Constipation

Table of Content

Constipation

Constipation: Around the World

Constipation is a common problem worldwide. Since only a few patients seek care for constipation, it is difficult to know accurately how many people suffer with this problem. Roughly it is believed that anywhere between 2-35% of adults have constipation.

Describing Constipation

Constipation refers to any difficulty in passing stools. There are many different descriptions and can include a change in toilet (bowel) habits, hard or too small stools, difficult-to-pass, or infrequent stools (usually less than three times per week). There may be a need to strain or use a lot of pressure while passing stools; many times, patients may sense that the bowels are not empty even after passing stools.

Causes of Constipation

  • Constipation has numerous causes, a few of which are listed below:
    • Low fiber intake (eating less vegetables or fruits)
    • Ignoring the urge to pass tools
    • Insufficient fluid intake
    • Insufficient movement or exercise
    • Diseases primarily of other parts of the body that also affect the colon, e.g. diabetes, thyroid problems

Diagnosis of Constipation

  • Constipation is diagnosed on the basis of the symptoms and a physical examination.
  • Common symptoms of constipation:
    • The need to pass stools has reduced from your normal frequency
    • Lumpy or hard stools, difficult-to-pass stools
    • Straining during defecations
    • Sensation of incomplete evacuation
    • Sensation of blockage
    • Manually stimulating defecation
  • It is important to mention any medication you are receiving to the doctor, since many medicines can cause constipation.
  • Your doctor may need to perform a rectal exam to check for abnormalities. This involves inserting a gloved finger into the rectum to check for lumps, abnormalities or blood in the stool.
  • Colonoscopy may be recommended to detect the presence of abnormalities such as rectal ulcers, inflammation or cancer.

When to Consult a Doctor?

  • Many patients treat constipation at home before going to consult a doctor; however, sometimes, it is important to talk to a doctor instead of attempting to treat it by oneself.
  • Constipation along with the following symptoms should prompt a visit to the doctor:
    • Weight loss
    • Blood in the stool
    • Anemia
    • Sudden change in bowel habits after the age of 50 years
    • Significant abdominal pain
    • Family history of colon cancer or inflammatory bowel disease
    • Constipation not responsive to simple treatment

Treatment of Constipation

  • Many patients suffer in silence and try to self-medicate while, for those who do seek medical help, treatments can be unsatisfactory.

Self Help

  • Constipation can be prevented by following a few simple rules every day:
    • Eat healthy foods that have a lot of fiber. Good choices are fruits and vegetables.
    • Drink plenty of water and other fluids.
    • When you feel the urge to pass stools, do so. Don't hold it in.

    Medication

    • Indigestible fiber supplements
    • Laxatives that work by softening the stool or help the intestine push the stool out.

    Food and Fiber Content

    References

    1. http://www.uptodate.com/contents/patient-information constipation-in-adults-beyond-the basics?source=search_result&search=constipation&selectedTitle = 1 ∼55#H4 accessed on March 2012
    2. Best Practice & Research Clinical Gastroenterology 2011; 25:3-18
    3. Neurogastroenterol Motil (2011) 23, 697-710
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    Causes and prevention of constipation along with symptoms usually experienced in this condition have been listed in this booklet to help patients understand and deal with their situation.
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