Constipation

The term constipation refers to having less than three bowel movements per week. Even though acute constipation is very common, some people suffer from chronic constipation, which can make it difficult to go about their daily lives. Chronic constipation is infrequent bowel movements or difficult passage of stools over several weeks.

Constipation is an uncomfortable condition. However, it is considered more of a symptom than a disease. The inadequate fiber content in the diet, insufficient fluid intake, an inactive lifestyle, stress, or underlying medical conditions or medicines may cause constipation.

The following are the most common symptoms of constipation. However, everyone may experience symptoms differently.
Symptoms may include:

• bleeding from your rectum
• blood in your stool
• constant pain in your abdomen
• inability to pass gas
• vomiting
• fever
• lower back pain
• Losing weight without trying

Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract or cannot be crossed out effectively from the rectum. It causes the stool to become hard and dry. Constipation has many possible causes.
Some of the common causes of constipation include:

Poor dietary habits

Poor dietary habits that can negatively affect bowel movements often cause constipation. When you don’t eat enough fiber-rich foods, such as fruit and vegetables, it can affect your digestion and passing of stools. It is because fiber works as a natural laxative, which holds water in the stool, increases its bulk, and makes it easy to pass.

Insufficient fluid intake

A lack of sufficient water in the body can also cause constipation. In dehydration, your body tries to conserve water by removing water from your stool. It causes the stools to contain less water, which makes them more difficult to pass through the rectum.

Use of certain medicines

Certain medicines, including iron salts, opioids, sedatives, over-the-counter antacids, and some blood pressure-lowering drugs may cause constipation.
Please consult your doctor if you are taking any of these medications. The list of certain medicines that can cause constipation include:

• Paracetamol – If you take more than seven tablets a week
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
• Iron and calcium supplements
• Aluminum-containing antacids
• Anticholinergic agents or medicines that oppose the actions of the neurotransmitter acetylcholine. These include drugs for Parkinson’s disease, depression, delusions, hallucinations, and muscular spasms.
• Anticonvulsants (drugs used to treat seizures) such as carbamazepine, phenobarbital, and phenytoin.
• Cancer drugs such as vinblastine, vincristine, vindesine, and vinorelbine
• Calcium-channel blockers such as verapamil
• Water pills (diuretics) such as furosemide

Underlying medical conditions

There are a variety of health conditions that can cause constipation, including:

• Irritable bowel syndrome
• Tumor of the adrenal gland
• Endocrine disorders like Diabetes, Hypothyroidism, Hyperparathyroidism, Hypercalcemia, Hypokalemia, insufficient production of pituitary hormones
• Bowel obstruction
• Narrowing of colon or bowel stricture
• Diseases like amyloidosis, lupus erythematosus, and scleroderma
• Colorectal cancer
• Structural defects in the digestive tract like fistula, imperforate anus, malrotation, etc.
• Rectal cancer

Overuse of laxatives

Laxatives are a common treatment for constipation. Most people take laxatives as a treatment for constipation without consulting a doctor. Laxative use, however, is not recommended. If you use laxatives often, you lose the ability to pass stool without them. Consequently, consumers are more likely to use laxatives and are at a greater risk of constipation in the long run.

The diagnosis of constipation depends largely on the patient’s history, Physical examination and Blood Tests.

Physical examination

This may include:

• Abdominal examination in which the abdomen may be examined for distension. Swollen or enlarged bowels may point to constipation.

• Rectal examinations may be done to check for scars, hemorrhoids, fistulas, or fissures around the perineum, the area between the anus and scrotum (in males), or the vulva (in females).

Blood Tests

• Complete Blood count (CBC)
• Thyroid Profile Test
• Total Calcium
• Blood Glucose Fasting
• Stool Examination
• Radiology tests such as Abdominal X-ray, CT scan, or MRI
• Colonoscopy or Endoscopy

Constipation is treated mainly with lifestyle changes and medications to soften the stools or stimulate their passage through the colon. Mild constipation improves with lifestyle modifications. If the constipation is severe, medication may be necessary.

Lifestyle changes

• Stay Hydrated
• Eat more high-fiber foods
• Get regular physical activity
• Get enough sleep
• Avoid alcoholic drinks as much as possible.
• Lessen or eliminate the consumption of oil and sugar-rich food

Medicines

In general, laxatives prevent and relieve constipation and promote bowel movements. The medicines are available over the counter (OTC) and come in capsules, suppositories, enemas, pills, gums, and liquids. Most laxatives are advised to be used only for a short period. Use medicines only if recommended by your doctor.