Article

Constipation

Constipation

June 1, 2017, 7:52 p.m.

Constipation is generally described as having fewer than three bowel movements a week.

Though occasional constipation is very common, you should see your doctor if you're still having trouble after a few days, if you have chronic constipation, or if there’s blood in your stool, or you have serious stomach pain.

 

Symptoms

  1. Signs and symptoms of constipation include:
  2. Passing fewer than three stools a week
  3. Having lumpy or hard stools
  4. Straining to have bowel movements
  5. Feeling as though there's a blockage in your rectum that prevents bowel movements
  6. Feeling as though you can't completely empty the stool from your rectum
  7. Needing help to empty your rectum, such as using your hands to press on your abdomen and using a finger to remove stool from your rectum

Constipation may be considered chronic if you've experienced two or more of these symptoms for the last three months.

 

Causes

Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract or cannot be eliminated effectively from the rectum, which may cause the stool to become hard and dry. Chronic constipation has many possible causes.

Blockages in the colon or rectum

Blockages in the colon or rectum may slow or stop stool movement. Causes include:

  1. Anal fissure
  2. Bowel obstruction
  3. Colon cancer
  4. Narrowing of the colon (bowel stricture)

Problems with the nerves around the colon and rectum

Neurological problems can affect the nerves that cause muscles in the colon and rectum to contract and move stool through the intestines. Causes include:

  1. Parkinson's disease
  2. Spinal cord injury
  3. Stroke

 

Difficulty with the muscles involved in elimination

Problems with the pelvic muscles involved in having a bowel movement may cause chronic constipation. These problems may include:

  1. Inability to relax the pelvic muscles to allow for a bowel movement (anismus)
  2. Pelvic muscles don't coordinate relaxation and contraction correctly (dyssynergia)
  3. Weakened pelvic muscles

Conditions that affect hormones in the body

Hormones help balance fluids in your body. Diseases and conditions that upset the balance of hormones may lead to constipation, including:

  1. Diabetes
  2. Overactive parathyroid gland (hyperparathyroidism)
  3. Pregnancy
  4. Underactive thyroid (hypothyroidism)

 

Complications

Complications of chronic constipation include:

  • Hemorrhoids/Piles which can cause pain and bleeding
  • Anal fissure -Torn skin in your anus – which causes a lot of pain
  • Fecal impaction
  • Rectal prolapse - Intestine that protrudes from the anus due to straining

 

Investigation:

Your doctor would take a detail hisotry and perform a physical examination before deciding on the following tests and procedures to diagnose chronic constipation and try to find the cause:

  • Blood tests for thyroid or calcium abnormality.
  • Examination of the rectum and lower, or sigmoid, colon (sigmoidoscopy /colonoscopy).
  • Evaluation of how well food moves through the colon (colonic transit study).
  • An X-ray of the rectum during defecation (defecography).

 

Lifestyle and home remedies

  • Increase your fiber intake. Slowly begin to eat more fresh fruits and vegetables each day. Choose whole-grain breads and cereals. A sudden increase in the amount of fiber you eat can cause bloating and gas, so start slowly and slowly increase over a few weeks.
  • Exercise most days of the week.
  • Don't ignore the urge to have a bowel movement.

 

Prevention

  • Include plenty of high-fiber foods in your diet, including beans, vegetables, fruits, whole grain cereals and bran.
  • Eat less processed foods and meat products.
  • Drink plenty of fluids.
  • Stay active and get regular exercise.
  • Try to manage stress.
  • Don't ignore the urge to pass stool.
  • Try to create a regular schedule for bowel movements, especially after a meal.

Dr Lee Chong Han (Source - Mayo Clinic and WEBMD)