Another C

Another C

Another C

by Johanna Patricia A. Cañal, MD, MHA, MSc

Let’s talk about something that is not usually discussed out in the open:  constipation.

Simply put, constipation is infrequent bowel movements or difficult passage of stool.  Easy enough to understand.  But, let’s make this clear, there is NO specific number of bowel movements that is normal.  Perfectly normal people have bowel movements that range from once a day to once every 4 days.  If one’s pattern is every 2-3 days, then so be it.  This is not constipation.  However, every 5 to 6 days is worrisome.  That deserves looking into.

The problem with the human gastrointestinal system is that it is highly flexible and adaptable.  That is, a small change in diet will cause a change in bowel movement (BM).  The degree of change in bowel movement also varies among different people.  A slice of papaya may or may not affect an individual’s BM immediately.

Constipation is known to be more common in women.  This probably has something to do with hormonal influences.  Certain medications cause constipation:  iron, certain antacids and certain pain medications.  Changes in routine may also cause constipation:  cross-ocean travel and changes in shift at work.  Dehydration, certain food and stress can cause constipation too.   Then there are certain conditions that predispose to constipation:  stroke, irritable bowel syndrome and even diabetes.

So, the first step in finding a solution to this problem is looking for the cause.  Know thyself.  Has there been a sudden change in lifestyle or time zone or diet?  Are you drinking enough fluids?  Have you been binging on apples lately?  Is there enough fiber in your diet?  Have you started taking a new medication?  The best thing would be to know all of these things before you see your doctor.  The doctor to see in this case is the gastroenterologist or the GI specialist. Knowing these things will make the process faster and less painful.  Treatment may range from the simple—just a tweak in your diet or activity level—to the mid-range such as medication to the complex, such as surgery.  That is something that you will have to discuss with your gastroenterologist.


This short article is part of a series of articles that is designed to make health care more understandable to non-doctors.

As a way of disclosure, I am a radiologist and a radiation oncologist.  My strengths, therefore, are diagnosing illness, particularly cancer, and cancer treatment.  Thus, I will be talking about medical tests and what these are about.

I shall also be talking about the dreaded disease, cancer.  In the 2nd decade of the 21st century, cancer is the #4 cause of death worldwide. NUMBER 4!  It used to be #10.  It has obviously been going up.  The number 1 and 2 killers are cardiovascular diseases…translated into heart attacks and strokes.  Number 3 is pneumonias and lung diseases.

The previous century was known as the century of infectious diseases.  The most common causes of disease and death were bacterial and viral pneumonia and tuberculosis.  The present century is the century of the lifestyle disease.  That is, infections don’t play as big a part as lifestyle diseases.  What are those?  Heart disease, strokes, cancers and injuries/accidents.

But then again, the 21st century has just started, and we already have a pandemic.  One never knows what will happen in the next 10, 20 or 30 years.  Thus, this series will discuss a range of topics, hopefully the topics most relevant to you.

If there is a topic that you want clarified, please do drop me an e-mail at [email protected]Please just fill in the subject line with: [SULIT] Your question


Johanna Patricia A. Cañal, MD, MHA, MSc

Another C

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