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Showing posts with label Constipation. Show all posts
Showing posts with label Constipation. Show all posts

Friday, January 21, 2011

Causes and Risk Factors of Constipation

The common causes of constipation are:

Not enough fiber in the diet - The American Dietetic Association recommends 20 to 35 grams of fiber each day, but the average American eats about 5 to 20 grams a day. Examples of fiber-rich foods are unprocessed wheat bran, unrefined breakfast cereals, fresh fruits (except bananas), dried fruits, vegetables (except potatoes), grainy breads and legumes.

Not enough liquid - Liquids like water and juice add fluid to the colon and bulk to stools, making movements softer and easier to pass. Recommended daily consumption of liquid is eight, eight-ounce glasses (totaling 64 ounces) per day.

Lack of exercise

Medications - Some medications that can cause constipation are: analgesics (Codeine, Demerol, Perocdan), antacids (Maalox, Mylanta), anticholingerics (Donnatal), anticonvulsants (Dilantin), anti-depressants (Tricyclics), Beta-blockers (Inderal, Tenormin) iron and calcium supplements, pain medications, antispasmodics and diuretics.

Irritable Bowel Syndrome (IBS) - IBS is a common condition marked by chronic or occasional diarrhea, alternating with constipation and accompanied by straining and abdominal cramps. (see Health Profile: IRRITABLE BOWEL SYNDROME)

Lifestyle changes, such as pregnancy, aging and traveling

Laxative abuse - A laxative is a food or chemical substance that acts to loosen the bowels by softening and increasing the bulk of bowel contents, increasing the amount of water in the colon and lubricating the intestinal walls. Over time, laxatives can damage nerve cells in the colon and interfere with the colon's natural ability to contract.

Ignoring the urge to have a bowel movement

Diseases such as multiple sclerosis, Parkinson's disease, chronic idiopathic intestinal pseudo-obstruction, stroke, spinal cord injuries, diabetes, under-active and over-active thyroid gland, uremia (excess urine waste product), amyloidosis (accumulation in the tissues/organs of amyloid), lupus, scleroderma (an autoimmune disorder that affects the tissues/organs), colorectal cancer, depression, colon tumors,diverticulosis and Hirschsprung's disease.

Treatment of Constipation

Most cases of constipation respond to conservative treatment such as dietary and lifestyle changes or mild laxatives.

Dietary changes include getting enough of the recommended daily amount of fiber (20 to 35 grams), drinking 64 ounces of water or juice a day, and limiting foods that have little or no fiber, such as ice cream, cheese, meat and processed foods.

Lifestyle changes consist of exercising, reserving enough time to have a bowel movement and having a bowel movement when needed.

Laxatives may be recommended if the above changes did not help the constipation.

There are four types of laxatives - bulk-forming, stimulant, lubricant and saline. Bulk-forming laxatives, such as Metamucil, Citrucel and Serutan increase the volume of feces, making them softer and easier to pass. Stimulant laxatives, such as Correctol, Ex-Lax, Dulcolax, Purge, Feen-A-Mint and Senokot stimulate the intestinal wall to contract. Lubricant laxatives, such as mineral oil, soften the stool so it is easier to pass. Saline laxatives, such as Milk of Magnesia, Citrate of Magnesia and Haley's M-O, increase the concentration of salts within the feces.

Note: Laxatives can be habit-forming. If laxative use causes asthma, skin rash, dizziness, irregular heartbeat, dehydration, muscle cramping, nausea or other side effects, please see a doctor immediately.

Other treatment methods may include:

Bowel retraining - may provide relief for people who have gotten into the habit of ignoring the urge. If a tight schedule has produced a tight sphincter, it may help to sit on a toilet, with book in hand, about 20 minutes each morning to encourage a return of reflexes that have disappeared. Straining is not recommended, since it may lead to tightening of muscles that should be relaxed for comfortable defecation.

