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How to tell if constipated: Constipation – Signs & Symptoms

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Constipation – Signs & Symptoms

Constipation often involves dry stool that’s hard to pass and the feeling that you’re unable to completely empty your bowels.

Constipation, which develops when digested food spends too much time in the colon, can result from a wide range of factors.

Common causes of constipation include:

Whatever the cause, constipation is often associated with the same common signs and symptoms.

Signs and Symptoms

There’s no real “right” number of bowel movements you should have in a day or week — it’s different for each person.

Having a bowel moment anywhere from three times a week to three times a day is generally considered within the healthy range.

Most commonly, though, constipation is said to occur when you have fewer than three bowel movements in a week.

Other signs and symptoms of constipation include:

  • Having lumpy, hard, dry stool that’s difficult to pass
  • Straining to pass stool
  • Feeling like you still need to go after you have a bowel movement (like you haven’t fully emptied your bowels)
  • Feeling like there’s a blockage in the intestines or rectum
  • Pain or bloating in the abdomen
  • Reduced appetite
  • Sluggishness or lethargy

Contrary to common belief, the body does not absorb waste that is trapped, which would cause significant danger to your overall health.

In fact, constipation is more often just bothersome rather than serious.

But chronic (long-term) constipation can lead to some complications, including hemorrhoids, tears in the skin around the anus (anal fissures), and rectal prolapse (a condition in which part of the rectum sticks out of the anus).

Constipation and Back Pain

It’s not unusual for constipation and back pain to occur together.

In some cases, constipation may indirectly result from back pain. That is, you can become constipated after taking certain pain medications, particularly drugs such as opiates.

In other cases, constipation and back pain may both be symptoms of another health issue.

For instance, irritable bowel syndrome can cause both constipation and backaches, even though the two symptoms may not be directly related.

Back pain can also develop from fecal impaction, another complication of chronic constipation.

This condition occurs when a large chunk of dry, hard stool gets trapped in the rectum and you’re unable to push it out.

Fecal impaction is especially common if you’re constipated for a long time and are taking a lot of laxatives.

Your body becomes accustomed to the medication and “forgets” how to normally pass stool once you stop taking the laxatives.

If you have a fecal impaction, the hardened stool may press on the sacral nerves of the lower back, resulting in back pain.

This back pain will remain until its source — the impaction — is removed through a procedure that usually involves a doctor manually reaching into the rectum to break up the hardened stool.

Constipation | Cedars-Sinai

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What is constipation?

Constipation is when your stools are painful or they do not happen often enough. It
is the most common GI (gastrointestinal) problem.

You may have constipation if:

  • You have bowel movements less than 3 times a week
  • Your stool is hard, dry, and in small pieces

Normal bowel movements vary depending on the person. They may happen as often as 3
times a day. Or they may happen just 3 times a week.

What causes constipation?

Your stool gets hard and dry when your colon (large intestine) absorbs too much water.

In most cases, as food moves through your colon, the colon absorbs water while it
makes stool. Muscle movements (contractions) push the stool toward your rectum. When
the stool gets to the rectum, most of the water has been soaked up. The stool is now
solid.

If you have constipation, your colon’s muscle movements are too slow. This makes the
stool move through your colon too slowly. The colon absorbs too much water. The stool
gets very hard and dry.

Some of the most common diet and lifestyle causes of constipation are:

  • Not getting enough exercise
  • Not drinking enough liquids
  • Not eating enough fiber
  • Not
    moving your bowels when you feel the urge to
  • Changes in your lifestyle, such as travel, pregnancy, and old age

Other causes of constipation include:

  • Medicines
  • A problem with how your stomach and bowels work (such as irritable bowel syndrome)
  • Your intestine does not work well
  • Taking too many medicines that help to loosen your bowels (laxatives)
  • Metabolic problems such as thyroid disease
  • Intestinal blockage

What are the symptoms of constipation?

Each person’s symptoms may vary. Symptoms of constipation may include:

  • Difficult and painful bowel movements
  • Less
    than 3 bowel movements a week
  • Feeling
    bloated
  • Not
    having much energy
  • Belly
    (abdominal) pain
  • Ineffective straining to move your bowels

The
symptoms of constipation can look like other health problems. Always talk with your
healthcare provider to be sure.

