Visiting the bathroom is part of the daily human experience. But occasionally, constipation strikes: a condition that causes a backup in your digestive system. The food you eat can take several days to exit your body. And for many, constipation can become chronic, meaning regularly passing lumpy, hard stools accompanied by straining. What's behind this unsettling phenomenon?
上廁所應該是人類每天的例行公事。但有時候難免會便秘，這狀況會在你的消化系統中囤積糞便。你吃的食物可能得花上好幾天才會離開你的身體。對許多人來說，便秘容易變成長期症狀，也就是得定期用力擠出硬梆梆的塊狀糞便。這惱人現象的成因究竟是什麼？
Constipation arises in the colon, also known as the large intestine. This muscular organ is split into four sections: the ascending, transverse, descending, and sigmoid colon, which connects with the rectum and anus.
便秘發生於結腸內，也被稱作大腸。這個肌肉發達的器官分成四個部分：升結腸、橫結腸、降結腸和乙狀結腸，乙狀結腸則和直腸與肛門相連。
The small intestine delivers stool—consisting of ingested food, bile, and digestive juices—to the large intestine. As this stool moves through the colon, the organ siphons off most of the water it contains, transforming it from liquid to solid. The longer this transmission takes, the more reabsorption occurs, resulting in increasingly solid stool. Once it reaches the sigmoid colon, a final bout of reabsorption occurs before it enters the rectum, distending its walls and telling the internal anal sphincter to relax. This is the point where you can usually decide whether to physically expel or retain the stool. That's regulated by the pelvic floor muscles, particularly the puborectalis and external anal sphincter.
小腸能將攝取的食物、膽汁、消化液組成的糞便運送到大腸。當糞便經過結腸時，結腸能吸取大部分的水分，將液態的糞便轉成固態。這個傳遞過程越漫長，重複吸收水分的次數就會更多，導致固態的糞便越來越硬。糞便抵達乙狀結腸後，會在進入直腸前進行最後一次水分吸收，接著腸壁會鼓起，通知肛門內括約肌放鬆。通常在這階段你可以決定要排出糞便或留住糞便。這是由骨盆底肌控制的，特別是靠其中的恥骨直腸肌和肛門外括約肌。
The puborectalis forms a sling-like formation around the rectum called the anorectal angle. And when you voluntarily relax your external anal sphincter, the stool is finally expelled.
恥骨直腸肌在直腸周圍形成吊索形狀的結構，被稱作肛門直腸角。當你自主放鬆你的肛門外括約肌時，糞便才能被排出。
When you're constipated, however, a desire to visit the bathroom isn't enough to coax your body into action. Usually, there's two factors behind this problem: the stool's slow movement through the colon and/or pelvic floor dysfunction.
然而，當你便秘時，想上廁所的慾望並沒有強烈到能誘導你順利排便。通常這問題背後有兩個因素：糞便在結腸中移動過慢及（或）盆底功能障礙。
In the first, stool moves excessively slowly through the intestines, causing over-absorption of liquid, which makes the stool dry and hard. With pelvic floor dysfunction, stool becomes difficult to eliminate from the rectum because of tightened pelvic floor muscles or due to a pelvic organ prolapse, usually through childbirth or aging. Both of these problems make the anorectal angle more acute, and it becomes difficult to expel waste.
在第一個狀況中，糞便在腸道中移動過慢，導致水分過度被吸收，讓糞便變得又乾又硬。而盆底功能障礙也會導致導致糞便難以從直腸中排出，造成的原因是骨盆底肌過度緊繃，或因生產、老化引起的骨盆腔器官脫垂。這兩種問題都會讓肛門直腸角的角度變得更小，導致糞便難以排出。
To identify constipation precisely, researchers have developed metrics, such as the Bristol stool chart. Most people who look at that chart will be able to tell they've experienced constipation before.
為了更精準地辨別便秘，研究者研發出專用指標，像是「Bristol 大便分類法」。大部分的人看到這個指標就能知道自己有沒有便秘。
When you're on the toilet, you should ideally be in a squatting position. With your buttocks firmly on the toilet seat, you can elevate your feet on a stool and lean forwards with a straight back, which straightens the anorectal angle and eases the passage of waste.
當你在馬桶上時，理想上你應該要採取蹲坐姿勢。屁股緊貼馬桶座椅時，你可以用板凳抬高雙腳，保持背部平直向前傾，這能讓肛門直腸角變得平直，讓糞便能輕易排出。
Going a day without a bowel movement isn't necessarily cause for alarm. But if you are experiencing chronic constipation, simple dietary and lifestyle changes, like fibrous vegetables, regular exercise, abdominal massage, and six to eight cups of water per day may help restore your daily trip to the toilet.
一天沒有排便並不需要擔心。但是如果你患有慢性便秘，只要稍微改變一下飲食習慣和生活模式，像是食用高纖蔬菜、規律運動、按摩腹部、一天喝六到八杯水，也許就能讓你重返每天的廁所之旅了。
