Constipation :Diagnosis, causes, remedies, and prevention

 

 

Definition

 

 

The infrequent and troublesome passing of stools is known as constipation.

The stool can be overly hard, irregular, tiny, or challenging to pass.

Constipation can come on suddenly in some people and is frequently a symptom of another gastrointestinal issue, like a bowel obstruction.

Constipation is more prevalent after the age of 60 and occurs more frequently with age.

A change in bowel habits without a corresponding change in food is a serious symptom that has to be brought up to your doctor.

 

 

Constipation types

 

 

Acute constipation: As the name implies, acute constipation develops suddenly and may become so severe that it requires prompt medical attention to ascertain the cause.

Constipation that is psychosomatic is typically brought on by excessive stress, such as that experienced while traveling or working under pressure.

If the external reason is removed, it usually goes away.

 

 

Hypotonic constipation: Hypotonic constipation can occur in people who have a chronic form of the condition.

Because the abdominal muscles are too weak to function effectively in the intestines, this type of constipation prevents the person from defecating appropriately.

Numerous factors, including an insufficient amount of physical activity, a diet lacking in fiber, and a diet lacking in water, might contribute to it.

 

 

Hypertonic constipation, often known as spastic constipation, is the opposite of this.

This indicates that although the person has pain and cramps, they are still unable to urinate.

Instead, the stools don't pass through the intestines normally.

Irritable bowel syndrome, a disorder marked by recurrent episodes of diarrhea and constipation, may result from this.

 

 

Constipation in the rectum is brought on by a person's restroom practices.

It occurs when someone continually ignores the urge to urinate despite having the urge, leading to the body's eventual refusal to transmit the appropriate signal to the brain to make a bowel movement.

The person's intestines will then become clogged with dried-up feces and become unable to fecate.

 

 

When an apparently healthy person experiences constipation, it is said to be functional constipation because no cause or reason can be identified.

Idiopathic constipation is a related condition that is resistant to conventional treatment.

Idiopathic constipation appears to have no cause as well and might be challenging to treat because the doctor is unsure of what caused it to begin with.

 

Risk factors

 

 

These are the risk factors mentioned by the American Academy of Family Physicians:

 

 

Getting less than 20 grams to 35 grams of dietary fiber each day.

 

Inadequate hydration, which causes feces to become drier.

 

Getting too little exercise.

 

Avoiding passing bowel movements when you feel the urge.

 

Taking specific drugs, such as opiates.

 

Changing your habit or life, such as by traveling or becoming pregnant.

 

The presence of specific illnesses or ailments, such as diabetes, lupus, or multiple sclerosis.

 

Having an obstruction, irritable bowel syndrome, or a tumor in the digestive system

 

 

Constipation's causes

 

 

Unusual food consumption, particularly of junk food, is the most frequent cause.

 

 

Absence of physical activity.

 

Extended sitting

 

Alcohol and tobacco use

 

Inadequate sleep decreased fluid/water intake

 

Rheumatoid bowel syndrome

 

Traveling

 

Pregnancy and childbirth

 

Symptoms

 

 

Constipation signs and symptoms include:

 

 

A lack of bowel motions

 

Straining when going to the bathroom

 

Hard and/or small feces

 

The feeling of incomplete elimination following restroom use

 

A lower abdominal ache

 

Bloating and occasionally distension of the abdomen

 

Anal hemorrhage or fissures brought on by the harm that hard feces inflict

 

Occasionally, diarrhea is brought on by a colon obstruction caused by hard stool.

 

Colonic perforation is uncommon.

 

Psychological discomfort and/or a fixation with using the restroom

 

Hemorrhoids, rectal prolapse, and diverticular disease may worsen.

 

 

Constipation complications

 

 

The majority of the time, constipation is acute, which means that it comes on suddenly and lasts only a short while.

 

 

These potential complicatons comprise:

 

 

Hemorrhoids (swollen, inflamed veins in the rectum or around the anus that may cause rectal pain and bleeding) (swollen, inflamed veins in the rectum or around the anus that may cause rectal pain and bleeding)

 

Alveolar fissures (small tears in the skin around the anus that are often accompanied by itchiness, pain, and bleeding)

 

Fecal obstruction (inability to push stool out because it has hardened and packed in the colon and rectum too tightly)

 

Abdominal prolapse (a condition in which part of the rectum sticks out of the anus)

 

 

Diagnostic procedures

 

 

Doctors employ the following examinations and techniques in addition to a basic physical examination and a digital rectal exam to identify chronic constipation and try to determine its cause:

 

 

Your physician will order blood tests to check for any systemic conditions, such as low thyroid (hypothyroidism).

