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Constipation; ‘diarrhoea’ of information on this

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Constipation can contribute to abdominal pain and bloating

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.

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We will focus on chronic constipa­tion, which occurs when we experi­ence two or more of the following for at least three months;

Lack of exercise can cause constipation
Lack of exercise can cause constipation

• Less than three bowel movements in a week

• Hard stools that are difficult to pass

• Straining to move bowel

• Abdominal discomfort and bloating

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• Frequent use of enemas and laxa­tives

• A sensation that your bowel is never really empty.

COMMON CAUSES OF CONSTIPATION

• Lack of exercise

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– 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

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– 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.

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• 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.

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• 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

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• 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.

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• 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

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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

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• Bleeding from the anus

• Anaemia

• Abdominal pain with vomiting

• Weight loss

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• 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

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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

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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”

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References:

• Chronic Constipation – Har­vard Medical School (Patient Educa­tion Center) – leaflet

By Dr. Kojo Cobba Essel

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Health Essentials

When blood is missing: The silent gaps in Ghana’s lifesaving system

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A person donating blood

The call often comes at the worst possible moment. A mother is bleeding heavily after childbirth. A road crash victim has been rushed into surgery. A child with severe anaemia needs an urgent transfusion.

Then comes the message to relatives: “The patient needs blood. Find donors.”

Within minutes, family members begin making frantic calls, sending WhatsApp messages, and appealing on social media. Some race from one hospital to another in search of matching donors. Others simply pray that blood arrives before it is too late.

For many Ghanaians, this is their first encounter with a reality healthcare professionals know all too well-blood remains one of the country’s most critical and vulnerable healthcare resources.

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Despite years of progress, experts say Ghana’s blood collection, storage, and transfusion system still faces significant gaps that affect access, quality, and safety. And in emergencies, those gaps can cost lives.

A system built out of necessity   

For decades, hospitals across Ghana collected blood however they could because patients needed it. There was no law governing blood services. There was simply the urgent need to save lives.

It was only in 2020 that Parliament passed the Blood Service Act (Act 1042), establishing the National Blood Service (NBS) as the agency responsible for ensuring safe and adequate blood supplies nationwide.

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Charity and philanthropy

According to Dr. Shirley Owusu-Ofori, Chief Executive Officer of the NBS, the law marked a major shift toward a coordinated national system. But reforming practices that evolved over generations remains a challenge.

The blood that is not there

One of the biggest weaknesses is Ghana’s continued dependence on family replacement donors. These are relatives and friends who donate blood only when someone they know requires a transfusion.

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The preferred option, experts say, is a strong pool of voluntary, unpaid donors who donate regularly, allowing blood to be available before emergencies occur.

“The blood should be waiting when the emergency happens, not the other way round,” Dr. Owusu-Ofori said.

The numbers reveal the challenge.

The World Health Organization recommends that countries collect at least 10 units of blood per 1,000 people.

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Ghana currently collects about 6.6 units per 1,000 population, an improvement from previous years but still well below the recommended threshold. Yet demand continues to rise.

An estimated 80 to 85 per cent of blood requests in Ghana are for emergencies, leaving little room for delays.

More than a bag of blood

Many people assume donated blood goes straight to a patient. It does not. Every unit must first be screened for infections such as HIV, hepatitis B, hepatitis C, and syphilis. It must then be processed, stored under strict temperature conditions, and transported safely.

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Blood itself is not a single product. Red blood cells, plasma, and platelets all require different storage conditions and handling procedures.

Maintaining those standards requires specialized equipment, trained personnel, and continuous monitoring.

And that is where another challenge emerges.

The infrastructure gap

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Across the country, some hospitals lack adequate blood storage facilities and the specialized equipment required to operate fully functional blood banks. Others depend on nearby facilities for supplies when emergencies arise.

While healthcare workers often improvise to meet patients’ needs, experts warn that blood safety cannot depend on improvisation.

