Health Essentials
Constipation; ‘diarrhoea’ of information on this
Constipation can contribute to abdominal pain and bloating
I have been wondering why I have this urge to write about constipation soon after the month of May during which we indulged in issues of blood pressure. This may have been influenced by the frequent complaints I hear day in day out about constipation. Do all these complaints qualify to be described as constipation?
Many people would rather not talk about constipation but if you have suffered from a bout or two you will definitely appreciate how painful and frustrating it may be. There is this other group of people who is obsessed with constipation and believes that all their problems will be solved once they can move their bowels frequently. Their bad mood is blamed on constipation, poor appetite also assumed to be from constipation and constipation cannot be excluded from any bout of headache they experience. This category of people swears by enemas and some of the concoctions they resort to could corrode the best of intestines.
Constipation may present as infrequent bowel movements or extremely hard stools that may cause unbearable pain. Periodic constipation may be relieved by the appropriate diet, proper hydration and exercise but chronic constipation is often more worrying and may require medical attention. Do not force yourself to be someone else, as individuals our bowel movements vary. Some may go up to three times a day while for others three times a week is just right. Listen to your body. It may appear absurd that we are discussing constipation at a time that Accra is flooded with diarrhoea stools and scattered black bags but some people may find this life-saving.
We will focus on chronic constipation, which occurs when we experience two or more of the following for at least three months;
• Less than three bowel movements in a week
• Hard stools that are difficult to pass
• Straining to move bowel
• Abdominal discomfort and bloating
• Frequent use of enemas and laxatives
• A sensation that your bowel is never really empty.
COMMON CAUSES OF CONSTIPATION
• Lack of exercise
– Regular exercise promotes muscle contraction in walls of the intestine.
• Poor water or fluid intake
– Drink about two litres of water a day
• Poor diet
– Ensure you have a lot of fibre in your meals
– Fruits and vegetables a must and go easy on refined foods such as polished rice.
• Change in routine
– Change in diet and time for meals as well as a lack of proper facilities to move bowel can all set the stage for constipation.
• Ignoring the urge
– If you have to go get the right place and go. Ignoring the urge frequently could lead to constipation but can we blame those who ignore the urge because they have to pay money for every single episode?
• Overuse of laxatives
– This is akin to teaching your bowel to wait for assistance before it performs.
• Certain medical conditions
– Medical conditions such as diabetes, anxiety and depression, abnormal potassium and calcium levels and an underactive thyroid have all been blamed.
• Bowel Disease
– Several of these and may include irritable bowel syndrome and tumours
• Pregnancy
– Changes in hormones or pressure on the intestines from the foetus may cause constipation.
• Side effect of some medication
– Some pain medicines and even some vitamins and supplements may have constipation as a side effect.
• Local pain
– Pain around the anus from infected haemorrhoids or cuts may lead one to suppress the urge.
For some of us the problem may be simpler than we can imagine; our intake is so little the body absorbs virtually everything. This scenario is very common in exclusively breast fed babies and may not be classified as constipation.
DO NOT IGNORE THE FOLLOWING
Quite often we delay seeking help for constipation but whenever you have any of the following it is better to act fast:
• New constipation
• Fever
• Rectal pain
• Bleeding from the anus
• Anaemia
• Abdominal pain with vomiting
• Weight loss
• Family history of colon cancer or other bowel disease.
THE UGLY SIDE OF CONSTIPATION
Chronic constipation may lead to developing haemorrhoids which may bleed or become painful, tears in anal tissue from hard stools that worsen the constipation and straining may even push rectal tissue out through the anus and may require surgical repair.
MANAGEMENT
Prevention is key and the focus should be on lifestyle modification. In some cases especially involving adults, health professionals may need to manually evacuate impacted stools from the rectum. Medications may be needed or as the causes showed one may have to stop taking some medicines and also certain conditions will need to be treated to stop the constipation.
