Constipation
What is it?
Constipation is a condition
in which bowel movements occur infrequently.
When this happens, the contents of the
intestine can harden and the hard, dry stools are
painful or difficult to pass. In
general, an adult who has not had a bowel movement
in more than three days is considered constipated.
Who gets it?
Constipation is a common
medical complaint. While
constipation can occur at any age, it is more
common among women than men, especially elderly
women, and often occurs during pregnancy.
What causes it?
Constipation can have many
causes. These include not drinking enough fluids,
eating a diet that is low in fiber, not getting
enough exercise, prolonged bedrest due to accident
or illness, having high levels of stress, travel,
overusing laxatives, and repeatedly ignoring the
urge to have a bowel movement. Chronic
constipation can be a sign of a more serious
illness, such as colorectal cancer, kidney
failure, hypercalcemia (high blood calcium
levels), hypothyroidism (underactive thyroid
gland), depression, diabetes, diverticulitis,
multiple sclerosis, stroke, lead poisoning, spinal
cord injury, or Parkinson's disease.
Sometimes constipation is caused by stool
material that is trapped in the lower portion of
the large intestine.
This is called impaction.
The elderly, disabled, and children are
more likely to have impaction as a cause of
constipation.
Anal fissures (small tears or cracks in the lining of the
anus) and irritable bowel syndrome can also cause
constipation.
Certain drugs, including antacids,
antihistamines, antihypertensives, beta blockers,
diuretics, belladonna, aspirin, blood pressure
medications, calcium channel blockers, iron or
calcium supplements, narcotics, and tricyclic
antidepressants list constipation as a possible
side effect.
What are the symptoms?
If you are constipated, you
will not have bowel movements as frequently as
normal. When
you do have a bowel movement, you may need to
strain because it consists of hard stools that are
difficult to pass.
You may feel as though the rectum has not
completely emptied.
People who are constipated may also feel bloated and have
frequent headaches.
Complications of continued constipation
include bowel obstruction, hemorrhoids, hernia
(the protrusion of an organ through a tear in the
wall that normally contains it), spastic colitis
(alternating bouts of diarrhea and constipation),
and dependency upon laxatives.
How is it diagnosed?
Constipation is diagnosed by
examination and a complete medical history.
Your doctor will want to know the frequency
and types of bowel movements that you have, and
any other symptoms you are experiencing.
He or she will also need a complete list of
any medications you are taking. Your
doctor will press upon your abdomen to feel for
any hardened areas, and may perform a rectal
examination.
In addition to routine blood, urine, and
stool tests, other diagnostic tests can help
determine if there is some underlying cause of
your constipation.
One common diagnostic test is sigmoidoscopy,
where a thin flexible viewing tube is inserted
through the anus to examine the rectum and lower
intestine (sigmoid colon). A
colonoscopy uses a longer instrument to view the
entire colon. You
may also need to have a barium enema x-ray.
For this procedure, you will drink a barium
solution that will reveal any blockages in the
intestine when x-rayed.
What is the treatment?
Constipation is most
effectively treated with a combination of high
fiber diet, regular exercise, and occasional
medications recommended by your doctor.
However, laxatives should be a last resort.
Using laxatives too often can be habit
forming and cause the loss of normal bowel
function over time.
Pregnant women should never use laxatives.
Your doctor may also recommend eating fruit
sprinkled with bran a few times each day, or
drinking prune juice.
It’s important to drink plenty of fluids
when increasing fiber with a bulking product like
bran. If
the bowel is impacted, your doctor can gently
remove the hardened stools with a gloved finger.
To encourage regular bowel movements, you
should make sure you have sufficient time each day
to sit on the toilet undisturbed, especially after
a meal. Alternative
therapies include acupressure, aromatherapy,
herbal therapy, massage, and yoga.
If constipation is a symptom of some other
disorder or disease, then the specific treatment
will vary according to the cause.
Self-care tips
Everyone becomes constipated
occasionally.
However, if you remain constipated for more
than one week, or symptoms continue even after
increasing your fiber, fluid, and activity levels,
you should contact your doctor.
Many people believe they should have a bowel movement every
day and overuse laxatives for this reason. Normal
frequency of bowel movements for one person may be
three each day, while for another it might be once
every three days. You
need to know what is normal for you.
You can prevent constipation by drinking 6
to 8 glasses of water and eating around five
servings of fruits and vegetables each day.
Contact your doctor if constipation
alternates with bouts of diarrhea, you notice
blood in your stool, you have pain during bowel
movements, or your constipation is combined with
sudden weight loss.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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