Constipation
Constipation is a condition where it is difficult to have a bowel movement. It can be that you cannot have a bowel movement at all or not completely.
Although the frequency of bowel movements can vary from person to person, you can be said to be constipated if you have a bowel movement less than 3 times a week.
People of all ages can experience occasional constipation. There are also certain people and situations that are more likely to lead to more consistent constipation or chronic constipation.
Symptoms of Constipation
Common symptoms of constipation are difficulty in defecating, and the frequency is less than 3 times a week. Signs and symptoms of chronic constipation include:
- Having hard or solid stools.
- Straining to defecate.
- Feeling as if there is a blockage in the rectum preventing a bowel movement.
- Feeling as if one cannot completely empty stool from the rectum.
- Needs help to empty the rectum. For example, using the hand to press on the abdomen and using the finger to remove stool from the rectum.
Causes of Constipation
Constipation most often occurs when stool or feces move too slowly through the digestive tract or cannot be effectively expelled from the rectum. This can cause stool to become hard and dry. Chronic constipation has many possible causes.
A blockage in the colon or rectum can slow or stop the movement of stool. Possible causes of constipation are:
- Small tears in the skin around the anus (anal fissures).
- Blockage in the intestine ( intestinal obstruction ).
- Colon cancer.
- Narrowing of the large intestine (intestinal stricture).
- Other stomach cancers that press on the colon.
- Rectal cancer.
- The rectum protrudes through the back wall of the vagina (rectocele).
Constipation can also occur due to problems with the nerves around the colon and rectum. These problems can affect the nerves that cause the muscles in the colon and rectum to contract and move stool through the intestines. Causes include:
- Damage to the nerves that control body functions (autonomic neuropathy).
- Parkinson’s disease.
- Spinal cord injury.
- Injury or trauma.
In addition, problems with the pelvic muscles involved in defecation can also cause chronic constipation, such as:
- Inability to relax the pelvic muscles to allow for a bowel movement (anismus).
- Pelvic muscles that do not coordinate relaxation and contraction properly (dyssynergia).
- Pelvic muscles weaken.
In addition to the various causes above, constipation can also occur due to hormonal factors. Hormones can help balance fluids in the body.
Diseases and conditions that disrupt hormonal balance can cause constipation, including:
- Diabetes.
- Overactive parathyroid glands (hyperparathyroidism).
- Pregnancy.
- Underactive thyroid (hypothyroidism).
Constipation Risk Factors
Several factors that can increase a person’s risk of experiencing constipation include:
- Gender. Constipation is more common in women than in men, especially during the premenstrual period and during pregnancy.
- Age. Constipation is also more common in older adults.
- Diet. For example, eating foods that are low in fiber.
- Lack of physical activity. Rarely or no exercise at all.
- Taking certain medications. Including tranquilizers, or drugs for high blood pressure.
- Mental health. Having a mental health condition, such as depression.
Diagnosis of Constipation
Diagnosis of constipation can be done through a medical interview about symptoms and a physical examination, including checking vital signs (temperature, pulse, blood pressure).
The doctor will use a stethoscope to listen to sounds in the abdomen. The doctor will check the abdomen for pain, tenderness, swelling, and lumps.
In addition to interviews and physical examinations, the doctor will also perform various types of tests and procedures to confirm the diagnosis, such as:
- Laboratory tests. Blood and urine tests reveal signs of hypothyroidism, anemia, and diabetes. Stool samples can show signs of infection, inflammation, and cancer.
- Imaging tests. Computed tomography (CT) or magnetic resonance imaging (MRI) can identify other problems that may be causing constipation.
- Colonoscopy. An examination of the inside of the large intestine. During this procedure, your doctor may take a small sample of tissue to test for cancer or other problems and remove any polyps.
- Colon transit study. Evaluation of how well food moves through the large intestine. This treatment involves swallowing a capsule containing a wireless recording device. It can also be done with radiocarbon-activated food and a special camera that records its progress (scintigraphy).
- Other bowel function tests. Including a certain type of x-ray (defecography), to rule out outlet dysfunction as a cause of constipation, and insertion of a small balloon into the rectum (anorectal manometry).
Constipation Treatment
Most cases of mild to moderate constipation can be treated at home. Self-care can start by taking inventory of what you consume and then making changes.
Some recommendations to help relieve or as a treatment step for constipation include:
- Drink more water. Avoid drinks containing caffeine and alcohol, which can cause dehydration.
- Add fruits, vegetables, whole grains, and other high-fiber foods to your diet.
- Move or exercise.
- Do not read, use your cell phone or other devices while trying to have a bowel movement.
- Review any medications or supplements you are currently taking.
Several prescription medications are available to treat constipation. These include lubiprostone, prucalopride, plecanatide, lactulose, and linaclotide. Your doctor will choose the medication that may be most appropriate based on your test results.
Surgery is rarely an option for treating constipation. However, your doctor may recommend surgery if the cause of your constipation is a structural problem in your colon.
For example, a blockage in the colon, intestinal stricture, anal fissure, or rectal prolapse. Some causes of outlet dysfunction and constipation can be treated with surgery. Sufferers may also need surgery if the cancer is in the colon, rectum, or anus.
Prevention of Constipation
Here are some ways you can prevent constipation:
- Eat lots of fruits, vegetables, and whole grains.
- Eat high-fiber foods and take fiber supplements if necessary.
- Drink plenty of water.
- Avoid alcohol and caffeine as they can cause dehydration.
- Get regular exercise.
- Regularly consume probiotics, such as those found in yogurt and kefir with active or live cultures of good bacteria.
- Train your muscles to defecate at the same time every day.
Complications of Constipation
Constipation that does not improve or becomes chronic can cause complications such as:
- Swollen veins in the anus (hemorrhoids). Straining during a bowel movement can cause swelling in the veins in and around the anus.
- Skin tears in the anus (anal fissures). Large or hard stools can cause small tears in the anus.
- Stool that cannot be passed (fecal impaction). Chronic constipation can cause an accumulation of hardened stool that gets stuck in the intestine.
- Bowel protruding from the anus (rectal prolapse). Straining during a bowel movement can cause a small amount of rectum to stretch and protrude from the anus.