Usually, people have bowel movements at quite regular intervals, and stool passes out of the body without difficulty, without much straining or the feeling of discomfort. Even though the usual frequency of bowel movements is different for each person, around 95 per cent of healthy adults have a pattern ranging from three times a day to three times weekly.
In case of constipation, bowel movements either take place less frequently than expected or the stool is hard, dry and difficult to pass. Constipation is almost never connected with any illness or digestive disorder. In its place, the condition results from diet, style of life, medicines taken or some other factor that either is hardening the stool or is interfering with the stool’s ability to pass comfortably. Several widespread factors leading to constipation in adults include:
* Low-fiber — You require around 25 grams to 30 grams of fiber each day in order to soften the stool and encourage appropriate bowel function. The vast majority of American diets contain less than half that amount.
* Insufficient intake of fluid— To help prevent stools from being dry and hard, your daily intake of fluid needs to be equivalent to at least six to eight glasses of water. This amount includes fluids that are found in milk, juice and other beverages, as well as in fruits, soups, stews and solid foods.
* A passive style of life— Due to the fact that regular physical activity is essential to encourage normal muscle contractions in the bowel wall, having a sedentary job or exercising rather seldom puts you at great risk of constipation.
* Ignoring the necessity to defecate — From time to time, due t a busy schedule or restricted access to toilets, people ignore the necessity to defecate. Over time, postponing bathroom trips until a more comfortable time may result in constipation.
* Travel and scheduling factors — Travel can encourage constipation by altering your diet, interfering with the usual timing of your meals, and restricting your access to toilets.
* Laxative overuse — Long-term use of over-the-counter laxative drugs can teach your bowel to rely on these medications, and may finally lead to constipation rather than alleviate it.
* A side effect of medicines — Constipation may constitute a side effect of various prescription and nonprescription medicines, such as iron supplements and vitamins that comprise iron; calcium supplements; antacid drugs containing aluminum; psychiatric medicines, including antidepressant drugs and tranquilizers; narcotic pain relievers; general anesthesia; diuretics; muscle relaxants; and certain prescription mediciations used by the physicians to treat seizure disorders, Parkinson’s disease, overactive bladder, and hypertension, particularly verapamil (sold under several brand names).
* Local pain or discomfort in the anus area— An anal fissure (small tear in the skin around the anus) or hemorrhoids may make bowel movements excruciating or uncomfortable. To avoid this, an individual may resist the necessity to defecate.
Less frequently, constipation may constitute a symptom of a disease or condition that either influences the digestive tract or the brain and spinal cord. Some examples are: irritable bowel syndrome, intestinal obstruction, diverticulitis, colorectal cancer, hypothyroidism, unusually high blood calcium levels (hypercalcemia), multiple sclerosis, Parkinson’s disease and spinal cord injury.
Constipation is a widespread problem striking at least 80 per cent of people at some time during their lives. In the United States, constipation treatment represents over 2.5 million visits to physicians’ offices annually, with at least $800 million spent each year for laxatives. Even though adults of all ages may suffer from constipation, the likelihood of experiencing this problem increases rapidly after age of 65 in both genders.
From time to time, long-term constipation develops into fecal impaction, which is a mass of stool that can’t be moved by colon contractions. As a result, the colon may become blocked. Fecal impaction can lead to serious pain and vomiting, and a patient with fecal impaction may need emergency treatment or even hospitalization. Fecal impaction is a widespread complication of long-term constipation in the elderly and bedridden, happening in nearly 30 per cent of all nursing home residents.
Symptoms
The common symptoms of constipation include:
* Fewer than three bowel movements per week
* Small, hard, dry stools that are complicated and painful to pass
* The necessity to strain excessively to have a bowel movement
* A feeling that your rectum is not empty after a bowel movement
* Frequent use of enemas, laxatives or suppositories
The typical symptoms of fecal impaction are:
* Passing stool unwillingly due to liquid stool leaking around the impacted mass of feces (can be mistaken for diarrhea)
* Abdominal pain, particularly after meals
* A persistent necessity to move the bowels
* Nausea and vomiting
* Headache
* Bad appetite, weight loss
* Malaise (general sick feeling)
* If the problem is not treated, dehydration, rapid pulse, rapid breathing, fever, agitation, confusion and urinary incontinence
Diagnosis
The majority of people with simple constipation are able to diagnose and treat themselves. If you experience constipation, start by evaluating your lifestyle. Evaluate your present diet, your level of daily physical activity, and your bowel habits. Particularly, do you frequently ignore the necessity of having a bowel movement because it is inconvenient? Then take some preventive steps, such as adding fiber to your diet, drinking lots of fluid, and having regular exercise. If this doesn’t alleviate your problem, consult your healthcare professional.
