Constipation

Constipation

Constipation is one of the most common gastrointestinal complaints. It is important to note that constipation is a complaint of the patient and not a disease. 

Constipation has different meanings to different individuals. Most commonly it refers to infrequent bowel movements, but it may also refer to a decrease in the volume or weight of stool, the need to strain to have a movement, a sense of incomplete evacuation, or the need for enemas, suppositories or laxatives in order to maintain regularity. It is normal for bowel movements to occur from three times a day to three times a week; some people may go a week or more without experiencing discomfort or harmful effects. However, constipation is defined as the passage of small amounts of hard, dry stools, 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. 

Causes 

Constipation is frequently caused by a disturbance of the large intestine function. The normal functions of the colon are to : 

• Remove water from the waste material that passes from the small intestine into the colon.

• Serve as a storage area for waste material.

• Help move and expel stool from the body. 

Constipation may occur because

• Too much water is removed by the colon, causing dry or hard stools. 

• Stool moves too slowly through the colon. 

• The patient is unable to expel stools. 

Common causes of constipation are : 

Not enough fibre in the diet : The most common cause of constipation is a diet low in fibre. A low-fibre diet is an important cause for constipation among older adults as they prefer to eat soft foods that are processed and low in fibre because of difficulties in chewing or swallowing. 

Not enough liquids : Liquids add fluid to the colon, making bowel contents softer and easier to pass. Liquids that contain caffeine, like coffee and cola drinks, and alcohol have a dehydrating effect by increasing the urine formation. 

Lack of exercise : Lack of exercise can lead to constipation 

Medications : Some medications can also cause constipation. These include :

• Pain medications (especially narcotics)
  Antacids that contain aluminum and calcium
  Blood pressure medications ( calcium channel blockers)
  Antispasmodics (drugs to reduce pain in the abdomen)
  Antidepressants ( mood elevating drugs)
  Iron supplements (medications to increase haemoglobin in the blood)
  Diuretics (drugs to increase urine formation)
  Anticonvulsants (drugs used to treat fits) 

Irritable bowel syndrome (IBS) : Some people with IBS, also known as spastic colon, have spasms in the colon that affects bowel movement. Diarrhoea can also occur or diarrhoea and constipation can alternate. 

Pregnancy : During pregnancy constipation can occur because of hormonal changes or because of compression f the intestine by the uterus. 

Aging : Aging may also affect bowel regularity because slower metabolism results in less intestinal activity and muscle tone. 

Changes in life or routine : People often become constipated when traveling because their normal diet and daily routine are disrupted. 

Abuse of laxatives : This is common among people who are preoccupied with having a daily bowel movement. Laxatives can become habit-forming. Laxatives act by stimulating the nerve endings in the colon which further stimulate the colonic movements. However, continuous use of laxatives can damage the nerve cells in the colon land interfere with the colon's natural ability to contract and produce bowel movement. Therefore, the dose of the laxative has to be increased frequently to produce bowel movements. 

Ignoring the urge to have a bowel movement : People who ignore the urge to have a bowel movement may eventually stop feeling the urge, which can lead to constipation. For example, some people delay having a bowel movement because they do not want to use toilets outside the home. 

Specific diseases : Diseases that cause constipation include neurological disorders, metabolic and endocrine disorders like diabetes and hypothyroidism. These disorders can slow the movement of stool through the colon. 

Problems with the colon and rectum : Intestinal obstruction, scar tissue ( adhesions), tumours, stricture ( localized narrowing of the colon ) or cancer can cause constipation. 

Stomach Bloating or Abdominal Distension.
Abdominal pain
Endoscopic procedures
Constipation
Diagnosis and Treatment of Constipation
Medications and Complications
Indigestion