Introduction to Constipation

People mean many things when they say they have constipation. The infrequent passing of stools, difficulties in voiding, sense of incomplete voiding are all suggestive of constipation. The normal reference range for bowel movements is very varied. Some people have bowel movements three times a day; others, only one or two times a week.

Medically, constipation is defined as fewer than three bowel movements in a week. Constipation may be considered severe when there is less than one bowel movement in a week.

Causes
  • Insufficient fiber intake in the diet.
  • Not chewing the food properly / eating hurriedly.
  • Reduced water intake.
  • Various medications
  • Antidepressants, tri-cyclic anti-depressants.
  • Anti-convulsants
  • Diuretics
  • Stopping cigarette smoking.
  • Abuse of laxatives.
  • Medications containing calcium and aluminum.
  • Endocrine disorders like - underactive thyroid.
  • Any severe illness like stroke, paralysis.
  • Major changes in life like pregnancy, old-age or traveling.
  • Lead poisoning.
  • Conditions that obstruct the normal passage of the stools within the intestines ' foreign bodies in intestines, strictures, adhesions, tumors, etc.
  • Abdominal surgeries..
  • Weakened pelvic floor muscles.
  • Constipation can occur sometimes as part of a condition called 'irritable bowel syndrome' where it alternates with diarrhea. .

Diagnosis

A proper clinical history and physical examination usually suffice to diagnose constipation.

The presence of hard stools, difficulty in eliminating them and feeling of incomplete voiding of stools usually indicate the presence of constipation. Very hard, small, pellet-like stools which are eliminated with a lot of difficulties certainly indicate constipation even if stool occurs every day.

In very severe constipation of long standing, a physical examination may reveal the presence of hard lumps over the abdominal surface.