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Constipation
Constipation can be defined as infrequent or hard pellet stools,
or difficulty in evacuating stool. Passing one or more soft,
bulky stool every day is a desirable goal. While troublesome,
constipation is not usually a serious disorder. However,
there may be other underlying problems causing constipation,
and, therefore, testing is often recommended.
What causes Constipation?
The stomach churns and mixes food so it can be digested.
The near-liquid food enters the small intestine which extracts
calories, minerals and vitamins. The small intestine ends in the
right-lower abdomen where it enters the colon. The colon, or
large bowel, is 5 to 6 feet long. Its function is to withdraw
water from the liquid stool, so that by the time it reaches
the rectum there is a soft-formed stool. If an excessive amount
of water is extracted, the stool can become hard and difficult to expel.
Constipation is often caused by a lazy colon that does not contract properly and fails to move the stool to the rectum. The colon can also become spastic and remain contracted for a prolonged time. In this case, stool cannot move along. Too much water is absorbed and hard pellet-like stool develops. Constipation also can result from a mechanical obstruction, such as tumors or advanced diverticulosis, a disorder that can distort and narrow the lower-left colon. Other conditions that can produce a sluggish, poorly contracting bowel include: pregnancy, anal fissures and hemorrhoids, certain drugs, thyroid hormone deficiency, the abuse of laxatives, travel, and stress. Diagnosis
The patient's medical history is the most important factor in diagnosing
constipation. The physician will perform a physical exam and might
perform the following exams:
Treatment
Because there are many causes of constipation, treatment depends on the
physician's findings and diagnosis. After serious problems are excluded,
chronic constipation usually responds to simple measures, such as adding
fiber, bran or a bulking agent to the diet.
Do Laxatives help?
General guidelines for treating constipation include: eating regularly, drinking plenty of liquids each day, regular walking and performing aerobic exercise. In particular, patients should respond to the urge to defecate. Retaining stool at this point will aggravate the condition. Diet--Foods that are high in roughage, bran and fiber are essential in correction and preventing constipation. In parts of the world where unprocessed grain is used and where large amounts of fiber are consumed, there is little constipation, and passing one or two large, soft stools a day is normal. The following foods should be eaten daily in adequate amounts:
There are two main types of laxatives: stimulants (chemical) and
saline (liquid or salt). They occasionally help temporary
constipation problems. However, chronic use of laxatives is
discouraged because the bowel becomes dependent upon them.
Bowel regularity should occur without laxatives. An occasional
enema is preferable over the chronic use of laxatives.
Surgery
With certain medical conditions, such as severe diverticulosis,
and with extreme constipation in some younger patients,
surgery may provide relief.
Bowel Retraining Program
Summary
Constipation usually is a short-term disorder that is easily
treated by simple measures. However, the condition may reflect
a serious underlying condition. For chronic constipation,
it is important that the patient understands how this occurs.
By the intake of proper foods and fiber supplements,
it is usually possible to retrain the colon so that normal regularity occurs.
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