Constipation
The term constipation can have a variety of meanings. Patients may use the term to indicate the lack of an urge to defecate, a decreased frequency of bowel movements, difficulty in passing hard scybalous stools, the feeling of an incomplete evacuation or prolonged straining at the toilet. In general, a condition is regarded as constipation when a person encounters fewer than three bowel movements per week while continuing a daily consumption of at least 19 g of fiber. In a few cases, the situation may take a more serious turn in the form of fecal impaction or fecolith obstruction. This is an acute condition and needs an urgent attention.
Standards of Treatment
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Treating constipation
- The daily dietary fiber intake should be increased and bulking agents like Ispaghula [psyllium], methyl cellulose, bran, karaya gum.
- Lactulose, sorbitol, and lactilol have minimum known side effects and are considered safe in pregnancy and in children and to the elderly patients.
- Senna, bisacodyl, sodium picosulphate, and magnesium salts should be used with caution. Low doses of polyethylene glycol and sodium phosphate could be used for intermittent lavage of the bowel.
- Drugs like Cisapride, Mosapride, Itiopride, and Docusates can also be used.
- Long-term use of Liquid paraffin could lead to reduced absorption of fat-soluble vitamins. Spontaneous leak of liquid paraffin from the rectum and soiling has been reported.
- For patients with intractable constipation behavioural techniques to modify pelvic floor and intestinal function are now being considered as the mainstay of therapy.
- Combination of bowel training, dietary management, and regular exercise are also helpful.
Causes of constipation
- Habitual or dietary
- Senile
- Drug induced
- Fecal impaction
- Functional disturbances
- Systemic disease
- Neurological conditions
- Lazy colon [Colonic inertia]
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Frequently Asked Questions
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