August 15, 2011

Constipation is a condition in which the waste matter in the bowels is too hard to pass easily, or in which movements are so infrequent that discomfort or uncomfortable symptoms result. It also refers to a sense of incomplete evacuation. There is no right number of daily or weekly bowel movements. Regularity may mean bowel movements three times a day for some people or three times a week for others. Constipation is a symptom, not a disease, and can be caused by different conditions.

Causes of constipation

The most common cause of constipation is poor diet. A diet high in animal fats and refined sugar, but low in fiber causes constipation. People who eat a lot of convenience foods or fast foods, which are low in fiber, may suffer from constipation. Some studies have suggested that high-fiber diets result in larger stools and more frequent bowel movements. Inadequate fluid intake can also cause constipation. Water and other fluids add bulk to the stools, making bowel movements easier. Poor bowel habits resulting from frequent travel, lack of exercise, or lengthy bed rest due to an accident or illness may also cause constipation.

Irritable bowel syndrome (IBS), also known as spastic colon, is a common cause of constipation. Some people develop spasms of the colon that slow the movement of intestinal contents through the digestive tract, leading to constipation. Pregnancy is another cause for constipation. The reasons may be mechanical due to the pressure of the heavy womb, which compresses the intestine, and hormonal due to the hormonal changes during pregnancy. A less common cause of constipation may be a stricture or obstruction that prevents wastes from being passed through the intestines, as in the case of hernia, tumor, or cancerous growth. Thyroid hormone deficiency can cause constipation and is more common in women than in men. Constipation can be a warning sign of a serious condition such as cancer. Other uncommon causes may include certain hormonal disturbances, medications, mechanical compression, diseases such as scleroderma or lupus, and certain neurological or muscular diseases, such as multiple sclerosis, Parkinson’s disease, and stroke. Injuries to the spinal cord and tumors pressing on the spinal cord may cause neurological problems resulting in constipation.

Constipation in children is usually due to poor bowel habits. Some children find it inconvenient to use toilets outside the home. Severe emotional stress at home and or at school may cause children to withhold their stools. When the periods between bowel movements become too long, children may develop fecal impaction, in which stool is packed so tightly in the bowel that the normal pushing action of the bowel is not enough to expel the stool spontaneously.

Prolonged constipation can cause uncomfortable symptoms such as nausea, heartburn, headache, or distress in the rectum or intestines, which may last until the stool is passed. These symptoms are a reaction of the nerves when the waste matter in the rectum causes pressure and stretching. Constipation can occasionally lead to complications, such as hemorrhoids (caused by extreme straining) or fissures (caused by the hard stool stretching the sphincters). Years of constipation and straining can weaken pelvic muscles, causing the bladder or rectum to bulge into the vagina and leading to urinary incontinence or increased difficulty with bowel movements. After many years of chronic constipation, diverticulosis and diverticulitis can develop. In diverticulosis, the wall of the colon weakens and develops small pockets or outpouchings. In diverticulitis, these outpouchings become obstructed and inflamed, and serious infection can result. Hospitalization and bowel surgery may become necessary.

Prevention and treatment

First, determine the cause of the problem. A physician can sometimes identify the likely cause by talking with you and doing a physical examination. If abnormalities or a blockage of the intestines are suspected, blood tests, stool tests, sigmoidoscopy, or colonoscopy may be recommended. If the test results show that there is no disease or blockage, evaluate your dietary habits. The goal of treatment is regular bowel movements and stools that are formed but not hard. Establish a regular routine for elimination. It is important to avoid unnecessary tensions and worry, including concern over constipation itself. Do not expect to have a bowel movement everyday. Regularity differs from person to person. If your bowel movements occur regularly without pain you are probably not constipated.

A well-balanced diet that includes fiber-rich foods, such as whole-grain bread, and fresh fruits and vegetables helps in preventing constipation. Dried beans, broccoli, and green leafy vegetables are rich in fiber. Drink at least eight glasses of fluid daily and exercise regularly to help to stimulate intestinal activity. Laxatives should be the last resort for treating constipation. Preventing constipation will help you feel better now and also reduce the risk of serious complications later in life.

SEE ALSO: Laxatives, Nutrition

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