Causes and risk factors
The most common cause of constipation is the dietary errors. Inadequate intake of water and low fiber food which causes difficulty in formation and passage of stools. Voluntary with holding the stool is another contributing factor. Sedentary lifestyle and use of narcotics increase the risk of suffering from constipation. Constipation can be a side effect of intake of certain medicines like anti histamines, anti spasmodic or diuretics. Structural abnormalities of colon or large intestine. Mechanical obstruction of intestine can also cause constipation. Parkinsonism, spinal cord lesions and certain medical conditions like thyroid disease, diabetes mellitus, hypercalcemia can present with constipation. Electrolyte and hormonal imbalances in women can also predispose constipation.
Clinical presentation:
A person suffering from constipation can come up with symptoms like difficulty in passing stools, incomplete evacuation, decrease frequency of stools or great straining while voiding stools, or manual assistance for voiding stools. An individual can also present with other associated complaints like fatigue, weakness, bloating of abdomen or headache. This straining while passing stool or hard stools can lead to engorgement of the anal veins causing hemorrhoids. It can also cause fissures in anus. Prolonged straining can lead to protrusion of the rectum which is called as ‘rectal prolapse’. Chronic constipation can lead to fecal impaction and intestinal obstruction which can endanger life.
Investigations:
Constipation can be caused due to various causes. The symptoms narrated by the patient are noted down by the consultant. The doctor can conduct a physical examination to rule out hemorrhoids and fissures. Investigations particularly sigmoidscopy or colonoscopy for examination of the rectum and intestine can be suggested. A non invasive technique like ultrasonography can also aid up in diagnosis.
Treatment:
The first line of treatment for constipation is to correct the dietary errors and lifestyle changes. High dietary fibrous food and adequate quantity of water should be implemented. Toilet training in children should be adopted. Regular exercises and a well balanced diet should be motivated. Voluntary withholding of stools should be avoided Medications like laxatives are prescribed but due to dependency its use is discouraged. Enemas for mechanical evacuation can be advised. If constipation is due to certain underlying causative factor it needs to be corrected. The underlying disease can be treated either by medicines or by surgery.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up constipation . Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine uses herbal and certain synthetically prepared medicines. These can also be effective to combat the symptoms. Certain yoga exercises have also found to be effective to relief constipation.
Recent updates:
As per the publication by digestive disease week a new research of an oral capsule that vibrates as it moves through the digestive tract has shown notable promise as a non-pharmacological treatment for constipation. Research team from Japan has determined magnesium-containing cathartics which are commonly used to treat chronic constipation which is functional can lead to hypermagnesaemia.
