More than 4 million americans frequently have constipation. And of this group most tend to be women and adults age 65 and above.
Constipation by definition is when you have less than three bowel movements per week. When constipated your stool can typically be hard, dry, small in size, and difficult to eliminate. Everyone is unique so you may not be constipated if you do not have a bowel movement every day. Some people have a bowel movement as often as three times a day and others as few as three times a week. It’s important to remember constipation is a symptom and not a disease. Everyone experience constipation at some time in their life and by understanding the causes we can help to prevent and treat it.
* not enough fiber in the diet
* lack of physical activity (especially in the elderly)
* irritable bowel syndrome
* changes in life or routine such as pregnancy, aging, and travel
* abuse of laxatives
* Neurological disorders
* multiple sclerosis
* Parkinson’s disease
* chronic idiopathic intestinal pseudo-obstruction
Treatment typically is dependant upon your specific case, however it is often diet and lifestyle changes that can help.
A diet with enough fiber helps the body form soft, bulky stool. High-fiber foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, Brussels sprouts, cabbage, and carrots. For people prone to constipation, limiting foods that have little or no fiber, such as ice cream, cheese, meat, and processed foods, is also important.
Also drinking enough water and other liquids, such as fruit and vegetable juices and clear soups, so as not to become dehydrated, engaging in daily exercise, and reserving enough time to have a bowel movement. In addition, the urge to have a bowel movement should not be ignored. So when you have to go, it’s probably a good idea to GO.
Most people who are mildly constipated do not need laxatives. However, for those who have made diet and lifestyle changes and are still constipated, a doctor may recommend laxatives or enemas for a limited time. These treatments can help retrain a chronically sluggish bowel. For children, short-term treatment with laxatives, along with retraining to establish regular bowel habits, helps prevent constipation.
A doctor should determine when a patient needs a laxative and which form is best. Laxatives taken by mouth are available in liquid, tablet, gum powder, and granule forms. They work in various ways:
* Bulk-forming laxatives (generally considered the safest) * Stimulants (cause rythmic intestinal muscle contractions) * Osmotics (good for people with idiopathic constipation) * Stool softeners (moisten the stool and prevent dehydration) * Lubricants (greasing the stool allowing it to pass easier) * Saline (draws water into the colon for easier bowel movements) * Chloride channel activators (increase intestinal fluid and motility) * Serotonin agonists (helps the intestinal muscles work correctly when a slow moving digestive system is due to LOW levels of seratonin)
Can constipation be serious?
Sometimes constipation can lead to complications. These complications include hemorrhoids, caused by straining to have a bowel movement, or anal fissures (tears in the skin around the anus) caused when hard stool stretches the sphincter muscle. As a result, rectal bleeding may occur, appearing as bright red streaks on the surface of the stool. Treatment for hemorrhoids may include warm tub baths, ice packs, and application of a special cream to the affected area. Treatment for anal fissures may include stretching the sphincter muscle or surgically removing the tissue or skin in the affected area.
Sometimes straining causes a small amount of intestinal lining to push out from the anal opening. This condition, known as rectal prolapse, may lead to secretion of mucus from the anus. Usually eliminating the cause of the prolapse, such as straining or coughing, is the only treatment necessary. Severe or chronic prolapse requires surgery to strengthen and tighten the anal sphincter muscle or to repair the prolapsed lining.
Constipation may also cause hard stool to pack the intestine and rectum so tightly that the normal pushing action of the colon is not enough to expel the stool. This condition, called fecal impaction, occurs most often in children and older adults. An impaction can be softened with mineral oil taken by mouth and by an enema. After softening the impaction, the doctor may break up and remove part of the hardened stool by inserting one or two fingers into the anus.
* Constipation affects almost everyone at one time or another.
* Many people think they are constipated when, in fact, their bowel movements are regular.
* The most common causes of constipation are poor diet and lack of exercise.
* Other causes of constipation include medications, irritable bowel syndrome, abuse of laxatives, and specific diseases.
* A medical history and physical exam may be the only diagnostic tests needed before the doctor suggests treatment.
* In most cases, following these simple tips will help relieve symptoms and prevent recurrence of constipation:
1. Eat a well-balanced, high-fiber diet that includes beans, bran, whole grains, fresh fruits, and vegetables. 2. Drink plenty of liquids. 3. Exercise regularly. 4. Set aside time after breakfast or dinner for undisturbed visits to the toilet. 5. Do not ignore the urge to have a bowel movement. 6. Understand that normal bowel habits vary. 7. Whenever a significant or prolonged change in bowel habits occurs, check with a doctor.
* Most people with mild constipation do not need laxatives. However, a doctor may recommend laxatives for a limited time for people with chronic constipation.
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