If you suffer constipation along with rectal bleeding, abdominal pain or abdominal distention (bloating), consult your physician without hesitation. It is best in this case for your physician to examine you, including a physical examination and digital rectal exam.
If your symptoms suggest that you might have fecal impaction, your healthcare professional can acknowledge the diagnosis by checking your abdomen and by checking for a mass of impacted feces in the course of the digital rectal examination. You may require also other tests, such as blood tests, plain abdominal X-rays, a barium enema or sigmoidoscopy (in which a special instrument is used to view the lower colon).
People at the age of 50 or more are at greater risk of developing colon polyps or colon cancer. Constipation may constitute a symptom of colon polyps or cancer, and you ought to make sure that your screening for colon cancer (by colonoscopy or another test) is the latest.
Expected Duration of the Problem
How long constipation persists depends on its cause. In most otherwise healthy adult patients, constipation improves steadily within several weeks after they increase their consumption of dietary fiber and fluid and start exercising on a regular basis. Nonetheless, constipation in bedridden people with neurological problems may appear to be persistent and is a risk factor for fecal impaction.
Prevention
Very often it happens that you can prevent constipation by taking the following steps:
* Add some more fiber to your diet — Set a dietary objective of 25 grams to 30 grams of fiber a day. Choose from a variety of high-fiber foods including: beans, broccoli, carrots, bran, whole grains and fresh fruits. In order to avoid bloating and gas, add these foods steadily over a period of a few days.
* Drink proper amounts of fluid — For the majority of healthy adults, this is the equivalent of six to eight glasses of water a day.
* Start a program of regular exercising — As little as twenty minutes of fast walking daily is able to activate your bowels.
* Help train your digestive tract to have regular bowel movements — Schedule a 10-minute spell to sit on the toilet at approximately the same time every day. The perfect time to do this is normally right after the morning meal.
* Never put off having a bowel movement until the time is more suitable — Respond to the necessity promptly.
* Use an over-the-counter stool softener or fiber supplement — This may prevent occasional constipation. Always follow the dosage instructions precisely as written on the labels of these medicines.
Treatment
If you suffer unpleasant symptoms of constipation, it is sensible to use a laxative treatment to help your bowel expel the stool. There are various laxative drugs available without a prescription, and they are secure for infrequent use. Salt-based or osmotic laxative medicines include laxatives comprising magnesium, such as milk of magnesia. This kind of laxative helps to end constipation by drawing water through the bowel wall into the bowel, loosening stool. Stimulant laxatives, including laxatives that contain senna, cascara or bisacodyl, make the colon muscles contract more often or more aggressively.
Laxative medications are available in forms that can be swallowed or inserted into the rectum as a suppository.
Enemas are also able to alleviate constipation, and are available at pharmacies without a prescription. An enema is a bag of liquid (normally a mixture of salt and water) joined to a plastic tube with a tapered tip. The enema fluid may be emptied into the rectum after the tip is inserted into the anus by lifting the bag a few inches and making it possible for the fluid to move with gravity. An enema loosens stool in the rectum, and stimulates the rectum to empty by stretching the muscles in the rectum.
If you experience fecal impaction, your healthcare professional may remove at least part of the fecal mass manually by means of using a lubricated, gloved finger inserted in the rectum. The rest of the mass can normally be removed with an enema, or by using water irrigation through a sigmoidoscope. When the impacted stool has been removed, your physician will have you follow a high-fiber diet and may suggest that you take a stool-softening medicines or laxative drug to encourage regular bowel movements.
When To Contact A Specialist
Consult your healthcare professional promptly if your bowel movements stop unexpectedly and totally, and you develop abdominal pain or distention. Moreover, call your physician without hesitation if you have any bleeding from your rectum.
Ask your physician for advice if constipation continues, or if you require laxatives more than two or three times weekly to help you move your bowels.
Prognosis
The substantial majority of people experiencing constipation can achieve normal bowel function through diet and changes in lifestyle.
The outlook for the majority of people with fecal impaction is optimistic. Nevertheless, it is typical for fecal impaction to come back if constipation is not improved with extra treatment. A long-term program of mild laxative medications, periodic enemas or both may appear to be indispensable.