The least we should all do is to eat meals that are rich in fibre and as stated earlier it includes fruits and vegetables, bran, nuts and seeds. Do not forget to drink adequate amounts of water or other healthy fluids and make sure you exercise almost every day to help speed the transportation of waste through the intestine. This is also a bonus for those who exercise regularly because they get some protection from colon cancer. Last but not least; establish a routine and whenever you feel the urge answer in a civilised way and place.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd/ Mobissel
(dressel@healthessentialsgh.com)
*Dr. Essel is a medical doctor, holds an MBA and is ISSA certified in exercise therapy, fitness nutrition and corrective exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
THOUGHT FOR THE WEEK – “although chest pain is commonly attributed to heart disease, many people with heart disease say they experience a vague discomfort for which PAIN doesn’t seem to be an adequate description”
References:
• Chronic Constipation – Harvard Medical School (Patient Education Center) – leaflet
By Dr. Kojo Cobba Essel
Health Essentials
Glaucoma – a call to have your eyes checked
As we raise awareness of Glaucoma this week (it should continue all year), the importance of community education to prevent vision loss, regular eye care and early detection of this silent disease is key. The theme “SEE THE FUTURE CLEARLY” puts the whole process into perspective.
What will you do if after years of enjoying the beauty of the world through your eyes, you wake up one day and realize your eyes are failing or have failed you? It could be a major life-changing event. You may even run the risk of causing accidents. Imagine what one goes through during the DUM phase of DUMSOR.
Now imagine life perpetually in DUM. All this could be prevented if you make time to care for your eyes: check your eye pressure and have your sight checked as well.
Glaucoma is a group of eye conditions that damage the optic nerve (nerve of the eye) leading to loss of vision. It is most often but not always associated with an increase in eye pressure.
In Ghana, glaucoma is a leading cause of blindness second only to cataract. Ghana appears to have many challenges with “vision” (note the pun) as we have been identified as the country with the second (some data quote third) highest prevalence rate of glaucoma.
Glaucoma is sometimes referred to as the “silent thief of sight” because it can damage your vision so gradually that you may not notice any loss of vision until the disease is at an advanced stage. The most common type of glaucoma, primary open-angle glaucoma has no noticeable signs or symptoms except gradual vision loss. As always, the key is to be diagnosed early and managed since this can prevent or minimize damage to the optic nerve. Early diagnosis is only possible if we have regular check-ups. I checked my eye-pressures six months ago, what about you?
Isolating the risk factors
1. Age – Anyone can get glaucoma, but it most often occurs in those above forty years.
2. Ethnicity – Africans and African Americans are at an increased risk compared to Caucasians. In high-risk groups it may be necessary to have your eyes checked even in your 20s.
3. Family History/ Genetics – You are at an increased risk if a member of your family has glaucoma.
4. Medical Conditions – Diabetics and people with hypothyroidism are also prone
5. Nearsighted/shortsighted – For this group of people, objects in the distance appear fuzzy without corrective lenses.
6. Prolonged Steroid use – especially if used as eye drops, increases our risk for glaucoma.
7. Other Eye conditions – Severe eye injury, some of which may even cause the eye lens to dislocate. Retinal detachment, eye tumours and some eye infections may also predispose us. Some eye surgeries may occasionally trigger glaucoma.
Recognising the warning signs
It is important to drum home the point that just as in high blood pressure, there may be no warning signs. As stated above, the commonest form of glaucoma will hardly warn you. In some forms of glaucoma, however, we may experience the following:
1. Gradual loss of peripheral (side) vision leading to tunnel vision where one is able to see only objects directly in front of him/her
2. Redness of the eye
3. Blurred vision
4. Halos around lights
5. Severe eye pain is sometimes associated with nausea and vomiting
6. Sudden onset of poor vision especially in low light
Overview of tests available
1. Measuring eye pressure. This is a simple painless procedure. It is often the first line for screening for people with glaucoma.
2. Visual Field Test – your doctor will use this test to determine whether glaucoma has affected your peripheral vision
3. Several other tests are available and include testing for optic nerve damage and measuring corneal thickness.
Treatment options
There is NO CURE for glaucoma, but it can be successfully managed. Our options include eye drops, oral medication or surgery, which reduce pressure in the eye to a level that is unlikely to cause further optic nerve damage.
You may not be able to prevent glaucoma, but you can avoid its complications if diagnosed and its management started early. Talk to your healthcare professional and have eye examinations when necessary.
