June 26, 2017

Constipation (Home Remedies and Medications for Relief)

Constipation definition and facts

  • Constipation is defined medically as fewer than three stools per week and severe constipation as less than per week.
  • Some of the symptoms include:
    • Lower abdominal discomfort
    • A sense of incomplete evacuation (the feeling that you still have to "go")
    • Straining to have a bowel movement
    • Hard or small stools
    • Rectal bleeding and/or anal fissures caused by hard stools
    • Physiological distress and/or obsession with having bowel movements.
  • It usually is caused by the slow movement of material through the colon (bowel).
  • The two disorders limited to the colon that cause constipation are colonic inertia and pelvic floor dysfunction.
  • There are many causes of constipation, for example, medications; poor bowel habits; low fiber diets; possibly abuse of laxatives; hormonal disorders; diseases primarily of other parts of the body that also affect the colon; and high levels of estrogen and progesterone during pregnancy.
  • Individuals should seek medical care if constipation is of sudden onset, severe, worsening, associated with other worrisome symptoms such as loss of weight, or is not responding to simple, safe and effective treatments.
  • Tests to diagnose the cause of constipation may include a history, physical examination, blood tests, abdominal X-rays, barium enema, colonic transit studies, defecography, anorectal motility studies, and colonic motility studies.
  • The goal of therapy for constipation is one bowel movement every two to three days without straining.
  • Treatment may include foods high in fiber, non-stimulant laxatives, stimulant laxatives, enemas, suppositories, biofeedback training, prescription medications, and surgery.
  • Stimulant laxatives, including herbal products, should be used as a last resort because they may damage the colon and worsen constipation.

What is constipation?

Constipation means different things to different people. For many people, it simply means infrequent passage of feces. For others, however, it means hard stools, difficulty passing them (straining), or a sense of incomplete emptying after a bowel movement. The cause of each of these symptoms of constipation vary, so the approach to each should be tailored to each specific patient.

Constipation also can alternate with diarrhea. This pattern commonly occurs as part of the irritable bowel syndrome (IBS). At the extreme end of the spectrum for it is fecal impaction, which is when the stool hardens in the rectum and prevents the passage of it (although occasionally diarrhea may occur even with obstruction due to colonic fluid leaking around the impacted stool).

The number of bowel movements generally decreases with age. Most adults have what is considered normal, between three and 21 times per week. The most common pattern is one a day, but this pattern is seen in less than half of individuals. Moreover, most are irregular, and don't have bowel movements every day or the same number every day.

Medically speaking, constipation usually is defined as fewer than three bowel movements per week. Severe constipation is defined as less than one bowel movement per week. There is no medical reason to have one every day. Going without one for two or three days does not cause physical discomfort, only mental distress (in some people). Contrary to popular belief, there is no evidence that "toxins" accumulate when movements are infrequent or that constipation leads to cancer.

It is important to distinguish acute (recent onset) constipation from chronic (long duration) constipation. Acute constipation requires urgent assessment because a serious medical illness may be the underlying cause (for example, tumors of the colon). It also requires an immediate assessment if it is accompanied by symptoms such as rectal bleeding, abdominal pain and cramps, nausea and vomiting, and involuntary loss of weight. The evaluation of chronic constipation may not be urgent, particularly if simple measures bring relief.

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Reviewed on 3/27/2017
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