Constipation
Constipation is infrequent or irregular bowel movements
in which feces are hard and dry. Although most people
have one bowel movement a day, as many as three movements
a day or a few a three a week are considered normal.
Regularity and ease of defecation are more important
than frequency. Doctors recommend that anyone who experiences
constipation after years of regularity seek medical
help. This is especially important when constipation
is accompanied by other symptoms such as weight loss,
abdominal pain, or rectal bleeding.
Constipation occurs when colon muscles fail to contract
and propel stools forward as usual. The colon continues
to absorb water from stools, making them hard and dry
and more difficult to pass. Primary causes usually include
not eating enough fiber or drinking enough fluids. Repeatedly
ignoring the urge to defecate can also be a factor.
Other causes include the overuse of laxatives, physical
inactivity, the use of certain medications (such as
antacids, iron, or codeine), hemorrhoids, an anal fissure,
irritable bowel syndrome, diverticular disease, or hypothyroidism.
In some cases, the abrupt onset of constipation is a
symptom of colon cancer.
Diagnosis & Treatment
Diagnostic tests to determine the cause of constipation
include a lower gastrointestinal (GI) series (an x-ray
procedure also called a barium enema) and sigmoidscopy,
or colonoscopy (examinations of the rectum and colon
using flexible viewing tubes passed through the anus).
Blood tests may be helpful in identifying an electrolyte
deficiency that may impair colonic function.
Treatment depends on the cause. Doctors generally
recommend adding fiber-rich vegetables, fruits, and
bran to the diet, drinking adequate fluids, and responding
promptly to the urge to defecate. Because constipation
is a side effect of medication, the doctor will review
all medications that a person is taking and adjust them
as necessary. Laxatives should be used cautiously and
infrequently, since long-term use may damage the colon.
An enema is used to treat severe constipation, but not
be used regularly. Painful conditions, such as hemorrhoids,
may cause some people to avoid defecation, which worsens
constipation. When the cause is an underlying problem,
such as hemorrhoids or irritable bowel syndrome, the
person should see a doctor.
Source: AMA Complete Medical Encyclopedia,
Copyright 2003, American Medical Association
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