home :: constipation

CONSTIPATION : Symptoms, Causes, Diagnosis, Treatment, Prevention, General Care and Home Remedies of Constipation

By constipation we understand a state in which bowels do not move regularly or are not emptied completely when they move and where the act of expulsion is attended with pain and difficulty. Constipation occurs when stools are difficult to pass.

Many patients are pre-occupied with constipation. Concern about the shake of the stool, it's consistency, its color, and the frequency of bowel movement is often reported to doctors. Such complaints are medically trivial. Only rarely (and then usually in older patients) does a change in bowel habits signal a serious problem. Weight loss and thin pencil-like stools suggest a tumor of the lower bowel. Abdominal pain and the swollen abdomen suggest a possible bowel obstruction. Some people are overly concerned with frequency because they have been taught that a healthy person has a bowel move­ment every day. This is not true. Most people pass stools anywhere from 3 times a day to 3 times a week. If your stools are soft and pass easily, you are not constipated.

Symptoms of Constipation

The symptoms of constipation may include, difficult or infrequent passing of mo­tions, incomplete evacuation, hard and dry stools, coated tongue, loss of appetite, nausea and foul breath, headache, constant fullness in the abdomen, acidity and heartburn. At times, constipation may be a mere symptom associ­ated with some other derangement and, there­ fore, should be treated not as a disease in itself but as a part of the whole. Constipation may occur with cramp­ing and pain in the rectum caused by straining to pass hard, dry stools. There may be some bloating and nausea. There may also be small amounts of bright red blood on the stools caused by slight tearing as the stools are pushed through the anus. The bleeding should stop when the constipation is relieved.

If a stool becomes lodged in the rectum (impacted), mucus and fluid may leak out around the stool, which sometimes leads to leakage of fecal material (fecal incontinence). You may experience this as constipation alternating with diarrhea.

Causes of Constipation

The most common causes of constipation are sedentary habits, wrong diet and faulty style of living, close mental application, grief, sorrow, home sickness and derangement of the stomach and liver. People who are ill and taking little food often become constipated. Other causes of constipation may include sedentary occupation, irregular living, abuse of laxative medicines, in­testinal obstructions and inadequate intake of roughage and fluids. Lack of fibre and inadequate water in the diet are common causes of constipation. Other causes include inactivity, delaying bowel move­ments, medications, pain caused by a tear (fissure) in the lining of the rectum, and laxative overuse. Irrita­te bowel syndrome may also cause constipation

Toilet training may contribute to constipation in young children. Chil­dren who are involved in play or other activities and ignore the urge to pass stools may become consti­pated. Children and adults who are reluctant to use toilets away from home may become constipated.

Diagnosis of Constipation

If you had a major change in bowel habits, expect a rectal examination and, usually, inspection of the lower bowel through a long (and sometimes cold) metal tube called a sigmoidoscope. An x-ray of the lower bowel (barium enema) is often needed. These procedures are generally safe and only mildly uncomfortable. If you have only a minor problem, you may receive advice similar to that under home treatment, without examination or procedures.

Prevention of Constipation

Eat plenty of high-fibre foods such as fruits, vegetables, and whole grains. You can also add fibre to your diet in the following ways (also see page 301):

Eat a bowl of bran cereal with 10 g of bran per serving.

Add 30 ml (2 tbsp) of wheat bran to cereal or soup.

Try a product, that contains a bulk-forming agent. Start with 15 ml (1 tbsp) or less and drink extra water to avoid bloating.

Avoid foods that are high in fat and sugar.

Drink 6 to 8 glasses (2 L) of water and other fluids every day. Drink extra fluids in the morning.

Exercise more.

Set aside relaxed times for having bowel movements. Urges usually occur sometime after meals. Estab­lishing a daily routine (after breakfast, for example) may help.

Go when you feel the urge, and encourage your children to do the same. Your bowels send signals when a stool needs to pass. If you ignore the signal, the urge will go away and the stool will eventually become dry and difficult to pass.

Home Treatment of Constipation

Eat plenty of vegetables, fruits and beans to add natural fibre to the diet.

Drink lots of fluids especially plain water or fruit juice.

A Regularity of time for bowel movement should be established and persisted even if unsuccessful in the beginning.

Physical exercise should be undertaken to stimulate the bowels. ­

Follow the diet outlined in Preven­tion to help relieve and prevent constipation.

If necessary, use a stool softener or a very mild laxative such as milk of magnesia. Do not use mineral oil or any other laxative for more than 2 weeks without consulting your doctor.

If an infant or child up to age 10 is having rectal pain because he or she is unable to have a bowel movement, put the child in a warm' bath with 56 g (2 oz) of baking soda in the tub. This may help relax the muscles that normally keep stool inside the rectum, allowing the child to pass the stool.

If your child is 6 months old or older and the warm bath does not work, use 1 or 2 glycerin supposi­tories to make the stool easier to pass. Use glycerin suppositories only once or twice. If constipation is not relieved or develops again, discuss the problem with your doctor.

Do not give laxatives or enema a child without talking to your child's doctor first

Home remedies of Constipation

Use spices like cumin, coriander, turmeric powder, fennel and asafetida as they make the food easy to digest.

Whole grain bread and cereals

Fried foods, beans, gas forming vegetables like cabbage, cauliflower and broccoli, nuts and dried fruits should be avoided.

Do not mix too many kinds of foods in one meal.

Drinking a glass of warm milk before going to bed helps in easy evacuation in the morning. In case of severe constipation, mix two teaspoons of castor oil in the milk.

Drink one liter of warm water and walk around for a few minutes immediately after waking up early in the morning.

Drinking lemon juice mixed with warm water two to three times a day eases constipation.

One or two teaspoons of aloe gel can be taken twice a day.

Pears are beneficial in the treatment of constipation. Patients suffering from chronic constipation should adopt an exclusive diet of this fruit or it's juice for a few days, but in ordinary cases, a medium-sized orange is also beneficial in the treatment of constipation.

Taking one or two oranges at bedtime and again on rising in the morning is an excellent way of stimulating the bowels. The general stimulating influence of orange juice excites peristaltic activity and helps prevent the accumulation of food residue in the colon are taken after dinner or with breakfast will have the desired effect.

Grapes have proved very beneficial in overcoming constipation. The combination of the properties of the cellulose, sugar, and organic acid in grapes make them a laxative food. Their field of action is not limited to clearing the bowels only. They also tone up the stomach and intestines and relieve the most chronic constipation. One should take at least 350 gm of this fruit daily to achieve the desired results. When fresh grapes are not available, raisins, soaked in water, can be used. Raisins should be soaked for twenty-four to forty-eight hours. This will make them swell to the original size of the grapes. They should be eaten early in the morning, along with the water in which they have been soaked.

CALL THE DOCTOR

If the patient is diabetic or pregnant.

If the change in bowel habit persists for longer than two weeks.

If the constipation is severe and is not re­sponding to home treatment.

If there is severe abdominal pain and no bowel movement for hours.

If the rectal bleeding is heavy (more than a few bright red streaks) or if the blood is reddish brown c black.

If rectal bleeding lasts longer than2 to 3 days after constipation h improved, or if bleeding occur more than once.

If you have sharp or severe abdominal pain.

If you have rectal pain that pain continues after you pass a stool keeps you from passing stools, at all.

If constipation and major change in bowel movements continue after 1 week of home treatment and there is no clear reason for such changes.

If you experience stool leakage (fecal incontinence).

If your stools have become consistently more narrow (may be no wider than a pencil).

If you are unable to have bowel movements without using laxatives.

If constipation is causing an infant or child to be in pain.