Constipation refers to infrequent or hard stools or difficulty passing stools. It may involve pain during the passage of a bowel movement, inability to evacuate after straining or pushing for more than 10 minutes, or no bowel movements after more than 3 days. Babies who are still exclusively breastfed may go 7 days without a stool.
Alternative Names
Irregularity of bowels; Lack of regular bowel
General considerations
Normal patterns of bowel elimination vary widely from one person to another and it is likely that a person does not have a bowel movement every day. While some healthy people have consistently soft stools or nearly liquid, others have consistently firm stools, but no difficulty passing.
When the stool is hard, infrequent, and requires a great effort to pass, you have constipation. The passage of large stools may tear the mucosal membrane of the anus, especially in children, which can cause bleeding and the possibility of an anal fissure.
Common Causes
Constipation is most often caused by a low-fiber diet, lack of exercise, not drinking enough water, or delay in going to the bathroom when the urge to defecate. Stress and travel can also contribute to constipation or other changes in bowel habits.
Other times, the reason for your constipation may be the presence of intestinal diseases (such as irritable bowel syndrome), pregnancy, certain medical conditions (such as an underactive thyroid or cystic fibrosis), mental health problems, disorders neurological or medication. More serious causes, like colon cancer, are much less common.
Constipation in children often occurs if they hold back bowel movements when they are not ready for training in using the toilet or afraid of it.
Home Care
Children and adults should get enough fiber in the diet. Vegetables, fresh fruits, dried fruits, like whole wheat, bran or oatmeal are excellent sources of fiber. To reap the benefits of fiber, it is very important to increase fluid intake to help pass the stool.
For infants with constipation:
* Over 2 months: test with 60 to 100 g (2 to 4 ounces) of fruit juice (grape, pear, apple, cherry, or prune) twice a day.
* Over 4 months: if the baby has begun solid foods, they can try baby foods with high fiber content (peas, beans, apricots, plums, peaches, pears, plums, spinach) twice a day .
Regular exercise is also very important to establish regular bowel movements. If the person is confined to a wheelchair or bed should change position frequently and perform abdominal contraction exercises and leg raises. A physical therapist can recommend exercises appropriate for your physical abilities of each person.
Stool softeners, such as those containing docusate sodium may help. Additionally, bulk laxatives such as psyllium may help add fluid and bulk to the stool. Also Suppositories or gentle laxatives like milk of magnesia liquid, may establish regular bowel movements. Enemas or laxatives should be reserved for severe cases only. These methods should be used only if fiber, fluids, stool softeners do not provide enough relief.
DO NOT give laxatives, or enemas to children without first consulting a doctor.
Call your doctor if
Call your doctor if you have:
* Sudden constipation with abdominal cramps and an inability to pass stool or gas. (Do not take laxatives and call your doctor immediately).
* Acute abdominal pain or severe, especially when accompanied by relaxation.
* Blood in the stool.
* Constipation alternating with diarrhea.
* Like stools, pencil thin.
* Rectal pain.
* You experience unexplained weight loss.
* Been using laxatives for several weeks or self care are not working.
Call if:
* A baby less than two months is constipated.
* An infant (except those exclusively breastfed) a stool in 3 days. If the child is vomiting or irritable, you should call your doctor immediately.
* A child is holding back bowel movements in order to resist toilet training.
What to Expect at Your Office
The doctor will perform a physical exam, which may include a rectal exam, and ask questions such as:
* How long have you had constipation?
* How many days between two stools?
* Is it worse when you are stressed (a)?
* What color, shape and consistency of the stools?
* Is there any bleeding with bowel movements?
* Have you experienced any abdominal pain?
* What surgeries or injuries have you had?
* What medications are you taking?
* Do you drink coffee or drink alcohol? Do you smoke?
* What other symptoms are present?
The following tests can help diagnose the cause of constipation:
* Anorectal manometry (pressure measurements of the anus and rectum)
* Barium enema
* Blood tests such as CBC, PT or PTT
* Proctosigmoidoscopy (an examination of the lower bowel)
* Stool studies
* Upper GI
* Radiographs of the abdomen
Prevention
Avoiding constipation altogether is easier than treating it, but involves the same steps in lifestyle:
* Eat lots of fiber
* Drink plenty of fluids each day (at least 8 glasses of water per day)
* Exercise regularly
* Go to the bathroom when you have the urge and not wait
Digestive Consultation
| 
| 
| 
| 
| 
| 