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'''Constipation''' is a condition of the ] where a person (or other animal) experiences difficulty in eliminating ]. Most doctors do not consider a person constipated unless they are experiencing difficulty passing hard, dry stool, and there has been a decrease in the number of ] from the amount that's normal for the person. A person can present with a decrease in bowel movements, along with signs of ] and still be considered constipated. This is usually due to the stool being impacted in the ] which impedes normal absorption of water, causing the waste material that does come out to be watery. '''Constipation''' is a condition of the ] where a person (or other animal) experiences hard ] that is difficult to ]; it may be extremely painful, and in extreme cases (''fecal impaction'') lead to symptoms of ]. Causes may be ]ary, ] and anatomical. Treatment is with a change in dietary habits, ]s, ]s, and rarely ].


==Signs and symptoms==
==Causes==
In common constipation, the stool is hard and difficult to void. Straining may cause ]s and ]s. The abdomen may become distended and diffusely tender and ]y, occasionally with enhanced ].
Some of the main causes of constipation include:
*Constriction, where part of the ] or ] is narrowed or blocked, not allowing feces to move past
*Paralysis, where ] is diminished or absent, so that feces are not moved along
*Excessive drying of feces, due to ], forming a hard bulk that cannot be eliminated
*Insufficient intake of ] or ], so that a suitable bolus is not formed
*] constipation, based on anxiety or unfamiliarity with surroundings. Two forms: ], and constipation-predominant ], characterized by a combination of constipation and abdominal discomfort and/or pain.


While many feel that one should have a bowel movement every day, it may be completely normal to defecate once a week as long as this does not cause any other symptoms. This depends on dietary habits, exercise and various other factors.
These causes may have a multiplicity of causes themselves.


Severe cases ("fecal impaction") may feature symptoms of bowel obstruction (], very tender abdomen) and "paradoxical diarrhea", where soft stool from the small intestine bypasses the impacted matter in the ].
People may take ]s to try to eliminate constipation. Earlier remedies included ]s.


==Diagnosis==
A common misconception holds that one should have a bowel movement every day. This is not really true. There is no "right" number of bowel movements. Each person's body finds its own normal number of bowel movements. It depends on the food one eats, how much one exercises, and other things.
The diagnosis is essentially made by the patient's description of the symptoms. Enquiring about dietary habits may reveal a low intake of dietary fiber, and symptoms suggestive of ] may be elicited.


During ], ''scybala'' (manually palpable lumps of stool) may be detected. ] gives an impression of the anal spincter tone, presence of tumors, presence of hemorrhoids and consistency of the stool.
At one time or another, almost everyone gets constipated. In most cases, it lasts for a short time and is not serious. When one understands what causes constipation, one can take steps to prevent it.


]s of the abdomen, generally only performed in hospitalized patients, may reveal impacted fecal matter in the colon, and confirm or rule out other causes of similar symptoms (such as bowel obstruction).
==Prevention==


==Causes==
Changing what one eats and drinks and how much one exercises will help relieve and prevent constipation. Here are other steps one may take.
The main causes of constipation include:
*Hardening of the feces
** Insufficient intake of ]
** ]
** Medication, e.g. ]s and those containing ], ], ]
*Paralysis or slowed transit, where ] is diminished or absent, so that feces are not moved along
** ] (slow-acting ])
** ]
** Medications, such as ], ]s (e.g. ]) and certain ]s
** Severe illness due to other causes
** Acute ] (a very rare inherited condition)
*Constriction, where part of the ] or ] is narrowed or blocked, not allowing feces to pass
** Strictures
** Diverticula
** ]s, either of the bowel or surrounding tissues
*] constipation, based on anxiety or unfamiliarity with surroundings.
** ]
** Constipation-predominant ], characterized by a combination of constipation and abdominal discomfort and/or pain


==Treatment==
===1. Eat more fiber===
In people without medical problems, the main intervention is the increase of fluids (preferably ]) and dietary fiber. The latter may be achieved by consuming more ]s and ], ] bread, or fiber supplements such as ] and ], which are widely available ].


