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Constipation

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Introduction

Constipation is a common disorder of the digestive system. Although it occurs in all age groups, it is more prevalent among the elderly.

Constipation is often a chronic condition. People with constipation have difficulty emptying their bowels or have infrequent bowel movements.

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What are the Causes of Constipation?

The inner lining of your colon absorbs water from the food passing through your digestive tract. With the required amount absorbed, your colon muscles squeeze rhythmically to expel the residual waste out through the rectum. This residue is stool.

Constipation can be due to

  • Poor diet: Adequate dietary fiber and water intake are essential to soften the stool. If your diet lacks these components, stools harden and become difficult to pass.
  • Physical inactivity: Physical activity and exercise enable the mobility of your digestive tract. People restricted to a bed or chair or who have a sedentary lifestyle are more prone to developing constipation problems.
  • Prescription medicines: Some medications can interfere with your colon’s water absorption, increasing the risk of constipation. These medications include opioid pain relievers, anticonvulsants, diuretics, calcium channel blockers, and antacids containing calcium or aluminum. Overuse of laxatives can also harden stools and cause constipation.
  • Underlying medical conditions: If the stool remains in the colon for a long duration, it can harden and turn problematic. Medical conditions such as intestinal obstruction, irritable bowel syndrome, and diverticulosis can restrict bowel movements, causing constipation. Conditions such as stroke and Parkinson’s disease can impact the mobility and muscle coordination of the colon.
  • Habitual changes: A change in routine during travel or stress can influence your bowel movements. Also, ignoring the urge to defecate can result in stool drying and hardening. It can put you at risk of faecal impaction.

What are the Symptoms of Constipation?

Signs of constipation include:

  • ● Bowel movements are less than three a week
  • ● Passing hard and dry stool
  • ● Having to strain to pass stool
  • ● Painful bowel movements
  • ● Abdominal pain and cramping
  • ● Feeling bloated
  • ● Inability to empty your bowel

How is Constipation Diagnosed?

Often, Constipation corrects itself. If you have a chronic Constipation problem that does not subside with simple remedies, you should consult your doctor. Your doctor will take a detailed medical history, including your diet, lifestyle habits, and bowel movement history. A physical exam includes lab tests and a rectal exam to check for signs of infection, inflammation, or cancer. Depending on the severity and the duration of your symptoms, your doctor will order other tests and procedures.

  • Anorectal manometry: In anorectal manometry, the doctor will place and inflate a balloon inside your colon. The test measures the muscle strength of your anal sphincter. It checks the contractility of the sphincter.
  • Barium enema X-ray: A barium enema involves inserting liquid dye into your rectum. The barium highlights the inner lining of your colon and rectum on an X-ray. It enables the doctor to detect any abnormalities causing constipation problems.
  • Colonoscopy: Your doctor will insert a thin, flexible tube fitted with a camera into your colon. A colonoscopy will allow your doctor to view the area better.

How is Constipation Treated?

Constipation usually resolves by itself. Prescription medications for constipation are often unnecessary. Simple lifestyle and dietary changes can help you manage this problem. These changes include:

  • ● Include fiber-rich food in your diet
  • ● Increase your fluid intake
  • ● Get more exercise
  • ● Attend to the urge for defecation
  • ● Allocate stress-free time for bowel movements
  • ● Avoid long-term use of laxatives

If you are still facing problems, your doctor can advise other forms of treatment.

  • Laxatives: Laxatives are substances that soften your stool and improve bowel movements. There are many kinds of laxatives; your doctor will prescribe them as per your symptoms.
  • ● Fiber supplements add bulk, softening your stool and making its passage easy.
  • ● Stimulants help increase intestinal contractions.
  • ● Lubricants (like mineral oil) can ease the passage of stool within the colon.
  • ● Osmotic laxatives help increase intestinal secretions and facilitate bowel movements.
  • ● Enema and suppositories soften the stool and help relieve constipation.
  • Prescription medications: Sometimes medicines for other disorders cause constipation, like opioid pain relievers. In such cases, your doctor can change the prescription and suggest an alternative. A peripherally acting mu-opioid receptor antagonist can be an alternative pain reliever. Constipation due to irritable bowel syndrome responds better to certain medicines. These medicines can draw water into your colon and help the movement of stool. If you have this condition, consult your doctor to get the required help.
  • Pelvic floor muscle retraining: For passing the stool, you have to relax the pelvic floor muscles. Some people with constipation have relief with pelvic floor muscle exercises and biofeedback training.
  • Surgery: Severe colorectal problems may require surgical treatment to clear the impacted stool and resect the problematic portion of your digestive tract.

What is the outlook of Treatments for Constipation?

Constipation is easily treatable with lifestyle and dietary changes in most people. Only severe and chronic cases require advanced treatment.

What Are the Risk Associated with Constipation Treatment?

With advances in the surgical sciences, colorectal intervention and surgery for Constipation pose a lesser risk. The complications of such surgery include:

  • ● Site infection
  • ● Leakage
  • ● Prolapse
  • ● Abdominal abscess
  • ● Injury to the intestine

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FAQ's

How Long is too Long to be Constipated?

Failing to pass stool for more than three days can harden your stool, making defecation painful.

What should you Avoid Eating when Constipated?

If you are Constipated, you should avoid eating the following:

  • ● Processed foods
  • ● Milk and dairy products
  • ● Red meats
  • ● Food containing gluten
  • ● Fired, fast foods
  • ● Alcohol

What can Constipation Indicate?

Constipation is a symptom rather than a disease. Constipation occurs in irritable bowel syndrome, diverticulosis, colorectal cancers, and other disorders like stroke, Parkinson’s disease, etc.

Why am I Suddenly Getting Constipated?

Constipation can be due to a change in diet, reduced fluid intake, stress, or ignoring the urge to defecate, causing the stool to harden.

Can Constipation occur During Pregnancy?

During pregnancy, the weight of the fetus can result in Constipation.

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