Constipation Overview
Constipation is a change in the usual bowel habits.
It is defined as decrease in frequency and liquidity of stool as compared to the normal pattern in a particular individual.
The usual complaints of the patients are straining at defecation >25% of time, lumpy/hard stools, sensation of incomplete evacuation,or less than 3
bowel actions per week.
Constipation 15+ important causes?
Various causes of constipation include:
consuming low fiber diet and less fluid
lack of exercise
pregnancy
old age
side effects of certain drugs
metabolic, endocrine, neurogenic causes
lower bowel abnormalities
psychogenic disorders
chronic use of enemas and laxatives
cancer of the bowel
ignoring the urge of passing stool
change in environment etc.
Each cause needs to be looked into and corrected accordingly.
Chronic constipation may be a problem both for the patient and practitioner.
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Poor oral intake and its causes need to be looked into. These may vary from ill
fitting denture to loneliness in elderly, non availability of food, poor intake of
high roughage diets because of ignorance or bad eating habits.
Any illness resulting into poor oral intake can cause constipation which can usually be managed with improved oral intake with roughage and promotion of fluid intake.
Restriction of intake is not always due to anorexia alone, but many myths stopping oral intake by patient during illness is a frequent underlying cause.
Constipation assessment?
- A thorough assessment of the patient is important.
- Note the possible causative factors of constipation.
- Duration and severity of problem.
- What all interventions the patient has tried and their outcome.
- Acute constipation associated with vomiting and if the patient has not
passed even wind and appears ill, GIT obstruction may be suspected.- These patients need to be referred immediately to a higher centre.
Constipation treatment?
Constipation natural treatment:
Health education plays a vital role for the individual as well as society at large. The non-pharmacological interventions should be tried first before moving on to laxative.
Advise high fiber diet (vegetables, salad, fruits, bran) and increased intakeof fluid.
Decrease the consumption of caffeinated drinks.
Avoid suppression of urge to defecate.
Make a regular bowel habit.
Bulk forming agents like ‘isapghula husk’ also help to relieve mild constipation.
Advise regular physical exercise such as walk for 1/2 to 1 hour daily andabdominal exercises.
Discourage the continuous use of laxatives.
constipation treatment medicine?
If there is no response with the above said non-pharmacological measures, then try the following pharmacological measures.
Lactulose 15–20 ml orally at night. Or Susp. magnesium sulphate 15–20 ml
at night.Tab sodium picosulphate 10 mg at night.
Isotonic polyethylene glycol (PEG) electrolyte solution 125–250 ml.
Any of these may be given 2–4 times a week. The dose can be decided as per the
adequate relief.
Phosphate enemas to be used on as and when required basis in patients having acute problem with severe constipation or sub-acute intestinal obstruction.