]s may be necessary in people in whom dietary intervention is not effective or inappropriate. Stimulant laxatives are generally avoided, as they may worsen crampy sensations commonly experienced in constipation. In various conditions (such as the use of ]), combinations of softeners, stimulants and hydrating agents may be necessary.
Fiber helps form soft, bulky stool. It is found in many vegetables, fruits, and grains. Be sure to add fiber a little at a time, so your body gets used to it slowly. Limit foods that have little or no fiber such as ice cream, cheese, meat, snacks like chips and ], and processed foods such as instant mashed potatoes or already-prepared frozen dinners. The chart below lists some high-fiber foods.


]s and ]s are generally reserved for hospitalized patients in whom the constipation has proven to be severe, dangerous in other ways, or resistant to laxatives. ], ] and ] oil ] are used. Severe cases may require ] solutions introduced as enemas.
'''Fruits'''
*]s
*]es
*]
*]s
*]s


Constipation that resists all the above measures requires physical intervention. ''Manual disimpaction'' (the physical removal of impacted stool) is done under ] or a ] - this avoids pain and loosens the anal sphincter.
'''Vegetables'''
*], raw
*], raw
*], raw
*], raw
*], raw
*], raw
*], cooked
*], raw


==In art ==
'''Breads, Cereals, and Beans'''
] wrote and sang "Constipation Blues" while suffering a serious bout. The ] recorded "The Strain" on the same subject.
* ]s of all kinds, cooked:
** ]s
** ]s
** ]
** Many others
* ] foods
** Whole-grain ], cold (All-Bran, Total, Bran Flakes)
** Whole-grain ], hot (], ])
** Whole-wheat ]
** ]

'''Bran'''

:Wheat ], otherwise known as ''miller's bran'', is very effective. Start with one teaspoon twice a day and gradually increase the amount until the stools float. This usually requires about two tablespoons of bran a day. Millers' bran may be mixed with cereal or yogurt and/or fruit. It can also be mixed in a glass of milk and chugged before it settles. (However, ] individuals should avoid milk. Yogurt is often well tolerated due to its relatively low lactose content.)

:Don't chew on the bran, it will just begin to act like a piece of chewing gum. Be sure to keep your liquid intake at a moderately high level if you are using bran.

:Miller's bran is as effective as any commercial fiber product, and is much cheaper. If the local grocery store doesn't carry it, try a health food store. Organic bran should be kept in the freezer to maintain quality and eliminate the possibility of insect infestation.

===2. Consume liquid===

Liquid helps keep the stool soft and easy to pass, therefore making it important to drink suitable amounts of fluid. When the body begins to get ], it draws fluid from wherever it can; the bowel is one of the first sources it taps. As a result, the stool dries out and hardens, becoming more difficult to pass. Try to drink at least a quart each day, and more if you are exercising or in a hot climate. If your urine is dark, you may not be getting enough liquid.

One should attempt to abstain from ] or ], or at least moderate one's intake, as caffeine and alcohol act as diuretics--they cause a net outflow of water from the body and dry out the digestive system.

===3. Engage in regular exercise===

Regular exercise helps your ] stay active and healthy. A short, brisk walk every day has been shown to have beneficial effects.

===4. Allow yourself enough time to have a bowel movement===

Sometimes we feel so hurried that we don't pay attention to our body's needs. Make sure you don't ignore the urge to have a ].

===5. Only use laxatives on doctors advice===

]s are medicines that will cause bowel movement. Most people who are mildly constipated do not need laxatives. However, if previous methods have little or no effect, your doctor may recommend laxatives for a limited time.

Your doctor will tell you if you need a laxative and what type is most effective for your circumstance. Laxatives come in many forms: liquid, chewing gum, pills, and powder that you mix with water, for example.

===6. Consult your doctor on any current medications you are taking===

Some medicines can cause constipation. They include ] pills, ], some ]s, iron pills, ] (water pills), and certain ]. If you take medicine for other reasons, ask your doctor if constipation is a side-effect.

