Constipation

Constipation is diagnosed and treated by the GI Division of Premier Medical Group.

What is constipation?

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Constipation is a condition of the digestive system and is defined as having a bowel movement fewer than three times per week. The normal time between bowel movements varies with people. For some people, normal is having 3 movements a day, and for others, normal is 2 to 3 times a week. Nevertheless, constipation is defined as “A condition in which bowel movements are infrequent or incomplete”. When a person is constipated, the stools are typically hard, small in size, dry and difficult to eliminate. With constipation you can feel bloated and your bowel movement can be painful when you strain to eliminate. In some cases, severe constipation causes bowel obstruction.

 

It’s important to remember that constipation is a symptom, and not a disease. Most people experience constipation at some point in their life. Your doctor may consider you constipated if you have two of the following symptoms.

  • Your stools are small and hard more than 25% of the time.
  • You have two or fewer bowel movements in a week.
  • You need to strain during a bowel movement more than 25% of the time.
  • Your bowel movements are not complete; you do not get compete evacuation.

Severe constipation symptoms may include all of these, as well as lower abdominal pain.

What are the causes of constipation?

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The most common cause of constipation is inadequate water intake. Food moves through the colon and as it does, the colon absorbs water from the food while it forms waste products. Muscle contractions in the colon work to push the stool closer to the rectum and by the time the stool is there, it should be in solid form. If the colon absorbs too much of the water or if the muscle contractions are sluggish or slow-moving, the stool can become dry and hard resulting in constipation.

Besides poor water intake, other causes of constipation can include:

  • Eating disorders
  • An overabundance of certain foods
  • Irritable bowel syndrome (IBS)
  • Pregnancy
  • Colon cancer
  • Insufficient water intake (less than 64 oz daily)
  • Poor fiber in the diet.
  • Some medications (especially narcotic pain medicines) and iron pills
  • Interruption of routine diet
  • Traveling; disruption of regular routine
  • Stress
  • Inadequate activity or exercise or immobility
  • Any medications which contain calcium or aluminum
  • Ignoring the urge to have a bowel movement (perhaps due to painful hemorrhoids or anal fissures)
  • Dehydration
  • Abuse of laxatives and/or stool softeners
  • Hypothyroidism
  • Neurological conditions such as Parkinson’s disease, pelvic floor dysfunction or multiple sclerosis
  • Lack of physical activity, (particularly in the elderly)

Other problems with the colon and rectum, such as intestinal obstruction and scar tissue (adhesions) caused by diverticular disease, inflammatory diseases and previous abdominal surgeries can also affect bowel motility resulting in constipation, often severe constipation. Other complications which can cause severe constipation are colorectal strictures, colon cancer, pancreatitis symptoms, diverticulosis, tumors, and congenital or otherwise neurological diseases such as Hirschsprung’s disease, which can squeeze, or constrict the intestine and rectum.

What are the symptoms of constipation?

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The most common symptoms of constipation are infrequent bowel movements and/or difficulty having a bowel movement. A swollen abdomen, abdominal pain, and vomiting can also be symptoms. Bowel movements will generally be dry, hard ribbon-like, beaded and other unusual shapes.

How is constipation diagnosed?

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Most people do not req