Constipation

Overview of Constipation

Constipation is a less frequent bowel movement that becomes difficult to pass. The changes in dietary or lifestyle choices can result in constipation. The other causes include the less intake of fiber that causes severe pain, bloody stool, and difficulty in stool passage that can take more than three weeks.

Constipation generally refers to fewer than three bowel movements a week. Chronic constipation can interfere with daily routine tasks. The treatment of constipation depends on the causing factor. Sometimes, causing factors cannot be diagnosed.

Constipation Meaning in Urdu

قبض کی علامات لاحق ہونے کی صورت میں ہفتے میں صرف تین بار پاخانے کی حاجت ہوتی ہے، جب کہ پاخانہ کرتے وقت تکلیف کا بھی سامنا کرنا پڑتا ہے۔ قبض کی علامت اگر شدت اختیار کر جائے تو پیٹ درد، قے، بخار، اور وزن میں کمی کا سامنا کرنا پڑ سکتا ہے۔ قبض سے چھٹکارا پانے کے لیے ایسی عادات کو ترک کرنے کا مشورہ دیا جاتا ہے جو اس کی وجہ بنتی ہیں۔ جب کہ اس سے نجات حاصل کرنے کے لیے ورزش، پانی اور فائبر سمیت دالوں اور کافی کو استعمال کیا جاتا ہے۔

Signs and Symptoms of Constipation

Some dietary changes can cause constipation for a few days, but chronic constipation can show the following signs and symptoms:

  • Hard or lumpy stools
  • Passing than three stools a week
  • Feeling like a blockage in the rectum that does not allow bowel movement
  • Use hands for bowel movement or fingers to remove stool
  • Having less than 3 stools a week

Chronic constipation involves experiencing these symptoms repeatedly.

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Causes of Constipation

When the stool moves gradually through the digestive tract and is difficult to remove from the rectum, it makes the stool dry and hard that is hard to pass. The following causes can contribute to chronic constipation:

Nerves Problems around the Rectum and Colon

The muscles of the colon and rectum contract when neurological problems affect the nerves. It makes it difficult to pass the stool. These neurological problems can move the stool through the intestines. The following neurological problems can affect the nerves:

  • Stroke
  • Multiple sclerosis
  • Damage to the nerves that control body functions
  • Spinal cord injury
  • Parkinson’s disease

Blockage in Colon and Rectum

A person may have a blockage in the colon and rectum that leads to constipation. The following causes can contribute:

  • Colon cancer
  • Rectal cancer
  • Anal fissures (Tiny tears in the skin around the anus)
  • Bowel obstruction (blockage in intestines)
  • Colon narrowing
  • Rectocele (Rectum bulge through vagina back wall)

Problem with Muscles That Contribute In Stool Elimination

When there is a problem in muscles that are involved in stool removal can cause chronic constipation. Given below factors can contribute:

  • Weakened pelvic muscles
  • Inability to relax pelvic muscles to remove stool
  • Dyssynergia is a condition in which pelvic muscles do not involve in relaxation and contribution properly

Hormonal Imbalance Due to a Condition

The imbalance of hormones can lead to chronic constipation. It occurs because hormones are responsible for balancing fluids in the body. Some conditions that lead to hormonal balance are:

  • Underactive thyroid
  • Pregnancy
  • Diabetes
  • Overactive parathyroid gland
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Risk Factors of Constipation

The following risk factors can lead to chronic constipation:

  • Being dehydrated
  • Being an older adult
  • Lack of physical activity
  • Mentally affected, like depression or eating disorders
  • Low fiber intake
  • Gender, like women
  • Intake of certain medications likes to lower blood pressure, antidepressants, etc.

Complications of Constipation

Chronic constipation can lead to the following complications:

  • Anal Fissures: Having a dried and dry stool may lead to a torn skin in your anus.
  • Rectal Prolapse: Hard bowel movement leads to straining that results in stretching and protruding of a small amount of the rectum.
  • Hemorrhoids: Bowel movement difficulty leads to straining that may result in veins swelling around the anus.
  • Fecal Impaction: A person with chronic constipation may experience dry and hardened stool blockage that can be stuck in the intestines.

