Constipation is not a disorder but a symptom of a
health problem, like a fever or a cough. There are two
general categories of constipation, idiopathic constipation,
and functional constipation.
Idiopathic means
‘‘of unknown origin.‘‘ Idiopathic constipation is constipation
that arises from an unknown cause. It may be
related to hormonal abnormalities, nerve, or muscle
damage, or something physicians do not yet understand.
Functional constipation occurs when the bowel
is healthy, but constipation develops because of diet,
lifestyle habits, psychological disorders, or abnormalities
in the rectum or anus.
Symptoms of constipation may include:
-bowel movements that occur less frequently than
normal
-straining to eliminate stools
-small, hard, dry, painful, stools
-a feeling of pressure in the rectum
-a feeling of abdominal fullness or bloating
-leakage of small amounts of liquid stool. This occurs
when there is a blockage or impaction and the colon
is abnormally stretched.
Constipation has many causes. The most common
cause in the United States is poor diet. A diet that
increases the chances of developing constipation is one
that is high in meat, dairy products, and refined sugar
and low in dietary fiber.
Other causes include:
little physical exercise. This is a particular problem in
the elderly.
-medications, especially narcotic drugs used to treat
pain, but also antidepressants, antacids containing
aluminum, iron supplements, tranquilizers, antispasmodics
and anticonvulsants
-pregnancy
-change in routine, for example traveling
-irritable bowel syndrome
-not drinking enough fluids; dehydration
-laxative abuse (People become dependant on laxatives
and need higher and higher doses to avoid
constipation.)
-poor bowel habits, such as ignoring the urge to have
a bowel movement or refusal to use public toilets
-tumor or other mechanical blockage
-eating disorders such as anorexia nervosa or bulimia
nervosa where there is low calorie intake and (for
bulimia) vomiting
-stroke or other conditions causing nerve damage
such as multiple sclerosis, Parkinson’s disease, and
spinal cord injuries
-disorders that affect the muscles that cause material
to move through the colon
-hormonal disorders such as diabetes, hypercalcemia
(too much calcium), and hypothyroidism (too little
thyroid hormone)
abnormalities of the rectum or anus
iron supplements
Diagnosis begins with a medical history so that
the physician can determine the normal frequency of bowel movements and the length of time the individual
has been constipated.
The clinical definition of constipation
requires that it be present for at least 12
weeks out of the past 12 months. The 12 weeks do
not have to be consecutive.
A physical examination including a rectal exam
and blood tests. Other tests, such as a thyroid hormone
test, may be necessary to rule out other disorders.
When symptoms are severe or do not improve
with treatment, the physician may order specialized
tests to determine how long material stays in the colon,
evaluate the condition of the muscles of the rectum
and anus, and look for evidence of cancer or other
disease.
These tests may include a sigmoidoscopy,
barium enema x ray, colorectal transit study, and
anorectal function tests.
