Constipation

Definition
Constipation is often defined as infrequent or irregular bowel movements that are typically difficult to pass and occur fewer than three times a week. The ROME Multinational Consensus in 2002 and 2006 provided criteria to help patients and physicians better understand what characterizes constipation. Based on their evaluation, constipation is generally defined as having fewer than three bowel movements a week, as well as straining, having a hard stool, or experiencing incomplete evacuation more than 25% of the time. Constipation, although similar is some ways, is not the same as irritable bowel syndrome, which is often associated with abdominal pain, irregular bowel movements, gas, and mucus in the stool.  

Causes
Constipation is a rather common intestinal complaint that may be caused by a number of ailments, conditions, or traumas. The most common cause of constipation includes a blend of factors including poor diet, lack of fluid intake, and lack of physical activity. Other causes often include a specific medical condition, side effects from a prescription medication, anal disease or cancer, colon or rectal cancer, anatomic irregularities, or a colonic stricture (narrowing).

Risk Factors
Risk factors of constipation generally include being an older adult, being female, eating a low-fiber diet, dehydration, little to no physical activity, or taking certain medications.

Symptoms
Constipation can last a few days, weeks, or months depending on the cause of the condition. Chronic constipation is typically defined as constipation that lasts more than three months. Patients with chronic constipation may experience two or more of the following symptoms:

  • Passing fewer than three stools a week
  • Straining during bowel movements
  • Passing lumpy or hard stools
  • Experiencing incomplete evacuation
  • Feeling pressure in your lower abdomen

Treatments
Treatment for constipation often requires making necessary dietary and lifestyle changes such as increasing fluid and fiber intake, as well as boosting physical activity levels. These conservative treatment techniques are typically considered before other treatment modalities are recommended. Should these methods be rendered ineffective, a physician may recommend a fiber supplement, stimulant, stool softener, or laxative to make passing bowel movements easier for patients. Prescription medications, biofeedback training, or surgery may be suggested if patients are experiencing severe, chronic constipation. 

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