Storage conditions, transportation systems, and quality controls must work every time.

A breakdown anywhere along the chain can compromise blood quality and patient safety.

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Unequal access

Geography presents another challenge. For years, Ghana relied on three major blood centres in Accra, Kumasi, and Tamale to serve the entire country. The arrangement made blood collection and distribution across vast regions difficult and expensive.

To address this, the National Blood Service has established five regional blood centres in the Greater Accra, Ashanti, Northern, Volta, and Central regions.

More are planned.

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But with 16 regions nationwide, large areas still remain underserved.

The result is uneven access to blood and blood products, particularly for facilities located far from regional centres.

Closing the regulatory gaps

The Food and Drugs Authority (FDA) says recent assessments have uncovered compliance challenges across the blood sector.

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According to Dr. Edwin Nkansah, Director of Vaccine Vigilance and Clinical Trials at the FDA, gaps exist across the entire transfusion chain, from donor recruitment and testing to storage and transfusion practices.

To strengthen oversight, the FDA is embarking on a programme to regulate and license selected blood facilities across the country. The aim is not punishment, he stressed, but improvement.

Facilities will undergo audits, receive technical support, and be guided to meet approved standards.

The goal is simple: ensuring that blood transfused in any hospital meets the same safety requirements.

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The missing link

For all the discussions about infrastructure, regulation, and accreditation, experts agree that the biggest solution lies with ordinary citizens.

Every unit of blood starts with a donor. Yet voluntary blood donation remains far below what the country requires.

Health officials estimate that if just one per cent of eligible Ghanaians donated blood regularly, shortages could be dramatically reduced.

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That would mean fewer desperate appeals from hospital wards and fewer families scrambling for donors during medical emergencies.

A race against time

Ghana has made important strides in strengthening blood services. Collection rates are improving. Regulatory oversight is expanding. New regional centres are being established. Yet significant gaps remain.

And for the mother experiencing postpartum haemorrhage, the accident victim on the operating table, or the child awaiting a transfusion, those gaps are not statistics. They are the difference between life and death.

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Until safe blood is available whenever and wherever it is needed, Ghana’s blood system will remain a critical work in progress—one whose success depends not only on regulators and hospitals, but also on the willingness of citizens to roll up their sleeves and donate.

Because when blood is missing, every second matters.- GNA

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The role of GAPHTO in disease prevention in Ghana, public health, national development

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President Owusu Asante
• President Owusu Asante

Every day across Ghana, thousands of public health professionals wake up before dawn and head into communities, schools, markets, health facilities and households. They inspect sanitation conditions, monitor disease outbreaks, educate communities on healthy practices, investigate health threats and help prevent epidemics before they occur.

Yet despite their critical contribution to national health and development, many Ghanaians know very little about the men and women behind these efforts.

These are the Public Health Technical Officers (PHTOs) — a dedicated workforce that operates largely behind the scenes but serves as one of the country’s most important lines of defence against disease and public health emergencies.

Now, the newly elected President of the Ghana Association of Public Health Technical Officers (GAPHTO), Mr Owusu Ansah Asante, wants to change that.

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Having assumed office this year, Mr Asante has placed visibility, professional recognition and strategic advocacy at the centre of his leadership agenda. His goal is to ensure that the work of Public Health Technical Officers is better understood, appreciated and supported by the public, policymakers and development partners.

While doctors and nurses are often the most visible faces of healthcare, Public Health Technical Officers perform preventive functions that help stop diseases before people require medical treatment.

They are involved in environmental sanitation, disease surveillance, outbreak investigations, health promotion, food hygiene inspections, water quality monitoring, vector control and community health education.

Their work becomes especially critical during disease outbreaks such as cholera, meningitis, yellow fever and other infectious diseases that threaten communities.

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“When outbreaks occur, our members are among the first responders in the field,” Mr. Asante explained. “They work directly with communities to identify risks, educate the public and implement preventive measures that save lives.”

