What to do when I feel constipated, but I'm not

Feel constipated even when you're not? That backed-up feeling can occur for various reasons. So why does it happen and what can be done for relief? Here's what you should know.

A variety of sensations such as gas, bloating and abdominal discomfort are not uncommon – but often confused with constipation due to a lack of information about the subject.

• Estimates indicate that close to 10-15 per cent of the population suffers from some type of indigestion problem that is often mistaken for constipation. This occurs even though the individual has normal bowel movements.

Diabetic gastroparesis (DG)
A common disorder that feels like constipation, but is not, is diabetic gastroparesis. People with either type 1 diabetes or type 2 diabetes can be affected by complications arising from DG.

• High levels of sugar eventually lead to damage of the nerves that control motility of the bowels. This damage occurs after several years of diabetes, and
• The individual gradually develops sensations of feeling full, constipated, gaseous and may develop abdominal cramps.
• Not everyone with diabetes develops DG and the disorder can occur in diabetics who have maintained proper control of their sugar levels.
• The diagnosis of DG is difficult and involves many tests that assess bowel motility.
• Treatment of DG involves changes in diet and use of medications.
• The condition is progressive and overall the treatment is not satisfactory.

Irritable bowel syndrome (IBS)
Another very common disorder mistaken for constipation is irritable bowel syndrome.

• The signs and symptoms of IBS are variable but most commonly include presence of abdominal cramps, a bloated feeling, gas, constipation or diarrhea and mucus in the stools.
• For the majority of people afflicted with this disorder, the condition is life-long, but the symptoms do wax and wane.

What is IBS?
It is not known exactly what causes IBS, but a variety of factors play a role.

• In general, it appears that the muscles that line the wall of the bowels for some unknown reason stop functioning or lose their coordinated contractions.
• The symptoms of IBS are often worsened with stress, eating certain foods (e.g., spices, fruits, beans, broccoli, alcohol, etc.), and hormones.
• Women are twice as likely to develop this disorder than men.

Treating IBS
Because the cause of irritable bowel syndrome is not known, treatment can only help manage the symptoms.

• To start, keep a food diary and avoid all foods that cause abdominal symptoms.
• Drink ample fluids, exercise and get adequate sleep.
• For moderate to severe symptoms, a visit to a health care provider or dietitian is recommended.
• You may be asked to add fibre to your diet. If dietary fibre alone does not relieve symptoms, you may take a laxative like polyethylene glycol or milk of magnesia.

Other abdominal disorders that may feel like constipation include peptic ulcer disease, use of certain medications (e.g., drugs to treat high blood pressure or pain killers), reflux or diverticulitis.

• The only way to know for sure what you have is to visit a healthcare professional and have the proper tests.