This is the only way to ensure that you can “…see clearly now the rain is gone. I can see all obstacles in my way” and you will enjoy this great vision for years to come.
Glaucoma is “a silent thief of sight.” This is another reminder that NOT ALL SILENCE IS GOLDEN! Get checked.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd (HE&W Group)
(dressel@healthessentialsgh. com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
Thought for the week – “The next big thing in Healthcare in Ghana is the Medics Clinic. Visit https://medicsgroupgh.com/ for more information.”
References:
1. 37 Military Hospital Eye Department infomercials
2. Mosby’s ACE the BOARDS
3. www.mayoclinic.com
By Dr. Kojo Cobba Essel
Health Essentials
Making the most of your visit to the doctor
Very often we leave the doctor’s office only to remember that we left out a major complaint. Some patients immediately rush back to the consulting room totally oblivious of the privacy that the next patient is entitled to. They expect that as they walk in, the doctor should ignore the seated or positioned patient and attend to them. That is totally outrageous. Others go home and continue to live with the condition hoping to be healed miraculously.
Most of us will be extremely lucky to spend fifteen (15) minutes with our doctor and this time is often much shorter in countries/communities where the doctor-patient ratio is so low that at best it can be described as criminal.
We are still in the first quarter of 2025, and I highly recommend that you see a doctor not only when you are unwell but as a means to assess your state of wellbeing and take the needed precautions.
To make the most out of our time with the doctor we need to PREPARE. If your condition is an emergency, then you do not have the benefit of time to prepare.
A must do!
Kindly ensure your personal hygiene is excellent.
- Take a good bath and brush your teeth
- Wear clean clothes that also make undressing easy, especially if you need to expose some areas for inspection/examination.
This may sound ridiculous, but the opposite does happen in real life.
Remember that doctors are human and when you are unkempt you may not get adequate contact with your doctor.
Research on the symptoms
If you have access to the internet or a book worth its salt you may read about your symptoms or wait to read after your doctor tells you your diagnosis.
Remember that if you need to research on the internet, it is essential that you use a reputable site.
In tune with your complaints
- Write down your complaints/symptoms if you think you may forget
- If you have had a similar problem and have the results of any investigations e.g. Laboratory tests, x-rays, CT scans etc kindly carry them along
- Let your doctor know if you react to any drugs
- Be truthful about any medications you have taken for the condition, if you do not remember the names make sure you go with the containers
- If you have any other medical conditions (and medication) make the doctor aware
- Remember to make a note of the following
- When did the symptoms/complaint begin?
- How long have you had these symptoms?
- Is it getting worse?
- Does anything make the condition worse?
- What makes you feel better?
- Is anything related to their onset?
- How often does it occur?
- How long does it last e.g. in pain conditions as well as rash, allergies etc
- Does anyone else in your family have them?
- How do they affect your daily life?
- Is it related to work or home?
You may need to modify these slightly when you have skin lesions, swellings etc. This list is by no means exhaustive, and you may not need to find answers to all of them before getting help, but they will definitely help you ace the visit to your doctor.
If your doctor books you for surgery, do not leave his presence without finding out the following:
- Will you go home on the same day of the surgery?
- Will you need assistance to go home or can you drive unsupervised for instance
- What form of anaesthesia will you be given?
Then, if your visit is for a medical examination, do remember that also being aware of disease conditions in your family will help your doctor select the appropriate tests and make the whole experience and time useful.
See you in the consulting room soon.
AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI)
Dr. Kojo Cobba Essel
Health Essentials Ltd (HE&W Group)
(dressel@healthessentialsgh.com)
*Dr. Essel is a Medical Doctor with a keen interest in Lifestyle Medicine, He holds an MBA and is an ISSA Specialist in Exercise Therapy, Fitness Nutrition and Corrective Exercise. He is the author of the award-winning book, ‘Unravelling The Essentials of Health & Wealth.’
Thought for the week – “The next big thing in Healthcare in Ghana is the Medics Clinic. Visit https://medicsgroupgh.com/ for more information.”
References:
By Dr. Kojo Cobba Essel
