Constipation is defined as a decrease in the frequency of bowel movements, or difficulty in passage of the stool. Each individual has a particular bowel pattern, and what is considered normal varies widely. There is no medical evidence that daily bowel movements are required for good health. If the stool is normally formed and passed without excessive straining, the person is not constipated, even though he or she may have a bowel movement only once or twice a week.
Diet, exercise, and medications can all affect bowel function. It is more important to pay attention to any any change in bowel habits than to worry about whether a regular bowel pattern is normal. If, for example, a person becomes suddenly constipated and the problem does not resolve itself in a few days, it may be a symptom of an underlying disease.
Causes of constipation
The initial symptom of appendicitis is pain, which generally starts in the upper abdomen and then moves to the lower right side. Constipation may occur, along with nausea, vomiting, and fever. Prompt surgical removal of the appendix is usually necessary.
Constipation may sometimes be a symptom of cancer of the colon, pancreas, liver, cervix, or uterus. In cancer of the cervix or uterus, there is also likely to be bleeding between menstrual periods or after menopause, a discharge from the vagina, and erratic urination. Cancer of the pancreas is characterized by back pain, jaundice (yellowing of the skin and eyeballs), indigestion, and weight loss. Liver cancer is likely to be accompanied by nausea and vomiting, feelings of pressure in the abdomen, jaundice, anemia, weight loss, and a dull ache in the area of the liver. Constipation that alternates with diarrhea may indicate cancer of the colon and rectum; other symptoms include discomfort in the rectum that is not relieved by moving the bowels, painful bowel movements, anemia, persistent bleeding into stools, gas, cramps, and weight loss.
Diabetes mellitus may affect the contractions of the intestine. Intestinal waste material is moved along by these regular contractions. If they are altered, the result could be either diarrhea or constipation. The classic symptoms of diabetes are excessive thirst, excessive urination, and excessive hunger. There may also be weight loss despite increased food intake.
Gastritis is an inflammation of the lining of the stomach. It has many causes and may be either acute or chronic. The major symptoms are loss of appetite, nausea, vomiting, bleeding, and pain that feels like an ulcer, but constipation may also occur.
Waste material is moved through the colon by rhythmic contractions of the colonic muscles. In some conditions, these muscles lose their tone and are unable to function properly, resulting in constipation.
Irritable bowel syndrome
This disorder involves the small intestine and colon, and is associated with varying degrees of abdominal pain, constipation, or diarrhea. It is apparently a reaction to stress in people who are susceptible to developing the condition.
A number of medications can affect bowel motility, resulting in constipation. Codeine and codeine derivatives are among the more common examples; others include antacids, iron pills, and antidepressants.
Constipation is common during pregnancy. Increased levels of the hormone progesterone, especially during the later months of pregnancy, causes the smooth muscle of the bowel to become sluggish. The uterus is also increasing in size and pressing on the bowels and pushing it upward and backward. The problem can best be prevented by exercise and a diet that includes vegetables, fruits and other high-fiber foods.
An underactive thyroid gland (hypothyroidism) may affect the contractions, or motility, of the bowel muscles, causing constipation. People with thyroid deficiency tend to feel apathetic and sluggish, and to be sensitive to the cold. The skin is dry, cool, and rough; the hair is brittle; and the voice is low and husky. Pulse rates are slow, and weight gain is common.
Advice about constipation
- See a doctor if you are constipated, especially if this represents a change in bowel habits.
- For simple constipation, increasing fluid intake and the amount of fiber in the diet may solve the problem. However, avoid taking large amounts of bran, which can cause gastrointestinal upset and even intestinal blockage.
- Increased walking or other physical activity may also increase bowel function.
- A laxative may be needed, but if you are pregnant, consult your doctor before taking it or any other medication.
- Both laxatives and enemas can cause constipation problems if used on a long-term basis.