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Prevention

The following steps can help you prevent chronic constipation:

  • Stay hydrated
  • Be more physically active or exercise regularly
  • Manage stress
  • Try to remove the stool when you feel it
  • Set a schedule to remove the stool
  • Add more fiber to the diet of both adults and children
  • Include high fiber foods, such as whole-grain cereals and bran, beans, veggies, etc.
  • Avoid certain foods that contain low fiber, including dairy products, meat, etc
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Diagnosis

A general physical exam and a digital rectal exam are performed to check the condition. But your doctor may order you the following tests:

X-ray: It helps to learn if the intestines are blocked or the location of the stool throughout the colon. Your doctor can treat the condition well while knowing about the position.
Blood test: For systemic conditions, a blood test is performed. It helps to learn the level of calcium and other essential nutrients.
Colonoscopy: A flexible and camera-equipped tube is used to diagnose the entire colon.
Sigmoidoscopy: A lighted and flexible tube is inserted into the anus to check the rectum and colon lower portion.
Anorectal manometry: A narrow and flexible tube is inserted in the anus, rectum and inflates a small balloon at the tube tip. This device helps to measure the muscle movement of the bowel.
Colonic transit study: A person needs to swallow a capsule in this procedure. It contains a radiopaque marker that helps to record the colon (evaluates how foods move through the colon) and is visible on X-rays.
Balloon expulsion test: This procedure is often performed along with anorectal manometry to measure the time amount that it takes to push the balloon in your rectum to place.
Defecography: Barium-made soft paste is inserted into your rectum. A person passes the paste along with the stool that will show up in X-rays that is the problem with the muscle function or muscle coordination.
MRI defecography: In this method, a doctor inserts a contrasting gel into the rectum. The gel is also passed through the stool that can be visualized and reveal the function of defecation muscle through an MRI scanner. This method also reveals the causing factor of constipation.

Treatment of Constipation | When to Consult a Doctor

The common treatment of chronic constipation includes lifestyle and dietary changes. These changes can help to boost the speed of bowel movement through the intestines. For severe cases, your doctor may ask for surgery or medicines.

The following treatments for constipation may help:

Changes in Diet and Lifestyle Choices

The treatment may begin with the following steps:

Regular Exercise: Physical activity and exercise can boost the muscles activity in the intestine. Make sure that you perform exercise or engage in physical activities.
Always Remove Stool When You Feel the Urge:  You should stay in the toilet if you feel the urge to have a bowel movement. It may take a few more minutes but it will prevent constipation.
Increase Fiber Intake: More fiber in your diet leads to improved stool passage. Try to add more veggies and fruits or whole grains. If you have not been eating fiber, start with a small amount. Because a sudden switch to more fiber may lead to gas and bloating.

Over-the-Counter Medicines

Laxatives are OTC medicines that help to boost bowel movement. These OTC include:

Stool softener: Some medicine moist the stools by drawing water from your intestines.
Fiber supplements: Your doctor may recommend fiber supplements to add bulk into the stool.
Lubricants: Some lubricants help to move the stool through the colon, such as mineral oil, etc.
Your doctor may also recommend other OTC as per your constipation cause, such as enemas, osmosis, stimulants, etc.

Prescription Medications

Some OTC may not work for chronic constipation. But your doctor may recommend the prescription medicines to soften the stool or to keep the bowel moving.

Surgery

 

Your doctor may recommend surgery if there is no improvement in bowel movement following other treatment. Surgical removal of the colon part may be an option for your chronic constipation.

Doctors to treat Constipation

Last updated on Monday 21/11/2022

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Dr. Bushra Ali

Hepatologist, Gastroenterologist | MBBS,MCPS,FCPS

National Hospital & Medical CenterRs 3000

Fatima Memorial HospitalRs 3000

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Today’s Slots

98%

Satisfaction Rate

22

Years

It was a good visit. do not waited much and satisfied

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Prof. Dr. Khalid Mahmud Khan

Internal Medicine Specialist, General Physician, Gastroenterologist | MBBS, FCPS, MRCP

Doctors HospitalRs 3500

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97%

Satisfaction Rate

25

Years

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Dr. Salman Javed

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Hameed Latif HospitalRs 3000

Omar Hospital & Cardiac CentreRs 3000

Health AvenueRs 3000

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99%

Satisfaction Rate

22

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Great experience with the doctor. Fully satisfied

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