diease

Constipation


OVERVIEW OF Constipation :

Constipation occurs when bowel movements become less frequent and there is presence of difficulty in passing the stool. It takes place due to changes in the diet habit and inadequate intake of fiber.


CAUSES :

Older age:

Older people tends to be less active and have a slower rate of metabolism and shows less muscle contraction strength along their digestive tract when comparing to younger adults.

Women: Pregnant women after childbirth or during pregnancy tends to shows the presence of constipation. Changes in woman’s hormone make them more prone to constipation. The baby which is resent inside the mother womb crushes the small intestine of the mother and making the digestive system improper and more prone to constipation.

Inadequate fiber intake results in constipation. High fiber food keep food moving through the digestive system.

Taking certain medication for example taking medication for cough which contains codeine might result in constipation.

Dehydration: Not taking enough amount of water might result in constipation as inadequate consumption of water might result in improper digestion.

Inadequate physical activity.

Stress

Eating large amount of milk or cheesy diet

Resisting the urge to have a bowel movement

Certain foods such as

 Result of constipation:

Hemorrhoids:

Swollen or inflamed veins in the rectum results in the condition called as Hemorrhoids.

Anal fissures:

Tears in the lining of the anus from the hardened stool trying to pass through might result in the condition called as Anal fissures.

Diverticulitis:

Diverticulitis is a condition which result in the infection in the pouchthat sometimes form of the colon wall from stool that has become trapped and infected.

Faecal Impaction:

A pile up of too much of stool or poop in the rectum and anus which is termed as faecal impaction.

Stress urinary incontinence:

Damage to the pelvic floor muscles from straining to move your bowels. These muscles help to control the bladder. Too much straining for longer period of time might cause urine to leak from the bladder.

Blockages in the colon or rectum

Colonal cancer

Abusive of laxatives

Irritable bowel syndrme


PATHOPHYSIOLOGY :

Constipation happens when the colon absorbs more amount of water from the stool which result in dryness of the stool and make it harder in consistency and difficult to push out it from the body.

A food normally mover through the digestive tract, nutrients are absorbed. The nutrients are absorbed from the small intestine and it is taken throughout the body through the blood stream. The waste products that remain in the small intestine moves towards the large intestine which is also called as the colon.

The colon absorbs water from this waste, which creates a solid matter called stool. If you have constipation, food may move too slowly through the digestive tract. This gives the colon more time – too much time – to absorb water from the waste. The stool becomes dry, hard, and difficult to push out.


COMMON CLINICAL SIGNS AND SYMPTOMS :

Pain in the abdomen

Feeling to Pee

Bowel movements fewer than three times a week

Feeling bloated or uncomfortable

Feeling sluggish

Feeling difficulty in passing the stool

Tiredness

 

 


DIAGNOSTIC :

Medical history:

The physician might ask for a description of the constipation including duration of the symptoms, frequency of bowel movements and other information to help determine the causes of constipation.

Physical Examination:

This might include a digital rectal examination(DRE) in which the physician might inserts a lubricated finger into the rectum to evaluate the tone of the muscles that closes off the anus. This examination alos helps to detect the tenderness, obstruction, blood , amount and caliber of stool and if any enlargement of the rectum is present.

Blood test:

The blood test might reveal certain conditions such as Hypothyroidism.

Abdominal X ray:

The x ray might scans any abnormalities in the colon.

Lower GI (gastrointestinal ) series also called as Barium Enema:

 A lower GI series is a procedure that examines the rectum, the large intestine, and the lower part of the small intestine. A fluid called Barium( a metallic chemical, chalky ,liquid used to coat the inside of organs so that they will show up on the x ray) is given into the rectum as an enema. An x ray of the abdomen shows strictures (narrowed areas), obstruction (blockages) and other problems.

Colonoscopy:

It is a procedure that allows the physician to view the entire length of the large intestine and can often help to identify the abnormal growths, inflamed tissues, ulcers and bleeding. It involves inserting a colonoscope a long flexible,lighted tube, in through the rectum up into the colon.

Sigmoidoscopy:

It is a diagnostic procedure that allows the doctor to examine the inside of a portion of the large intestine and also it aids in identifying the causes of diarrhoea, abdominal pain, constipation, abnormal growths and bleeding. A short flexible,lighted tube called sigmoidoscope is inserted into the rectum and it reaches the intestine .

Colorectal transit study:

This test shows how well the food moves through the colon. Markers are ingested which are visible on x ray. The patient follows a high fiber diet during the course of the test and the movemet of the markers through the colon is monitores with abdominal x rays taken several times three to seven days after the capsule is swallowed.

Anorectal function test:

This test diagnose the constipation caused by an abnormal functioning o the anus or rectum.

Anorectal manometry:

A narrow, flexible tube into your anus and rectum and then inflates a small balloon at the tip of the tube. The device is then pulled back through the sphincter muscle. This procedure allows your doctor to measure the coordination of the muscles you use to move your bowels.

 


TREATMENT AND PROGNOSIS :

Opioid pain relief drugs: These include codeine (present with acetaminophen in Tylenol #3), oxycodone (OxyContin), and hydromorphone (Dilaudid).

Tricyclic antidepressants: These include amitriptyline (Elavil) and imipramine (Tofranil).

Certain anticonvulsants: Examples include phenytoin (Dilantin) and carbamazepine (Tegretol).

Calcium channel blockers: These lower blood pressure, and certain types lower heart rate. They include diltiazem (Cardizem) and nifedipine (Procardia).

Antacids that contain aluminum: These include Amphojel and Basaljel.

Antacids that contain calcium: One example is Tums.

Diuretics: These remove excess fluid from the body. They include hydrochlorothiazide (Hydrodiuril) and furosemide (Lasix).

Iron supplements: Doctors prescribe these to treat iron deficiency anaemia.


PROGNOSIS :

The prognosis is good whem adequate measurements are taken. If systemic involvement is present then that should be taken into an account.


PREVENTION :

  • Include plenty of high-fiber foods in your diet, including beans, vegetables, fruits, whole grain cereals and bran.
  • Eat fewer foods with low amounts of fiber such as processed foods, and dairy and meat products.
  • Drink plenty of fluids.
  • Stay as active as possible and try to get regular exercise.
  • Try to manage stress.
  • Don't ignore the urge to pass stool.
  • Try to create a regular schedule for bowel movements, especially after a meal.
  • Make sure children who begin to eat solid foods get plenty of fiber in their diet.


REFERENCE :

https://www.medicalnewstoday.com/articles/150322#causes

https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/treatment

https://www.webmd.com/digestive-disorders/digestive-diseases-constipation

https://www.healthline.com/health/constipation

https://my.clevelandclinic.org/health/diseases/4059-constipation