Constipation is a condition in which elimination
of faeces (or "stools") from the bowels via the anus,
also described as "evacuation of the bowels", is
difficult and may be painful.
This is a common condition, especially in the elderly.
Note that as the frequency of bowel movements (evacuations) varies
considerably from person to person, it is not possible to define "normal"
with sufficient precision to describe constipation
simply in terms of the frequency of elimination of faeces. One
possible explanation for the frequency of, and variation in frequency
of, bowel movements is its dependence, in part, on diet - in
addition to, and affecting, general digestive well-being.
Key aspects of constipation are:
Possible causes of constipation:
- Dietary causes may
include insufficient intake of dietary fibre over a prolonged period
of time.
- Insufficient intake of water / fluids
may exacerbate the problem.
- Side-effects of medication
- note that the possible known side effects of prescribed medications
are usually listed on the leaflet that comes with it. If medication
is a suspected cause of constipation a change of
medication may be possible.
- Some medical conditions
can include, cause, or exacerbate constipation (among
other symptoms).
- Pregnancy - not in
all cases, but some source suggest that around 20% of pregnancies
can involve some level of constipation due to hormonal changes.
- State of mind / Emotion / Stress
is sometimes said to lead or contribute to constipation but such psychological
issues and their effects are extremely difficult to assess objectively.
If this is thought to be a contributory factor any number of relaxation
techniques may be helpful.
- Idiopathic, i.e. "cause
unknown" ... so not strictly a "cause" but often included
in such lists and useful to cover all other cases.
Symptoms & Effects of constipation:
- Faeces are hard and small
- Difficulty and/or pain
passing faeces
- Variation (change) in frequency of
bowel evacuation from that which is "normal"
for the individual. Some texts describe constipation in terms
od reduced frequency of bowel movements, others mention only a change
in freqency - together with discomfort when passing stools.
Medical treatment(s) for constipation may involve,
in cases of recurrent or chronic
constipation:
- increasing intake of dietary fibre (roughage)
- use of laxatives
- enemas.
When the need is for general management of the condition to minimise
its severity and effects, the following may be discussed:
- exercise may be recommended (in some cases, i.e. only if person
sufficiently mobile)
- toileting - when the need is felt (i.e. don't postpone), yet relaxed
and unhurried.
In severe cases, e.g. of faecal impaction (which may result from chronic
constipation, especially in elderly and senile people), manual removal
of faecal bolus under anaesthetic may be recommended.
