what is constipation?
Constipation is a condition in which a person has infrequent or uncomfortable bowel movements. A person is generally considered to be constipated when bowel movements result in the passage of small amounts of hard, dry stool, usually fewer than three times a week. however, normal stool elimination may consist of bowel movements three times a day or three times a week; it depends on the person.
About 4 million people in the United States have frequent constipation. Constipation is the most common gastrointestinal problem, generating 2.5 million doctor visits a year.
what causes constipation?
Hard, dry stools are the result of the colon absorbing too much water. Normally, as food moves through the colon (also known as the large intestine), the colon absorbs water while forming stool (waste products). muscle contractions then push the stool into the rectum, and by the time the stool reaches the rectum, most of the water has been absorbed, making the stool solid.
When the contractions of the muscles of the colon are slow or sluggish, stool moves through the colon too slowly, causing too much water to be absorbed. Some of the more common causes of constipation include the following:
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medications
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lack of exercise
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not enough fluids
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not enough fiber in the diet
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irritable bowel syndrome
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ignore the urge to defecate
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changes in habits or lifestyle, such as travel, pregnancy and old age
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problems with bowel function
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laxative abuse
what are the symptoms of constipation?
The following are the most common symptoms of constipation. however, each individual may experience symptoms differently. symptoms may include:
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painful and difficult bowel movements
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bowel movements less than three times a week
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feeling bloated or uncomfortable
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feel slow
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abdominal pain
The symptoms of constipation may resemble other conditions or medical problems. always see your doctor for a diagnosis.
How is constipation diagnosed?
Tests performed by a doctor will depend on the duration and severity of the constipation, as most people experience constipation at one time or another. The doctor will also consider the patient’s age and whether there is blood in the stool, recent changes in bowel habits, or weight loss.
diagnosis of constipation may include:
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medical history. The doctor will ask for a description of the constipation, including the duration of symptoms, frequency of bowel movements, and other information to help determine the cause of the constipation.
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physical exam. A physical exam may also include a digital rectal exam (DRE), in which the doctor inserts a lubricated, gloved finger into the rectum to test the tone of the muscle that closes the anus. This test also helps detect tenderness, obstruction, blood, amount and size of stool, and whether there is an enlarged rectum.
Other diagnostic tests may include:
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abdominal x-ray
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lower gastrointestinal tract series (also called a barium enema). A lower GI series is a procedure that examines the rectum, large intestine, and lower part of the small intestine. A liquid called barium (a metallic, chemical, chalky liquid used to line the inside of organs so they show up on an x-ray) is administered into the rectum as an enema. An x-ray of the abdomen shows strictures (narrowed areas), obstructions (blockages), and other problems.
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colonoscopy. Colonoscopy is a procedure that allows the doctor to view the entire length of the large intestine and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, through the rectum and into the colon. The colonoscope allows the doctor to see the lining of the colon, remove tissue for further examination, and possibly treat any problems that are discovered.
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sigmoidoscopy. A sigmoidoscopy is a diagnostic procedure that allows the doctor to examine the inside of a portion of the large intestine and is helpful in identifying causes of diarrhea, abdominal pain, constipation, abnormal growths, and bleeding. A short, flexible, lighted tube, called a sigmoidoscope, is inserted into the intestine through the rectum. the endoscope blows air into the intestine to inflate it and make it easier to see inside.
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colorectal transit study. This test shows how well food moves through the colon. the patient swallows capsules that contain small markers that are visible on the x-ray. the patient follows a high-fiber diet during the course of the test, and the movement of the tracers through the colon is monitored with abdominal x-rays taken several times three to seven days after swallowing the capsule.
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Anorectal function tests. These tests diagnose constipation caused by abnormal function of the anus or rectum.
treatment for constipation
Your doctor will determine the specific treatment for constipation based on:
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your age, general health, and medical history
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condition extension
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your tolerance to specific medications, procedures, or therapies
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expectations for the course of this condition
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your opinion or preference
Most of the time, constipation can be treated through dietary and lifestyle changes, which relieve symptoms and help prevent the condition. treatment may include:
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modifications in the diet. a diet with 20 to 35 grams of fiber per day helps in the formation of soft and bulky stools. while adding foods such as beans, whole grains, bran cereals, fresh fruits and vegetables is helpful in adding fiber to the diet. It may also be helpful to limit foods such as ice cream, cheese, meats, and processed foods, which contain little or no fiber.
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laxatives. Laxatives may be prescribed after diet and lifestyle changes have not been effective.
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elimination or change of medication
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biofeedback. Biofeedback is used to treat chronic constipation caused by anorectal dysfunction. this treatment retrains the muscles that control the release of bowel movements.
Lifestyle changes, such as increased water and juice intake, regular exercise, and allowing enough time for daily bowel movements, may be helpful.
what are good sources of fiber?
what are the complications of constipation?
Constipation can cause complications, such as hemorrhoids, which occur when straining to have a bowel movement, or anal fissures (tears in the skin around the anus), which occur when hard stools stretch the sphincter muscle. this can result in rectal bleeding.
Stressing also sometimes causes rectal prolapse, in which a small amount of intestinal lining protrudes through the anal opening. constipation can also cause fecal impaction, which occurs mainly in children and older adults. hard stool compresses the intestine and rectum so strongly that the normal pushing action of the colon is not enough to expel the stool.
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