Constipation

Overview

Constipation is a condition characterized by infrequent bowel movements or difficulty passing stools. It is generally described as having fewer than three bowel movements per week. Chronic constipation persists for several weeks or longer and can interfere with daily tasks. Symptoms of chronic constipation include passing fewer than three stools a week, having lumpy or hard stools, straining during bowel movements, feeling a blockage in the rectum, and feeling like you cannot completely empty the stool from your rectum. The underlying cause of constipation may be found in some cases, but in others, it may remain unknown.

Understanding the disease

Symptoms

The symptoms of constipation include passing fewer than three stools a week, having lumpy or hard stools, straining to have bowel movements, feeling as though there's a blockage in your rectum that prevents bowel movements, and feeling as though you can't completely empty the stool from your rectum. Additionally, children experiencing constipation may have less than three bowel movements a week, have hard, dry, and difficult-to-pass stools, experience pain while having a bowel movement, have stomach pain, have traces of liquid or pasty stool in their underwear, and require help to empty their rectum. If you or your child are experiencing persistent changes in bowel habits, it is recommended to consult a doctor.

Risk Factors

Risk factors for developing constipation include:

1. Being an older adult
2. Being a woman
3. Being dehydrated
4. Eating a diet that's low in fiber
5. Getting little or no physical activity
6. Taking certain medications, including sedatives, opioid pain medications, some antidepressants or medications to lower blood pressure
7. Having a mental health condition such as depression or an eating disorder These factors may increase the likelihood of experiencing chronic constipation.

Development

Constipation can develop due to various reasons, both acute and chronic. In the case of occasional constipation, it may be caused by factors such as dehydration, lack of physical activity, or a low-fiber diet. Eating a diet high in processed foods, dairy products, and meat, and not consuming enough fluids can also contribute to constipation. Stress, certain medications such as sedatives or opioid pain relievers, and some antidepressants can also lead to chronic constipation. In children, constipation can be caused by factors such as toilet training, dietary changes, or a lack of physical activity. Encouraging children to consume a high-fiber diet and stay hydrated can help alleviate constipation. In summary, constipation can be caused by a variety of factors, including dietary habits, lifestyle, certain medications, and age. It is essential to identify the underlying cause and make necessary adjustments to prevent or alleviate constipation.

Assessment and Diagnosis

Triage

You should see a doctor if constipation is accompanied by any of the following symptoms:

1. Fever
2. Not eating
3. Blood in the stool
4. Abdominal swelling
5. Weight loss
6. Pain during bowel movements
7. Part of the intestine coming out of the anus (rectal prolapse) If constipation in a child lasts longer than two weeks or is causing significant discomfort, it is also advisable to consult a doctor. In some cases, the doctor may recommend laxatives or other treatments to alleviate the constipation.

Diagnosis

Doctors use various tests and procedures to diagnose chronic constipation and identify its cause. These include a general physical exam, digital rectal exam, blood tests, X-rays, sigmoidoscopy, colonoscopy, and sometimes more-extensive tests like MRI defecography. For children, a complete medical history, physical exam, and tests like abdominal X-ray or anorectal manometry may be conducted to diagnose constipation.

Management and Treatment

Complications

Potential complications of chronic constipation include swollen veins in the anus (hemorrhoids), torn skin in the anus (anal fissures), stool that can't be expelled (fecal impaction), and intestines protruding from the anus (rectal prolapse).

Prevention

constipation can be prevented by following certain measures, such as:

1. Including plenty of high-fiber foods in your diet, including beans, vegetables, fruits, whole grain cereals, and bran.
2. Eating fewer foods with low amounts of fiber, such as processed foods, dairy, and meat products.
3. Drinking plenty of fluids.
4. Staying active and getting regular exercise.
5. Managing stress and not ignoring the urge to pass stool.
6. Creating a regular schedule for bowel movements, especially after a meal. By incorporating these habits into your lifestyle, you can help reduce the risk of developing chronic constipation.

Home Remedies

Here are some home remedies for constipation:

1. Encourage plenty of fluids: Drinking enough water can help soften stools and prevent constipation.
2. Promote physical activity: Regular exercise can promote normal bowel function.
3. Create a toilet routine: Set aside time after meals for your child to use the toilet. Provide a footstool if needed.
4. Remind your child to heed nature's call: Ignoring the urge to have a bowel movement can contribute to constipation.
5. Be supportive and reward efforts: Offer small rewards for trying to move bowels, but avoid punishing children for accidents.
6. Include high-fiber foods in the diet: Fruits, vegetables, whole grains, and beans are rich in fiber, which can help prevent constipation.
7. Limit low-fiber foods: Reduce consumption of processed foods, dairy, and meat products.
8. Manage stress: Stress can contribute to constipation, so try to stay relaxed and practice stress-reducing techniques.
9. Maintain a healthy weight: Consult with a doctor to develop an appropriate exercise and diet plan for a healthy weight.
10. Lift heavy objects carefully: Always bend from the knees when lifting heavy objects to avoid straining. Please note that these remedies are general suggestions and may not be suitable for every individual. Consult a healthcare professional for personalized advice.

Treatment

Treatments for constipation in children and adults may include:

1. Dietary changes: Encourage a high-fiber diet, including fruits, vegetables, whole grains, and legumes. Drink plenty of fluids, particularly water.
2. Exercise: Regular physical activity can help stimulate normal bowel function.
3. Toilet routine: Set aside regular time after meals for your child (or yourself) to use the toilet.
4. Reminders: Help your child remember to heed nature's call and not ignore the urge to have a bowel movement.
5. Laxatives: Over-the-counter laxatives, such as osmotic or stimulant laxatives, may be recommended by a doctor for short-term use in managing constipation. Be sure to follow the instructions carefully and only use them as directed. It is important to consult with a healthcare professional before starting any treatment for constipation, as they can provide personalized advice based on the underlying cause and severity of the constipation.

Preparing for medical consultation

To prepare for an appointment for constipation, you should:

1. Make the appointment with your primary healthcare provider or a gastroenterologist, if necessary.
2. Prepare a list of your symptoms, including any that may seem unrelated to constipation.
3. Gather information about your personal and family medical history.
4. List all medications, vitamins, or supplements you are taking, including the doses.
5. Ask if there are any pre-appointment restrictions, such as fasting before specific tests.
6. Bring a family member or friend to the appointment to help you remember information.
7. Be prepared to discuss any treatments you have already tried for constipation. Remember to share any concerns you have about your symptoms and any impact they may have on your daily life. Following these steps will help you make the most of your appointment and facilitate an effective conversation with your healthcare provider.