Mataracy
VIP Contributor
Constipation means delay in evacuation of the bowels. It is important that normal bowel habit varies considerably from person to person.
CAUSES OF CONSTIPATION
(a)Habit. If the normal desire to have the bowels open (call to stool) is ignored for social reasons then the normal defecatory reflex evoked by the presence of faeces in the rectum, is gradually lost. The stool becomes hard and dry due to water absorption. This type of constipation is a particular problem in the elderly. Chronic constipation results in loss of muscle tone in the rectum and causes difficult or incomplete evacuation of the bowels which aggravates the condition.
(b) Diets low in fibre cause slow intestinal transit and the formation of small hard stool.
(C)Local causes
(I) Anal conditions. Painful anal conditions such as anal fissure or strangulated hemorrhoids will result in constipation. It is difficult to know whether hemorrhoids cause or are caused by constipation.
(ii) Any disease causing obstruction to the bowel especially the large bowel,will cause constipation.
TREATMENT
The treatment of constipation is that of the cause. Usually,habit constipation responds to phosphate or soap and water enemas. In milder cases purgatives either as suppository or by mouth,may suffice . However if purgatives such as senokot or milpae are tried their use should be discontinued as soon as possible as purgative abuse may cause constipation in the long term. Once constipation has been relieved, the institution of high fibre diet,possibly with the addition of dietary bulking agent such as normacol or fibogel,will help to prevent recurrence. In the elderly or demented patients, chronic constipation may be a very difficult problem.
CAUSES OF CONSTIPATION
(a)Habit. If the normal desire to have the bowels open (call to stool) is ignored for social reasons then the normal defecatory reflex evoked by the presence of faeces in the rectum, is gradually lost. The stool becomes hard and dry due to water absorption. This type of constipation is a particular problem in the elderly. Chronic constipation results in loss of muscle tone in the rectum and causes difficult or incomplete evacuation of the bowels which aggravates the condition.
(b) Diets low in fibre cause slow intestinal transit and the formation of small hard stool.
(C)Local causes
(I) Anal conditions. Painful anal conditions such as anal fissure or strangulated hemorrhoids will result in constipation. It is difficult to know whether hemorrhoids cause or are caused by constipation.
(ii) Any disease causing obstruction to the bowel especially the large bowel,will cause constipation.
TREATMENT
The treatment of constipation is that of the cause. Usually,habit constipation responds to phosphate or soap and water enemas. In milder cases purgatives either as suppository or by mouth,may suffice . However if purgatives such as senokot or milpae are tried their use should be discontinued as soon as possible as purgative abuse may cause constipation in the long term. Once constipation has been relieved, the institution of high fibre diet,possibly with the addition of dietary bulking agent such as normacol or fibogel,will help to prevent recurrence. In the elderly or demented patients, chronic constipation may be a very difficult problem.