 

 

Sigmoidoscopy is the medical term for the operation where your doctor inserts a flexible, lit-up tube into your anus to check your rectum and lower part of your colon.

 

 

Colonoscopy: This diagnostic treatment enables your doctor to examine the rectum and entire colon using a flexible, camera-equipped tube.

 

 

A small balloon is inflated at the end of a narrow, flexible tube that your doctor inserts into your anus and rectum to measure the function of your anal sphincter muscles (anorectal manometry).

After then, the instrument is drawn back through the sphincter muscle.

Through this process, your doctor will be able to assess how well your bowel-moving muscles coordinate.

 

 

Balloon expulsion test for measuring the speed of the anal sphincter muscle:

This test, which is frequently combined with anorectal manometry, time how long it takes you to push a balloon filled with water out of your rectum.

 

 

Colonic transit study: Evaluation of how efficiently food passes through the colon

You could ingest a capsule with a wireless recording device or a radiopaque marker during this treatment.

Over several days, the passage of the capsule through your colon will be monitored and will be visible on X-rays.

 

 

You might occasionally consume food that has been radiocarbon-activated, and a specialized camera will track its development (scintigraphy):

Your doctor will examine your colon and look for indications of intestinal muscle failure.

 

 

Defecography: An X-ray of the rectum taken during defecating

Your doctor will put a soft barium paste into your rectum during this operation.

After that, you expel the barium paste through your bowels.

On X-rays, the barium is visible and may suggest a prolapse or issues with muscle coordination and function.

 

 

Similar to barium defecography, a Doctor will insert contrast gel into your rectum during an MRI defecography.

The gel is then passed.

The defecation muscles can be seen and their performance evaluated using an MRI scanner.

This examination can also identify conditions like rectocele or rectal prolapse that can lead to constipation.

 

Treatment and medications

 

Depending on the underlying cause, treatment options include:

 

 

Enemas, stool softeners, and a brief course of laxatives may be used to remove the affected stools.

 

 

Dietary adjustments, such as increasing the intake of fiber daily.

Dietitians typically advise consuming 30g of fiber daily.

Wholegrain cereals, fruits, vegetables, and legumes are all excellent sources of fiber.

Because they frequently promote constipation, foods including milk, cheese, white rice, white wheat, and red meat should be consumed in moderation.

 

 

Drinking more drinks will help your feces expand.

However, it's crucial to limit your consumption of diuretic beverages like alcohol, tea, and coffee.

 

 

If a person is hesitant or unwilling to increase the amount of wholegrain meals, fresh fruits, or vegetables in their diet on a daily basis, fiber supplements may be useful.

When using fiber supplements, please see your doctor or dietician first because they can worsen or induce constipation.

 

 

Exercise improves intestinal motility, one of the many advantages of regular exercise.

Exercise should ideally be done for 30 minutes a day.

People who struggle with mobility issues need to be as active as they can be every day since even a little bit of regular exercise can assist.

 

 

Treatment for an underlying condition can involve abdominal hernia surgery, hormone replacement therapy for hypothyroidism, or anal fissure treatment might involve anesthetic cream and sitz (salt water) baths.

 

 

Bowel stimulants and substances that raise the water content of the stool are the two primary categories of laxatives.

Bowel stimulants produce discomfort but can enhance bowel contractions.

Agents that raise the water content may prevent the colon from absorbing water, or they may cause the stool to swell or become more voluminous.

Laxatives can significantly ease both acute and chronic constipation when administered properly.

There is minimal proof that consistent use of laxatives in the proper dosages causes "lazy" or "twisted" bowels.

 

Prevention of Constipation

 

The right amount of activity, together with specific foods and beverages, can help reduce the symptoms of constipation.

 

 

Foods and  Drinks

 

 

Consume high-fiber foods including fresh fruit, bran cereals, raw veggies, salads, raisins, and raw vegetables.

 

Consume figs or prunes.

 

To soften the stools, eat oatmeal, applesauce, legumes (dry beans), and barley.

 

You can buy already-ground flax meal.

The seeds can also be purchased and ground yourself.

Natural fiber and Omega-3 fatty acids, which are important for your health, can both be found in flax meal.

It can be sprinkled on top of or blended into cuisine.

 

At least eight glasses of fluids should be consumed daily.

Best drinks are water and herbal tea.

Juices and caffeinated beverages should be avoided because your body may eventually develop dependent on them.

 

In the morning, drink several glasses of warm to hot beverage.

Water or herbal teas are suitable.

 

 

Exercise:

 

 

Engage in everyday activity, such as a brisk 30-minute walk.

 

Even if you are unable to make a bowel movement, spend 15 minutes in the bathroom in the morning.

Your digestive tract is both soothed and stimulated by this.

 

After a meal, relax  for 15 minutes  to promote digestion