Constipation overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Constipation or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest. It may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. The term obstipation is used for severe constipation. Causes of constipation may be dietary, hormonal, anatomical, a side effect of medications (e.g. some painkillers), or an illness or disorder. Treatments consist of changes in dietary and exercise habits, the use of laxatives, and other medical interventions depending on the underlying cause.

Historical Perspective

The Egyptian Ebers papyrus, from 16th century BC, is the first book that presented a basic description for constipation. Ebers papyrus defined constipation as intoxication of body with hazardous agents from feces in bowels. In early 1900s, all-bran products first introduced to the prevent and treatment of auto-intoxicated patients due to constipation. In 1970s and 1980s, Denis Burkitt an English surgeon, claimed the hypothesis about dietary fibers followed by the definition of "The Commonest Western disease".

Pathophysiology

Constipation may be classified according to etiology into seven subtypes include lesions of gut, neurologic, metabolic, endocrine, psychiatric, drugs, and idiopathic.

Diagnosis

History and Symptoms

When the stool is hard, infrequent, and requires significant effort to pass, you have constipation. The passage of large, wide stools may tear the mucosal membrane of the anus, especially in children. This can cause bleeding and the possibility of an anal fissure.

Abdominal X Ray

X-rays of the abdomen, generally only performed on hospitalized patients or if bowel obstruction is suspected, may reveal impacted fecal matter in the colon, and confirm or rule out other causes of similar symptoms.

Ultrasound

Ultrasound may be used to detect tumors, fibroids, ovarian cysts or pregnancy

Treatment

Medical Therapy

In people without medical problems, the main intervention is to increase the intake of fluids (preferablywater) and dietary fiber. The latter may be achieved by consuming more vegetables and fruit and whole meal bread, and by adding linseeds to one's diet. The routine non-medical use of laxatives is to be discouraged as this may result in bowel action becoming dependent upon their use. Enemas can be used to provide a form of mechanical stimulation.

In alternative and traditional medicine, colonic irrigation, enemas, exercise, diet and herbs are used to treat constipation.

References

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