the normalization of bowel movements.

Relationship between sleep disorders and bowel dysfunction – Journal of Neurogastroenterology and Digestion

The quality of sleep can also affect bowel movements: if a person wakes up frequently during the night or lacks sleep, they are at increased risk of constipation.

What is the result

Signs of a good bowel movement - regular, fast and painless bowel movements, formed, but soft stools.

Even if there are no problems with defecation now, they can develop if going to the toilet is wrong.

The best position for defecation is squatting. You can take it on a regular toilet with the help of a special footrest.

Instead of toilet paper, clean the anus with water or fragrance-free wet wipes.

/list/proctologia/

11 important questions for proctologist Maryana Abritsova

It is dangerous to ignore the urge to go to the toilet or sit on the toilet for a long time: this can lead to constipation or hemorrhoids.

A proper diet, regular exercise, regular sleep and toileting will help ease bowel movements.

What to do? Readers ask, experts answer

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symptoms, causes and treatments

What consistency should the stool be? What should be the shape of the chair? How often should a healthy person empty their bowels? So, constipation: what do we know about it?

Normal stools

The frequency of stools varies from person to person and can vary considerably: from 3 times a day to 3 times a week. Normally, the stool has a relatively soft texture, is formed, defecation (the process of emptying the intestines) does not cause difficulty or pain. Doctors use the so-called Bristol scale, according to which 7 types of stool are observed ¹ . The frequency, shape and consistency of stools depend on the diet and fluid intake, food composition, hormonal levels, genetic characteristics, as well as on the sex and age of the person. In men, stools are softer in texture, larger in volume, and on average, bowel movements occur more frequently than in women ² .

The most physiological is the morning bowel movement. This is due to the following reasons:

completion of the transit of feces along the intestines during the night;
their accumulation in the lower parts of the large intestine and rectum;
transition to a vertical position, in which the pressure of the contents of the intestine on the receptors causes a natural urge to defecate;
a higher level of adrenergic activity in the morning, which leads to relaxation of the rectum ³ .

Symptoms and diagnosis of constipation

Chronic constipation is widespread, affecting 3 to 27% of the population in developed countries ⁴ .

Constipation may be episodic due to short-term causes (traveler's constipation, pregnancy, bed rest, drugs, stress) or chronic lasting more than 3 months ^{3, 5} .

Causes of constipation

Constipation is functional, that is, such that there are no serious diseases of the gastrointestinal tract. In other cases, constipation accompanies various diseases, which were its root cause, that is, it is a symptom, a sign, and not an independent condition.

The reason for the development of functional constipation is a violation of intestinal motility, slowing down the transit of its contents. Such constipation is more common in women ⁶ , perhaps partly due to the influence of female sex hormones on intestinal motility. Among the reasons also called a violation of the sensitivity of the receptors of the small pelvis, the anorectal zone, which is manifested in a decrease in the urge to defecate.

It is impossible to overestimate the role of intestinal microflora in the formation of normal stool. Microorganisms that inhabit the intestines are involved in the breakdown of dietary fiber, their metabolites provide energy to the intestinal cells, and also prevent the colonization of the intestine by pathogenic flora. If the balance of microflora is disturbed, the reproduction of pathogenic bacteria and the inhibition of beneficial strains leads to disruption of the intestinal epithelium, indirectly affects the nervous regulation of intestinal tone and motility ^{3, 5} .

Constipation in children

The current definition of constipation in an infant is generally to mean a combination of infrequent stools (2 or less times a week) with difficulty or pain in defecation that persists for at least a month . In older children, infrequent stools are no longer a mandatory sign of functional constipation and its diagnosis can be made when stools are present 2 or more times a week in combination with other signs ⁷ .

Functional constipation accounts for a significant proportion in children. The development of constipation can be caused by disturbances in the autonomic nervous system, the peculiarities of the child's nutrition, and disturbances in the composition of the intestinal microflora. Constipation in children, especially chronic ones, can lead to behavioral disorders, cause duodenogastric and gastroesophageal reflux, heartburn, lead to intoxication of the child's body ⁸ .

Therapeutic approaches in the treatment of constipation

One of the key places in the treatment is the correction of nutrition with an increase in the proportion of dietary fiber in the diet. It is important to follow a diet with enough fruits and vegetables. If there are no contraindications due to other concomitant diseases, the amount of fluid consumed should be increased.

Among the drugs can be called laxatives, drugs that increase the peristaltic activity of the intestine by stimulating the nerve endings of the mucosa. In recent years, more and more doctors in the treatment of constipation have resorted to prescribing drugs that restore the balance of intestinal microflora ^{2-5, 8} .

Hilak forte for constipation

Hilak forte regulates the balance of intestinal microflora and normalizes its composition ⁹ .Hilak forte is a metabolic product of 4 beneficial intestinal bacteria (E. coli, Enterococcus and two types of Lactococcus). The metabolites that make up the drug contribute to the restoration of the intestinal mucosa, restore electrolyte balance, and prevent the reproduction of pathogenic flora. Together, all these processes have a beneficial effect on the condition of the gastrointestinal tract and contribute to the treatment of constipation.

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