How does constipation manifest itself? Which complaints are seen?
Although each person defecates at different frequency, if there is less than 3 defecations per week, constipation is mentioned. In general, constipation is divided into 2 types:
Acute constipation (also called "situational" or "short term")
Chronic constipation
Who has constipation in particular?
In Western countries, about one in four people suffer from constipation. Women who have to deal with obstipation are more likely to be women, but constipation is also a problem for young people, infants, young children and children, which is often a problem that bothers parents and children. Pregnant women also suffer from severe constipation.
Short-term (situational) constipation
it is not a disease but a signal from the body that something is not going well in the body. In medicine, a constipation is mentioned,
Defecation occurs less than 3 times a week
This is only possible with great effort and strain, and
If the stool remains hard in the intestine for a long time and is lumpy (see Bristol stool form scale, type 1 and type 2)
Complaints are usually seen outside the bowel
Chronic constipation
An obstacle that lasts for at least 3 months and at least two of the following concomitant symptoms occur at least every 4th defecation:
Severe bucking
Lump or hard stools (see Bristol stool form scale, type 1 and type 2)
Subjectively feeling that full discharge cannot be achieved
Subjectively feeling of congestion
Manual help during defecation
Defecation less than 3 times a week
Soft, amorphous stools with laxative medications only
Eliminating the possibility of irritable bowel syndrome
The difference is the rate and duration of constipation:
Chronic constipation develops over a long period of time, generally thought to last for more than 6 months, while acute constipation occurs quite quickly, within a few hours or days.
Constipation is associated with extremely hard stools, pain during defecation, incomplete emptying of the stool and a feeling that the bowel outlet is blocked. If blood is detected in the stool during abdominal defecation, abdominal pain, fever or alternating constipation and diarrhea, these are "alarm symptoms", in which case consult a physician immediately.
In general, it is recommended to see a doctor in case of obstacles, especially if this is not situational and short-term.
What causes constipation?
Obstipation may have different causes. Here it is important to have a general knowledge about the physiology of the intestine: The feces need to reach a certain volume in order to provide the necessary "stimuli" to the intestinal contents of this large tubing of muscles. If the swollen fibers and the fluids required for this are missing in our diet, the required stool volume cannot be achieved. When the fluid consumption is too low, the bowel draws water from the feces, so that the feces harden and the intestine makes it difficult to carry it forward, resulting in constipation.
In addition to these constipation reasons (fiber-poor nutrition, low fluid consumption), there are a number of other triggers:
Inactivity
Psychological problems / stress
Physical / organic causes (eg changes in the pelvic floor, hemorrhoids, changes in the intestine, skin cracks in the breech area (anal fissures), intestinal system constriction, etc.)
Adverse effects on metabolism / hormonal balance (eg hypothyroidism, diabetes, pregnancy)
Adverse effects due to drugs (eg calcium and aluminum containing preparations used for stomach burning (antacids), antidepressants, diuretics, high blood pressure medications (eg beta blockers), opiates (strong painkillers or cough medicine codeine), etc.)
Decrease in bowel motility due to neurological causes (eg Multiple Sclerosis, Diabetes mellitus, Parkinson's disease, etc.)
Impairments in electrolyte balance (eg potassium deficiency, usually seen in excessive laxative use)
How can constipation be diagnosed?
The first step to make a diagnosis is to take a history of the disease (comprehensive history). The doctor will discuss several issues with you.
Existing organic intestinal diseases
Questions about other diseases such as neurological disorders (eg Parkinson's disease, Multiple Sclerosis, diabetic nerve disease (neuropathy), etc.)
Questions about family history (family diseases)
Frequency of defecation, color and structure of stool
Nutrition habits, eating and drinking
Concomitant symptoms such as pain and bloating
Questions about drugs taken and which may have an effect on defecation
Checking thyroid function
Following the anamnesis, a physical examination is performed in which the doctor looks at the exit of the intestine and listens to the abdomen. A stool sample can provide information about digestive disorders and unhealthy bacterial colonization in the intestine. The stool is also examined for occult blood (occult = invisible).
Blood tests (thyroid hormones, electrolytes such as sodium, potassium, calcium) are examined in the laboratory. Functional constipation may be started if these values are within normal range, if the patient is younger than 50 years and no warning signal (acute occurrence of obstipation, fecal blood, fatigue) is detected in the anamnesis.
In the case of chronic constipation, a more detailed examination is performed and possibly the intestine and anorectal region are displayed (proctosigmoidoscopy and rectosigmoidoscopy).
Other possible diagnostic methods:
Ultrasound examination of the whole abdomen (sonography)
Radiological examination (X-ray) of the large intestine is now generally performed in the form of computed tomography (CT).
Determination of colon transit time (the time that nutrients pass through the intestine)
If an organic cause of constipation is detected, the underlying disease should be treated. If there is no reason that makes it possible to give reason-oriented treatment for "bowel laziness", general measures should be taken first to relieve constipation.
22AXX
Colace 2-IN-1 Stool Softener & Stimulant Laxative Tablets, 30 Count, Gentle Constipation Relief in 6-12 Hours
