Constipation refers to the infrequent number of bowel movements per week, specifically, less than 3 bowel movements per week. The main reason for the constipation is due to the digestive system, where an individual has hard feces that are difficult to expel.
- Abdominal pain
- Heaviness of body
- Lack of appetite
- Acid eructation
- Anal bleeding
- Trouble having a bowel movement
The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction.
Constipation has many causes. Generally causes of constipation can be divided into congenital, primary, and secondary. The most common kind is primary and not life-threatening. It is defined by ongoing symptoms for greater than six months not due to an underlying cause such as medication side effects or an underlying medical condition. It is the most common kind of constipation, and is often multi factorial.
Secondary causes include side effects of medications such as opiates, endocrine and metabolic disorders such as hypothyroidism, and obstruction such as from colorectal cancer. Underlying associated diseases include hypothyroidism, diabetes, Parkinson’s disease, celiac disease, non-celiac gluten sensitivity, colon cancer, diverticulitis, and inflammatory bowel disease.
- Medical conditions
The diagnosis is typically made based on a person’s description of the symptoms. A physical examination should involve at least an abdominal exam and rectal exam. Abdominal exam may reveal an abdominal mass if there is significant stool burden and may reveal abdominal discomfort. Rectal examination gives an impression of the anal sphincter tone and whether the lower rectum contains any feces or not.
Rectal examination also gives information on the consistency of the stool, the presence of hemorrhoids, blood and whether any perineal irregularities are present including skin tags, fissures, anal warts.
Imaging and laboratory tests are typically recommended for those with alarm signs or symptoms. Laboratory tests may include CBC (complete blood count), thyroid function tests, serum calcium, serum potassium, etc. Abdominal X-rays are generally only performed if bowel obstruction is suspected, may reveal extensive impacted fecal matter in the colon, and may confirm or rule out other causes of similar symptoms. Colonoscopy may be performed if an abnormality in the colon like a tumor is suspected. Other tests rarely ordered include anorectal manometry, anal sphincter electromyography, and defecography.
- Adequate exercise
- Fluid intake
- High-fiber diet
- Fiber supplements
- Physical intervention
- Surgical intervention