Question : My sister, 20, has had difficulty moving her bowelssince childhood. She usually does so once a week. The excreta islarge and hard, resulting in pain. She takes fruit andvegetables daily.

Answer : Constipation is characterised by difficulty in passingstool or an absence of the urge to eliminate. In general, if thebowel movement is less than three times in a week or the bowelmovement is regular but the stool is hard or difficult to pass,it is defined as constipation.

Symptoms include bloating, loss of appetite, mild nausea,indigestion, headache, coated tongue, tiredness and bad breath.Chronic constipation can affect one's health as waste remains inthe intestines for excessive periods, causing toxins to beabsorbed by the body.

Constipation is the common ailment that happens in all agegroups. The underlying causes include lack of dietary fibre,high intake of refined carbohydrate, inadequate fluid intake,sedentary lifestyle and the unnecessary usage of laxatives.

Your sister may supplement her diet with probiotics which arefriendly bacteria that play a role in preventing the growth ofundesirable microorganisms, including candida yeast and bacteriathat cause diseases by maintaining healthy intestinal floranecessary for the proper digestion and assimilation of food.

Increase intake of whole grains, fresh vegetables and fruitwhich are rich in fibre. Dark green leafy vegetables, papaya,prunes, wheat bran, oat bran and psyllium husks are all theeffective natu- ral sources that enhance bowel movement.

Limit the intake of refined and processed foods which have beenstripped of their fibre content. Foods high in sugar and fatstend to stay in the body for a longer period of time and slowdown the bowel transit rate.

Drink at least eight glasses of water daily. Two glasses ofwater are recommended after each serving of fibre. This helps tosoften the stool and make the stool bulky and easy to movethrough the gastrointestinal tract.