Rectal suppositories - helpful in providing lubrication and in stimulating the defecation reflex. They are usually composed of glycerin, which is sometimes blended with sodium sterate, a fatty acid. Bisacodyl-containing suppositories have added potency, because they act directly on the bowel to stimulate emptying.

Enemas - usually become attractive only when oral laxatives cannot do the job. Introducing water into the colon helps to stimulate defecation. "Disposable" enemas deliver a solution of highly concentrated, nonabsorbable salts into the rectum and sigmoid colon. These salts attract an outpouring of fluid into the bowel and thus promote bowel contraction. Oil-containing enemas are sometimes recommended as softeners for feces that have become hardened within the rectum.

Biofeedback - may be recommended for people with chronic constipation caused by anorectal dysfunction. Biofeedback involves using a sensor to monitor muscle activity displayed on a computer screen allowing for accurate assessment of body functions. With this information, the doctor helps the person learn how to use the anorectal muscles.

Surgery - Surgical removal of the colon may be an option for people with severe symptoms caused by colonic inertia (lack of movement in the colon) and unremitting extreme constipation.

Thursday, January 20, 2011

Constipation

Myth: You Should Have a Bowel Movement Every Day

What's "normal" varies from person to person. Some people go 3 times a day; others, 3 times a week. Although having a bowel movement once a day is common, it's fine to skip a few days without one. You're considered severely constipated if you have less than one movement a week. Seek medical help for sudden constipation or constipation that lasts more than 2 weeks.

Myth: Constipation Creates Toxins and Health Problems

Some people believe that constipation causes the body to absorb poisonous substances in stools. They believe that this can cause diseases such as arthritis, asthma, and colon cancer. But there’s no evidence that the stools produce toxins or that colon cleansing, laxatives, or enemas can prevent cancer or other diseases.

Myth: Constipation Just Means I Need More Fiber

Fiber can often help constipation. But sometimes constipation is caused by diseases like stroke, diabetes, thyroid, or Parkinson's disease. In rare cases, it can signal illnesses such as colorectal cancer or autoimmune disease. See a doctor if constipation lasts more than 2 weeks or if you have bloody stools, severe pain with bowel movements, or unexplained weight loss.

Fact: Dairy Can Cause Constipation

Eat too much dairy and it may cause or aggravate constipation. So how much is OK? A normal adult-size portion of milk is one cup, cheese is 1½ ounces (about the size of four stacked dice), and ice cream is a ½ cup (the size of half a baseball). Two to 3 servings of dairy a day is enough. Talk to your doctor if small amounts seem to constipate you.

Myth: Swallowed Gum Will Get Stuck in Your Stomach

Chewing gum won't stick to your insides like it would to the the bottom of your shoe – and it won't cause constipation. Indigestible parts of gum move out of your body through bowel movements, usually within a few days. Very rarely, swallowing large amounts of gum or many pieces in a short time can block the digestive tract, especially if you swallow it with other indigestible things.

Fact: Vacations Can Cause Constipation

Travel can change your daily routine and diet, causing constipation. Avoid dehydration-related constipation by drinking water, especially if you're flying. Also move around when you can – for example, while waiting for plane connections or by taking rest stops when driving. Other travel tips: Exercise, limit alcohol, and make a point of eating fruits and vegetables.

Fact: Mood Can Affect Your Regularity

Emotional stress may trigger constipation or make it worse. Massaging the abdomen can help relax the muscles that support the intestines and get your bowels moving. Acupressure or shiatsu massage may help too. Meditation, yoga, biofeedback, and relaxation techniques are other ways to reduce stress.

Myth: Holding It Won't Hurt

You may feel too busy at work to have a bowel movement. Or you'd rather wait until you're home. But ignoring the urge when it comes may not only make you physically uncomfortable – it can cause or aggravate constipation. Some people find it helps to set aside time after breakfast or another meal for a bowel movement. But no matter when nature calls, answer.

