Causes and Treatment of Constipation

Management of Abnormally Infrequent and Difficult Bowel Movements

Mar 22, 2009 Anthony Lee

Constipation is a symptom that many people experience. How does one address this issue?

Constipation is a problem whose definition often varies from one individual to another. The medical community defines the condition as having at least one of three features: bowel movements that occur less than three times per week, strained efforts during defecation, and/or sensation of incomplete removal of stool. Although constipation is common, the treatment depends on its cause, which can be benign or serious.

Causes

Most of the time, constipation is due to the content of the stool itself. Successful passage of stool requires water and fiber, the latter of which consists of indigestible plant material that functions by retaining water. If either of these is inadequate, stool becomes hard and difficult to move. Overconsumption of beverages such as alcohol and coffee may also contribute to constipation.

Constipation can also be due to functional disturbance of the intestine. This can be due to certain medications, such as opioids and psychotropic medications. Other causes of functional constipation include various neurological conditions, such as spinal cord injury, and endocrine abnormalities, such as hypothyroidism.

The third major cause of constipation involves anatomical abnormalities, which are often serious in nature. One of the most common is colon cancer with a tumor that narrows the space within the colon. Constipation may also result from a segment of colon twisting around itself (volvulus) or pushed into the next segment (intussusception). Other anatomical causes of constipation include descent of the rectum (rectocele) due to a dysfunctional pelvic floor and, for patients who previously had abdominal surgery, fibers of scar tissue within the abdominal cavity that can get caught around the intestines.

Treatment

A physician evaluating a patient for constipation should rule out anatomical causes, particularly when the constipation appears sudden and severe. In such cases, abdominal surgery is performed to correct localized colon cancer, volvulus, intussusception, or intraabdominal adhesions. Rectal surgery may be done if the anatomical obstruction is in that general vicinity.

Otherwise, patients may be advised to stop medications underlying the constipation. Laxatives and enemas may be considered but do not address the root of the problem. Hence, the primary recommendation for treating constipation is dietary change. The patient should consume more water if the amount is inadequate and reduce consumption of alcohol, coffee, and tea because of their dehydrating effects. In addition, the diet should have additional fiber through fruits, vegetables, and fiber supplementation.

Lastly, there is debate about whether physical activity may be a factor in constipation. For now, physicians suggest aerobic activity to stimulate motility of the bowel in addition to the above nonsurgical measures.

References

The copyright of the article Causes and Treatment of Constipation in General Medicine is owned by Anthony Lee. Permission to republish Causes and Treatment of Constipation in print or online must be granted by the author in writing.

Human Intestines