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Constipation
By peace | October 31, 2005
Constipation
WHAT IS CONSTIPATION?
Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may find it difficult and painful to have a bowel movement.
Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish. Many people think they are constipated when, in fact, their bowel movements are regular. For example, some people believe they are constipated, or irregular, if they do not have a bowel movement every day. However, there is no right number of daily or weekly bowel movements. Normal may be three times a day or three times a week depending on the person.
In addition, some people naturally have firmer stools than others. At one time or another almost everyone gets constipated. Poor diet and lack of exercise are usually the causes. In most cases, constipation is temporary and not serious. Understanding causes, prevention, and treatment will help most people find relief.
Bowel habits are affected by diet. The average Singaporean diet includes 12 to 20 grams of fibre per day, and is below the recommended 25 to 30 grams of fiber. Exercise is also beneficial to proper function of the colon.
About 80 percent of people suffer from constipation at some time during their lives, and brief periods of constipation are normal. Not passing motion does not result in poisons remaining inside your body. Widespread beliefs, such as the assumption that everyone should have a movement at least once each day, have led to overuse and abuse of laxatives.
Eating foods high in fibre, including bran, shredded wheat, whole grain breads and certain fruits and vegetables will help provide the 25 to 30 grams of fibre per day recommended for proper bowel function.
Constipation is a very common problem in infants and children and is frequently seen by both pediatricians and family doctors. Most of the time, reassurance, dietary changes, and laxatives are effective treatment for both the patient and family.
Constipation can occur at any age and the evaluation and treatment may be different depending on the child’s age. The newborn infant should have his/her first stool within the first 24 hours after birth.
Failure to pass stool by 48 hours of life may signify a more serious condition such as Hirschsprung’s disease, meconium ileus due to cystic fibrosis, or hypothyroidism and further evaluation of the infant is needed.
Constipation is usually diagnosed when an infant or child has hard stools or has difficulty stooling. This condition can be quite distressing for the family but is usually easy to treat. Infants are noted to strain excessively and have difficulty passing stools, even though their stools are of normal consistency.
The difficulty in passing stool is thought to represent a delay in maturation of intestinal motility and is self-resolving; use of glycerin suppositories may be helpful. The frequency of bowel movements in infants varies considerably, and an infant who has soft, pain-free, but infrequent stools is not constipated and does not need further evaluation. As the child gets older, constipation can be due to a large number of factors including anal fissure, diet lacking in fiber and fluids, overuse of laxatives, family or behavior problems, and (rarely) ectopic anus. Constipation in children can also present, paradoxically, as watery diarrhea and incontinence due to overflow around impacted stool, a condition called encopresis.
More often than not, however, constipation is purely a functional problem unrelated to an underlying disease. Most individuals with uncontrolled constipation develop a variety of symptoms:
- Large bowel pain.
- Rectal discomfort.
- Abdominal fullness.
- Bloating
- Nausea
- Anorexia
- A general feeling of malaise.
These individuals feel as if they never completely evacuate their bowels. Severe chronic constipation may be accompanied by fecal impaction
Causes of Constipation
Several factors may act together and cause constipation. This include inadequate fibre and water intake, a sedentary lifestyle, and environmental changes. Constipation may be aggravated by travel, pregnancy, or change in diet. In some people, repeatedly ignoring the urge to pass motion may result in constipation.
More serious causes of constipation include growths or areas of narrowing in the colon, so it is wise to seek the advice of a doctor when constipation persists. Uncommonly, constipation may be due to a nervous or endocrine disorders, including thyroid disease, multiple sclerosis, Parkinson’s disease, stroke, and spinal cord injuries.
Can Medication Cause Constipation?
Yes, many medications, including pain killers, antidepressants, tranquilizers, and other psychiatric medications, blood pressure medication, diuretics, iron supplements, calcium supplements, and aluminum containing antacids can cause or worsen constipation. Do check with your doctor if you have constipation after being started on a new medication.
When Should I See A Doctor About Constipation?
Most of the time, the cause of constipation is not serious. But, in rare cases, chronic constipation may be a sign of an obstruction or abnormality in the colon. You should seek medical advice if there is a persistent change in your bowel habit for more than 3 weeks - this may either be an increase or decrease in frequency, size of stool or an increased difficulty in passing. The important factor is the change - if you have been passing one time every three days and now pass one time a day, this is not normal. If blood appears in the stool, consult your doctor right away. Your doctor can evaluate you to determine the cause of your constipation and rule out any underlying disorder.
Your doctor may ask you questions like these:
-How long have you had symptoms?
-Have you any medical problems, and if yes, what medications are you on?
-What is your diet like?
-What is your daily activity like?
-How often do you need use laxatives or enemas?
-How Can The Cause Of Constipation Be Determined?
There are many possible causes of constipation. It is important to find the cause and treat them specifically. Repeatedly taking laxatives may help but it does not treat the cause. Your doctor will want to check for any anatomic causes, such as growths or areas of narrowing in the colon. Examination of the anus and rectum is usually the first step, since it is relatively simple and may show the cause of the problem. Examination of the intestine with either a colonoscopy or barium x-ray study may also be required. This is to look for conditions such as such as polyps, cancers, or diverticular disease, which may cause constipation. If this is found, then the underlying condition can be treated.
Other test may be needed to identify specific problems with the movement of your intestines. A “marker studies” in which the patient swallows a capsule containing markers that show up on x-rays taken several days later, provide clues to disorders in the movement of the intestines. Other physiologic tests check the function of the anus and rectum. These include testing the reflexes of anal muscles that control bowel movements using a small plastic catheter, or x-ray testing to evaluate function of the anus and rectum during defecation. In many cases, no specific anatomic or functional causes are identified and the cause of constipation is said to be nonspecific.
Treatment of Constipation
Most patients with constipation are successfully treated by a few simple steps. Eat well balanced, regularly scheduled meals to promote normal bowel function. If you have not been consuming much roughage, take additional fibre in your diet. Ensure that you drink enough fluids to help keep the stools soft. Try to drink at least 8 to 10 glasses of liquid each day in the form of juice, milk, coffee, tea, soup, water or other fluids. An increase in activity will also help the bowel move.
High fibre diet, in addition to relief of constipation, may help to lower cholesterol levels, reduce the risk of developing colon polyps and cancer, and help prevent symptomatic hemorrhoids.
Fibre supplements takes time (up to weeks) for the full effect to take place. However, they are not harmful to the body. Laxatives stimulate the colon to work more rapidly. Continuous use of laxatives can cause the colon to stretch and weaken and, eventually the colon may not work right without them. Thus, laxatives, enemas or suppositories, although it provides rapid relief, is harmful in the long term, and you should avoid long term usage unless recommended and monitored by your doctor.
A change in lifestyle may also help. Having a specific time each day to have a bowel movement may be helpful. In some cases, bio-feedback may help to retrain poorly functioning anal sphincter muscles.
In rare circumstances are surgical procedures necessary to treat constipation. Your doctor can discuss these options with you in greater detail to determine the best treatment for you.
Topics: Diseases, Health, Man's health, Woman's Health |
