Constipation

What is constipation?

Constipation is the presence of 2 or more of the following symptoms for at least 3 months:

• Straining more than 25% of the time.

• Hard stools more than 25% of the time.

• Incomplete evacuation more than 25% of the time.

• 2 or less bowel movements per week.

 Constipation can be causedlow fiber diet; medical conditions such as hypothyroidism, diabetes, immobility, and neurologic disease; and some medications such as opiates, anti-hypertensives, iron and calcium supplements.

How is constipation detected?

Several examinations are needed by your specialist to determine the cause of your constipation:

• Digital examination—usually the first step, since it is relatively simple and may provide clues to the underlying causes of the problem.

• Colonoscopy—involves inserting a scope to visualize the inside of the large intestine and determine to rule out masses that are causing obstruction.

• Barium enema—a radiographic study where dye is inserted through the anal area, creating an image of the large intestine on x-ray.

• Colonic transit study—involves ingestion of a radiopaque marker and undergoing an x-ray to see where the markers are. It may show areas of the large intestine that exhibit slowed movement.

How is constipation managed?

Treatment depends on the possible cause as determined from the examinations done. Surgery maybe recommended if there is an anatomical problem (mass obstructing the intestine, internal prolapsed of bowels, elongated segment of large intestine etc.) causing the constipation. Otherwise, non-surgical intervention may be the key to improving the patient’s symptoms. These include:

• Treating the underlying medical problem.

• Patient counseling.

• Increasing physical activity.

• Increasing fluid intake.

• Using bulk-forming agents, laxatives, enemas or suppositories.