Constipation Management

Constipation is hard to define but there is an agreement that if someone is defecating less than three times per week is considered having constipation. Constipation  is considered one of the most common gastrointestinal problems that affects nearly everybody during his life. It affects all age groups, even infants. It ranges from simple straining to most dangerous diseases such as cancer. It is considered a warning sign of many serious complications such as bleeding, hemorrhoids, and colon cancer. There are many causes that may trigger constipation. Better understanding of the cause will give better judgment in choosing the suitable remedies.

Most of these causes include:

1. Intestinal obstruction due to cancer or structural defect. This causes a narrowing of the colon which block the passage of stool.

2. Slow intestinal movement due to colon dilatation or paralysis.

3. Insufficient fluids or fibers intake. If someone does not drink sufficient amount of fluids, his intestine will reabsorb fluids which will make stool very hard.

4. Physical inactivity will slow the movement of the intestine.

5. Using some medications. There are a huge amount of medications which may cause constipation. For example, over the counter drugs that may cause constipation are Antidiarrheals, NSAIDS, some antacids, Ca supplements, and Iron supplements. While example of prescription medications that cause constipation include: Furosemide, Verapamil, Dicyclomine, Levodopa, Chlorpromazine, Codeine, and Morphine.

6. Psychological problems.

7. Abnormalities in the nervous system.

There are many complications of constipation. For example, long term residence of stool in the colon will give bacteria an opportunity to decompose fiber and produce more gases which cause a condition called bloating. Another complication of constipation is death due to too much straining in heart failure patient which puts a lot of pressure on the heart.

The objectives of constipation management are to treat the cause if it known, to increase intestinal movements to help pushing the stool out, and alteration of nutrition methods. Patients are encouraged to increase fluid consumption, eat foods that have high fibers contents, and exercise regularly to enhance intestinal movements. After following these measures, most patient should recover without significant problems. However, if constipation still exists, there are many medications that might help such as laxatives.

References:
1. Di Palma JA. Expert commentary--new developments in the treatment of constipation. MedGenMed. Jan 1 2005;7(1):17.
2. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology. Apr 2006;130(5):1480-91.
3. http://emedicine.medscape.com/article/184704-overview#aw2aab6b2b5