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Mariusz Klin, M.D., Ph.D

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 as few as three a week, are considered normal. Regularity and ease of defecation are more important than frequency. Dr. Klin recommends that anyone who experiences constipation, after years of regularity, should 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 normal. 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. Dr. Klin generally recommends 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, Dr. Klin 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 Dr. Klin.

Source: AMA Complete Encyclopedia, Copyright 2003, American Medical Association
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