Jonathan Diaz
Ramsey Darling
Constipation
Constipation is passage of small amounts of hard, dry
bowel movements, 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.
Many people think they are constipated when, in fact, their bowel movements are
regular. For example, some people believe they are constipated, or irregular,
if they do not have a bowel movement every day. However, there is no right
number of daily or weekly bowel movements. Normal may be three times a day or
three times a week depending on the person. In addition, some people naturally
have firmer stools than others.At one time or another almost everyone gets
constipated. Poor diet and lack of exercise are usually the causes. In most
cases, constipation is temporary and not serious. Understanding causes,
prevention, and treatment will help most people find relief. Those reporting
constipation most often are women, children, and adults age 65 and over.
Pregnant women also complain of constipation, and it is a common problem
following child birth or surgery.
Constipation is the most common
gastrointestinal complaint in the United States, resulting in about 2 million
annual visits to the health care provider. However, most people treat
themselves without seeking medical help.
To understand constipation, it
helps to know how the colon (large intestine) works. As food moves through it, the
colon absorbs water while forming waste products, or stool. Muscle contractions
in the colon push the stool toward the rectum. By the time stool reaches the
rectum, it is solid because most of the water has been absorbed.
The hard and dry stools of constipation
occur when the colon absorbs too much water. This happens because the colon's
muscle contractions are slow or sluggish, causing the stool to move through the
colon too slowly.
Although treatment depends on the
cause, severity, and duration, in most cases dietary and lifestyle changes will
help relieve symptoms and help prevent constipation.
A diet with enough fiber with 20
to 35 grams each day helps form soft, bulky stool. A healthcare provider or
dietitian can help plan an appropriate diet. High-fiber foods include beans;
whole grains and bran cereals; fresh fruits; and vegetables such as asparagus,
brussels sprouts, cabbage, and carrots. For people prone to constipation,
limiting foods that have little or no fiber such as ice cream, cheese, meat,
and processed foods is also important.
Other changes that can help treat and prevent constipation
include drinking enough water and other liquids such as fruit and vegetable
juices and clear soup, engaging in daily exercise, and reserving enough time to
have a bowel movement. In addition, the urge to have a bowel movement should
not be ignored.
Most people who are mildly
constipated do not need laxatives. However, for those who have made lifestyle
changes and are still constipated, health care providers may recommend
laxatives or enemas for a limited time. These treatments can help retrain a
chronically sluggish bowel. For children, short-term treatment with laxatives,
along with retraining to establish regular bowel habits, also helps prevent
constipation. health care provider
should determine when a patient needs a laxative and which form is best.
Laxatives taken by mouth are available in liquid, tablet, gum, powder, and
granule forms. They work in various ways:
Bulk-forming laxatives generally
are considered the safest but can interfere with absorption of some medicines.
These laxatives, also known as fiber supplements, are taken with water. They
absorb water in the intestine and make the stool softer. Stimulants cause
rhythmic muscle contractions in the intestines. Most laxative makers have
replaced or plan to replace phenolphthalein with a safer ingredient. Stool
softeners provide moisture to the stool and prevent dehydration. These
laxatives are often recommended after child birth or surgery. Lubricants grease
the stool enabling it to move through the intestine more easily. Mineral oil is
the most common lubricant. Saline laxatives act like a sponge to draw water
into the colon for easier passage of stool.
People who are dependent on
laxatives need to slowly stop using the medications. health care provider can
assist in this process. In most people, this restores the colon's natural
ability to contract.
Treatment may be directed at a
specific cause. For example, the health care provider may recommend
discontinuing medication or performing surgery to correct an anorectal problem
such as rectal prolapse.
People with chronic constipation
caused by anorectal dysfunction can use biofeedback to retrain the muscles that
control release of bowel movements. Biofeedback involves using a sensor to
monitor muscle activity that at the same time can be displayed on a computer
screen allowing for an accurate assessment of body functions. A health care
professional uses this information to help the patient learn how to use these
muscles.
Surgical removal of the colon may
be an option for people with severe symptoms caused by colonic inertia.
However, the benefits of this surgery must be weighed against possible
complications, which include abdominal pain and diarrhea.
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