Constipation

Constipation is a condition in which elimination of faeces (or "stools") from the bowels via the anus, also described as "evacuation of the bowels", is difficult and may be painful.

This is a common condition, especially in the elderly.

Note that as the frequency of bowel movements (evacuations) varies considerably from person to person, it is not possible to define "normal" with sufficient precision to describe constipation simply in terms of the frequency of elimination of faeces. One possible explanation for the frequency of, and variation in frequency of, bowel movements is its dependence, in part, on diet - in addition to, and affecting, general digestive well-being.

Key aspects of constipation are:

Possible causes of constipation:

• Dietary causes may include insufficient intake of dietary fibre over a prolonged period of time.
• Insufficient intake of water / fluids may exacerbate the problem.
• Side-effects of medication - note that the possible known side effects of prescribed medications are usually listed on the leaflet that comes with it. If medication is a suspected cause of constipation a change of medication may be possible.
• Some medical conditions can include, cause, or exacerbate constipation (among other symptoms).
• Pregnancy - not in all cases, but some source suggest that around 20% of pregnancies can involve some level of constipation due to hormonal changes.
• State of mind / Emotion / Stress is sometimes said to lead or contribute to constipation but such psychological issues and their effects are extremely difficult to assess objectively. If this is thought to be a contributory factor any number of relaxation techniques may be helpful.
• Idiopathic, i.e. "cause unknown" ... so not strictly a "cause" but often included in such lists and useful to cover all other cases.

Symptoms & Effects of constipation:

• Faeces are hard and small
• Difficulty and/or pain passing faeces
• Variation (change) in frequency of bowel evacuation from that which is "normal" for the individual. Some texts describe constipation in terms od reduced frequency of bowel movements, others mention only a change in freqency - together with discomfort when passing stools.

Medical treatment(s) for constipation may involve, in cases of recurrent or chronic constipation:

• increasing intake of dietary fibre (roughage)
• use of laxatives
• enemas.

When the need is for general management of the condition to minimise its severity and effects, the following may be discussed:

• exercise may be recommended in some cases, such as if person sufficiently mobile
• toileting when the need is felt (i.e. don't postpone), yet relaxed and unhurried.

In severe cases, e.g. of faecal impaction (which may result from chronic constipation, especially in elderly and senile people), manual removal of faecal bolus under anaesthetic may be recommended.