Fact: Medications Can Cause Constipation

Some medications for pain, depression, high blood pressure, and Parkinson's disease can cause constipation. Too much vitamin D and iron, can also lead to constipation. Calcium supplements, especially if taken with another supplement or medication that binds the stool, may also cause problems. Talk with your doctor if you have concerns.

Fact: A Low-Fiber Diet Can Cause Constipation

Not enough fiber is a common cause of constipation. To prevent it, try to get 5 or more servings a day of foods rich in fiber, like whole-grain bread, cereal, and pasta. Limit foods that are low in fiber or high in fat and sugar, such as processed foods. If you don't normally have much fiber in your diet, add it slowly to avoid gas and bloating.

Myth: All Fiber Is Created Equal

Insoluble fiber in foods adds bulk to stool and helps stools pass through the intestines faster, easing constipation. Good sources are whole grain breads, pasta, and cereal. Soluble fiber found in fresh fruits and vegetables may not work as well. To encourage the growth of bacteria in the colon that may keep the intestines healthy, try citrus fruits and legumes, such as beans. 

Fact: Prunes Help Keep You Regular

This small, dried fruit has earned a big reputation as "nature's remedy" for constipation. Prunes can prevent or improve constipation symptoms. They're packed with fiber, which adds bulk to stool and speeds its passage through the colon. Prunes also contain sorbitol, a natural laxative. And they are safe for long-term use. For children, try freezing prune juice into a popsicle or mixing it with another juice to improve the taste.

Fact: Drinking Water May Help

Drinking plenty of water helps prevent dehydration, which can cause constipation. Liquids can help keep your stool soft to help prevent and alleviate constipation. Talk to your doctor about how much water is good for you. Remember to limit caffeinated or alcoholic beverages – too many of these can cause dehydration.

Fact: Exercise Keeps You Regular

Lack of physical activity can contribute to constipation. Exercise, however, can help make your bowel movements more regular and reduce stress. Wait at least an hour after eating a big meal before you exercise to give your body time to digest your food. Then get moving! Try a 10- to 15-minute walk several times a day. Stretching and yoga can also help constipation.

Myth: Coffee Can Fix Constipation

It's true that the caffeine in coffee can stimulate the muscles in your digestive system to contract, causing a bowel movement. So why isn't it recommended as a fix for constipation? Coffee can actually make stools harder to pass because it is a diuretic, so it draws liquid out of stools. If you are constipated, avoid coffee and other diuretics such as alcohol and caffeinated tea and cola.

Myth: Colon Cleansing Will Clear Me Out

Enemas and colon irrigation (high colonics) may temporarily remove body waste, but they're not an effective way to prevent or cure constipation. Enemas can actually cause constipation for older people who get them regularly. Colonic irrigation, which is usually done by colonic hygienists or therapists, can damage the colon and can lead to other issues. Talk to your doctor if you are considering the procedure.

Myth: Castor Oil is a Cure-All

Castor oil is a powerful laxative. But like other laxatives, it should not be used long-term. Overusing laxatives can hurt your body's ability to absorb nutrients and some medications. Castor oil can damage the bowel muscles, nerves, and tissue if overused – all which can cause constipation. Use it only with a doctor's guidance

Myth: Constipation Is Only an Older Person's Condition

Older people are more likely to become constipated. This can be because of medical conditions, poor nutrition, greater use of medications, or not enough physical activity. But constipation is one of the most common gastrointestinal issues among other age groups, too. And it's not unusual during pregnancy or after childbirth or surgery. Remember, if you're pregnant and considering taking something to relieve constipation, check with your doctor. 

Myth: It's Normal to Have Bloody Stool

Blood in a bowel movement is not always serious, but you should always call your doctor if it happens. Bright red blood is usually from hemorrhoids or tears in the anal lining called fissures. Constipation and straining during bowel movements can be the cause. Maroon or tarry black blood or clots usually mean bleeding is coming from higher in the gastrointestinal tract. The cause may be more serious.