==Points to Remember==

* Constipation affects almost everyone at one time or another.
* Many people think they're constipated when really they aren't.
* In most cases, following these simple tips will help prevent constipation:
** Eating a variety of foods, especially ]s, ], ]s, and fresh fruits and vegetables.
** Drinking plenty of liquids.
** Exercising regularly.
** Not ignoring the urge to have a bowel movement.
** Understanding that normal bowel habits are different for everyone.
** If one's bowel habits change, check with one's doctor.
* Most people with mild constipation do not need ]s. However, doctors may recommend laxatives for a limited time for people with chronic constipation.
* Medicines that you take for another problem might cause constipation.
* Avoid milk, use instead soya, rice or oat milk
* Vegetarians have less constipation

== Constipation in Art ==
] wrote and sang "]" while suffering a serious bout. He had the following to say about the condition:

:''"I never before had been constipated in my life and it didn't dawn on me until I was five hours on the stool in the hospital that nothin' was gonna happen. I had doctors give me enemas and still nothin' happened. I had tears in my eyes, and I noticed this beautiful roll of toilet paper and I took out a pencil and, at the bottom of the toilet paper, I started writin' the song backwards, from the bottom up. The more I rolled out the toilet paper, the more I got into the song. I wrote exactly as I felt, each movement, each sound, each pain..."''

The ] recorded "The Strain" on the same subject.


==External links== ==External links==
* *
* *
{{Gastroenterology}}


{{Gastroenterology}}


] ]

Revision as of 21:48, 10 August 2005

Constipation is a condition of the digestive system where a person (or other animal) experiences hard feces that is difficult to eliminate; it may be extremely painful, and in extreme cases (fecal impaction) lead to symptoms of bowel obstruction. Causes may be dietary, hormonal and anatomical. Treatment is with a change in dietary habits, laxatives, enemas, and rarely surgery.

Signs and symptoms

In common constipation, the stool is hard and difficult to void. Straining may cause hemorrhoids and anal fissures. The abdomen may become distended and diffusely tender and crampy, occasionally with enhanced bowel sounds.

While many feel that one should have a bowel movement every day, it may be completely normal to defecate once a week as long as this does not cause any other symptoms. This depends on dietary habits, exercise and various other factors.

Severe cases ("fecal impaction") may feature symptoms of bowel obstruction (vomiting, very tender abdomen) and "paradoxical diarrhea", where soft stool from the small intestine bypasses the impacted matter in the colon.

Diagnosis

The diagnosis is essentially made by the patient's description of the symptoms. Enquiring about dietary habits may reveal a low intake of dietary fiber, and symptoms suggestive of hypothyroidism may be elicited.

During physical examination, scybala (manually palpable lumps of stool) may be detected. Rectal examination gives an impression of the anal spincter tone, presence of tumors, presence of hemorrhoids and consistency of the stool.

X-rays of the abdomen, generally only performed in hospitalized patients, may reveal impacted fecal matter in the colon, and confirm or rule out other causes of similar symptoms (such as bowel obstruction).

Causes

The main causes of constipation include:

Treatment

In people without medical problems, the main intervention is the increase of fluids (preferably water) and dietary fiber. The latter may be achieved by consuming more vegetables and fruit, whole meal bread, or fiber supplements such as psyllium and senna, which are widely available over-the-counter.

Laxatives may be necessary in people in whom dietary intervention is not effective or inappropriate. Stimulant laxatives are generally avoided, as they may worsen crampy sensations commonly experienced in constipation. In various conditions (such as the use of morphine), combinations of softeners, stimulants and hydrating agents may be necessary.

Enemas and Clysters are generally reserved for hospitalized patients in whom the constipation has proven to be severe, dangerous in other ways, or resistant to laxatives. Sorbitol, glycerin and arachis oil suppositories are used. Severe cases may require phosphate solutions introduced as enemas.

Constipation that resists all the above measures requires physical intervention. Manual disimpaction (the physical removal of impacted stool) is done under sedation or a general anesthetic - this avoids pain and loosens the anal sphincter.

In art

Screamin' Jay Hawkins wrote and sang "Constipation Blues" while suffering a serious bout. The Bonzo Dog Band recorded "The Strain" on the same subject.

External links

Diseases of the human digestive system
Upper GI tract
Esophagus
Stomach
Lower GI tract
Enteropathy
Small intestine
(Duodenum/Jejunum/Ileum)
Large intestine
(Appendix/Colon)
Large and/or small
Rectum
Anal canal
GI bleeding
Accessory
Liver
Gallbladder
Bile duct/
Other biliary tree
Pancreatic
Other
Hernia
Peritoneal
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