Constipation

Constipation or irregularity, is a condition of the digestive system where a person experiences hard feces that are difficult to eliminate; it may be extremely painful, and in severe cases lead to symptoms of bowel obstruction. Obstipation refers to severe constipation. Causes of constipation may be dietary, hormonal, a side effect of medications, an illness or disorder, and anatomical. Treatment is with a change in dietary and exercise habits.

In people without medical problems, the main intervention is the increase of fluids and dietary fiber. The latter may be achieved by consuming more vegetables and fruit, whole meal bread and by adding linseeds to one's diet. The routine non-medical use of laxatives is to be discouraged as this may result in bowel action becoming dependent upon their use. Enemas can be used to provide a form of mechanical stimulation.

Laxatives may be necessary in people in whom dietary intervention is not effective or inappropriate. Stimulant laxatives are generally avoided, as they may worsen crampy sensations commonly experienced in constipation. In various conditions, combinations of hydrating, bulk-forming and stimulant agents may be necessary. Many of the products are widely available over-the-counter.

Enemas and clysters are a remedy occasionally used for hospitalized patients in whom the constipation has proven to be severe, dangerous in other ways, or resistant to laxatives. Sorbitol, glycerin and arachis oil suppositories can be used. Severe cases may require phosphate solutions introduced as enemas.

Constipation that resists all the above measures requires physical intervention. Manual disimpaction is done under sedation or a general anesthetic—this avoids pain and loosens the anal sphincter.

Constipation is usually easier to prevent than to treat. The relief of constipation with osmotic agents, i.e. lactulose, Polyethyleneglycol(PEG), or magnesium salts, should immediately be followed with prevention using increased fiber and a nightly decreasing dose of osmotic laxative. With continuing narcotic use, for instance, nightly doses of osmotic agents can be given indefinitely to cause a daily bowel movement.

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Related Links:

• US National Library of Medicine
• Mayo Clinic

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