According to him, preventive healthcare remains one of the most cost-effective investments any nation can make because it reduces the burden on hospitals while improving the overall health and productivity of citizens.

“Many people only think about healthcare when they visit a hospital. Yet there are professionals working every day to prevent diseases before people become patients. That contribution deserves greater public appreciation and support,” he said.

Founded in 1984, GAPHTO has evolved into one of Ghana’s most significant public health professional associations.

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Today, the association boasts more than 4,000 members working across districts, municipalities, metropolitan assemblies, regional health directorates and various public health institutions nationwide.

For more than four decades, the association has contributed to Ghana’s efforts in disease prevention, environmental health management, sanitation improvement and public health education.

Members have played active roles in major national health interventions, helping to address public health challenges ranging from sanitation-related diseases to epidemic preparedness and response.

Despite these contributions, Mr Asante believes the profession has not received the level of recognition that matches its impact.

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“There is a lot of excellent work being done across the country by Public Health Technical Officers. Unfortunately, much of this work goes unnoticed because it happens quietly in communities. One of our goals is to tell these stories and help people understand the importance of what our members do,” he said.

For the new GAPHTO President, increasing visibility is not merely a public relations exercise.

Instead, he sees communication and public engagement as strategic tools for strengthening public health outcomes and attracting support for preventive healthcare initiatives.

Under his leadership, the association plans to strengthen its communication efforts, improve engagement with the media, expand public education activities and highlight the achievements of members across the country.

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Mr Asante believes greater visibility will not only enhance public appreciation for the profession but also create opportunities for partnerships, policy influence and professional development.

“We want GAPHTO to become a household name in matters of public health and disease prevention. When people hear about sanitation, disease surveillance, health promotion and community health protection, they should immediately recognise the role of Public Health Technical Officers,” he said.

Beyond visibility, the new leadership is committed to building the capacity of members to respond to emerging public health challenges.

Rapid urbanisation, climate change, population growth and evolving disease patterns continue to create new public health risks that require innovative solutions and highly skilled professionals.

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Mr Asante noted that his administration will focus on continuous professional development, leadership training, research and knowledge sharing to ensure members remain equipped to address contemporary health challenges.

“We live in a rapidly changing world. Public health professionals must continue to upgrade their skills and knowledge to respond effectively to new and emerging threats,” he said.

The GAPHTO President is convinced that the association’s work extends far beyond the health sector.

According to him, effective disease prevention and environmental health management contribute directly to economic growth, educational outcomes and national productivity.

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Healthy communities are more productive, children are able to attend school consistently and families spend less on medical treatment when diseases are prevented before they occur.

This, he argues, makes Public Health Technical Officers important contributors to Ghana’s broader development agenda.

“Public health is not only about health. It is about development. It is about creating environments where people can live productive lives and contribute meaningfully to society,” he explained.

As part of his vision, Mr Asante is seeking stronger collaboration between GAPHTO and government institutions, development agencies, civil society organisations, academia and the private sector.

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He believes partnerships will be essential for addressing complex public health challenges that require coordinated action across multiple sectors.

The association also hopes to create stronger platforms for advocacy on issues relating to sanitation, environmental health and disease prevention.

As Ghana continues to pursue universal health coverage and strengthen its health systems, Mr Asante believes Public Health Technical Officers must occupy a more prominent place in national conversations about healthcare and development.

His message is simple: disease prevention deserves as much attention as disease treatment, and the professionals who dedicate their careers to protecting communities deserve greater recognition.

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For decades, they have worked quietly in the background, helping to keep Ghanaian communities healthy and safe.

Under the leadership of Mr Owusu Ansah Asante, GAPHTO hopes that story will no longer remain hidden.

The association’s new chapter seeks not only to strengthen the profession but also to ensure that the thousands of men and women who stand on the frontlines of disease prevention finally receive the visibility their contributions have long deserved.

By Geoffrey Buta

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