What Causes Constipation?

Constipation is having more than one definition and it includes a hard stool, feeling of difficulty to pass the stool, infrequent or irregular habits of passing the stool and unsatisfied or incomplete emptying of the bowel often.

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In irritable bowel syndrome this constipation alternate with diarrhea. As the age grows naturally the bowel movement decreases and almost 3 to 20 bowel movements per week in older people is said to be normal. But in young adult one movement per day is common and this pattern is not applicable to all. But most people are irregular and fail to pass the stool daily.

It is medically accepted that about 3 movement of bowel per week is enough and when it is below 3 it is said as constipation and when it goes below 2 and this condition is called the severe form of constipation.

There are many underlying causes like tumors that cause constipation and it is important that acute type of constipation should be examined and it is very essential when it accompanies symptoms like rectal bleeding, abdominal pain, nausea and vomiting.  The chronic form with no unwanted symptoms requires no immediate medical help.

Several medications such as antidepressants, narcotic pain killers, anticonvulsants, and several heart related drugs like calcium channel blockers, iron preparations and particularly aluminium containing antacids causes’ constipation. To avoid these medicine induced constipation, it is advisable to have more fiber during this medication or the medicine may be substituted by other medicines.

Defecation is almost a habit forming in nature and it is only comes under voluntary control. Hence, it is possible that constipation may arise because of the suppression of the action of the bowel on their own and it depends on the individual’s habit. Diet is the most important factor in avoiding constipation and it is best that the diet should contain sufficient fiber for the best bowel movement. Vegetables, fruits and whole grains are good examples that contain much fiber.

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It is somewhat believed using much stimulant type of laxative causes damage to nervous system of the bowel which causes constipation. Hormone levels in the body plays an important roll in causing constipation which include hypothyroidism, hyperparathyroidism. Changes in the progesterone and estrogen levels during menstrual period and pregnancy also cause constipation. The nervous system of the intestine is affected by diabetes, any obstructive diseases of the colon, narrowing of passage by any means and cancer of the colon cause constipation. Brain diseases like Parkinson’s disease and multiple sclerosis cause constipation and it also happens in colonic inertia where the function of the muscles of the colon is disturbed. Pelvic floor dysfunction is also a reason for constipation.

Medical history is very important to define the type of constipation and it is very useful for diagnosis and appropriate treatment. A history of having painful defecation may be suspected for anal fissure or narrowing of the rectum, a strained defecation may be of pelvic dysfunction.

A dietary history is also very useful in diagnosis and if the diet is not having enough fiber, a high fiber diet may be prescribed. The past medication history is also very important in diagnosis of the cause. A physical examination including rectal examination is very essential. Blood test for hormones including thyroid and parathyroid gland is very useful. Abdominal X-ray may reveal any unwanted excessive stool in the colon. A barium meal X-ray may help in studying the normal anatomy of the colon and tumors or narrowing of the colon if any.

Dietary fiber is called bulk forming laxatives and plenty of fiber is available in vegetables, fruits and whole grains. These laxatives keeps water within the stool and it adds volume to stool and there by the bowel movement are kept well for defecation.

Certain laxatives contain mineral oil which also works like bulk forming laxatives and it coats the stool and prevents the loss of water from the stool and increases the stool volume. Stool softeners are called as emollient laxatives which contains compound like docusate and this turns the stool in to soft form. Certain indigestible things like lactulose are called hyperosmolar laxatives which are helpful in relieving from constipation by retaining water in the colon. Saline laxatives are non-absorbable ions like magnesium citrate which is also having the property of maintaining water at the colon and makes the stool soft.