How is constipation diagnosed?

Most people have constipation at one time or another. To see if you have constipation,
your healthcare provider will do several tests. These tests will depend on how long
you have had symptoms and how serious your case is.

First your healthcare provider will look at:

  • Your age
  • If you have any blood in your stool
  • Any changes in your bowel habits
  • Weight loss

Your healthcare provider will likely:

  • Ask about
    your past health.
    You will be asked to give details about your constipation,,
    such as how long you have had symptoms and how often you have bowel movements.
  • Give you a
    physical exam.
    Your healthcare provider will do a full physical exam.
  • Give you a
    digital rectal exam.
    This exam helps tell if the area is soft, blocked, or
    bloody. It can also check how much and what kind of stool you have. Your healthcare
    provider will also see if your rectum is bigger than normal.

Your healthcare provider may also do other tests such as:

  • Abdominal
    X-ray.
    This X-ray test can show the fullness of the bowels.
  • Blood
    work.
    Blood is taken for testing.
  • Lower GI
    series (also called barium enema).
    This is an X-ray exam of your rectum, the
    large intestine, and the lower part of your small intestine. You will be given a
    fluid called barium. It coats the organs, so that they can be seen on an X-ray. An
    X-ray of your belly will show if you have any narrowed areas (strictures), blockages,
    or other problems.
  • Colonoscopy.This test looks at the full length of your large intestine. It
    can help check for any abnormal growths, tissue that is red or swollen, sores
    (ulcers), or bleeding.
  • Sigmoidoscopy.This test lets your healthcare provider check the inside of
    part of your large intestine. It helps to tell what is causing constipation.
  • Colorectal
    transit study.
    This test shows how long it takes for food to move through your
    colon. You will be asked to swallow pills (capsules) filled with small markers that
    can be seen on an X-ray. The X-rays will show how the capsules moved through your
    colon.
  • Anus and
    rectum (anorectal) function tests.
    These tests can tell if you are constipated
    because your anus or rectum is not working well.

How is constipation treated?

Your healthcare provider will come up with a care plan for you based on:

  • Your age, overall health, and past health
  • How serious your case is
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • Your opinion and what you want to do

In most cases, diet and lifestyle changes can help reduce constipation symptoms. They
can also stop it from happening. These changes may include:

  • Drinking
    more water and juice.
  • Getting
    regular exercise.
  • Giving
    yourself time to have a bowel movement each day.
  • Eating more
    fiber.
  • Taking
    laxatives.
  • Stopping or
    changing medicine.
  • Doing
    biofeedback (part of a special physical therapy program)

Foods

Moderate fiber

High fiber

Bread

Whole-wheat bread, granola bread, wheat bran muffins, grain bars, waffles, popcorn

Cereal

100% whole-grain cereals, oatmeal, granola, and oat bran

100% bran cereals

Vegetables

Beets, broccoli, Brussels sprouts, cabbage, carrots, corn, green beans, green peas,
acorn and butternut squash, spinach, potato with skin, avocado

Fruits

Apples with peel, dates, papayas, mangoes, nectarines, oranges, pears, kiwis, strawberries,
applesauce, raspberries, blackberries, raisins

Cooked prunes, dried figs

Meat substitutes

Peanut butter, nuts

Baked beans, black-eyed peas, garbanzo beans, lima beans, pinto beans, kidney beans,
chili with beans, trail mix

What are possible complications of
constipation?

Constipation can cause other health problems such as:

  • Hemorrhoids.  Red, swollen veins in the rectum. They happen when you need to
    keep straining to have a bowel movement.
  • Anal
    fissures. 
    Tears in the skin around the anus. They happen when hard stool
    stretches your sphincter muscle. They can cause bleeding in your rectum.
  • Rectal
    prolapse. 
    This is when a small amount of your intestinal lining pushes out
    from your anal opening. It is caused by straining to have a bowel movement.
  • Fecal
    impaction.
    This is when a large lump of hard, dry stool stays stuck in your
    rectum. The colon’s normal pushing action can’t push out the stool. This is seen
    mostly in children and older adults.

Can constipation be prevented?

Many of the same lifestyle changes that help treat constipation may also help to stop
it from happening:

  • Have plenty of fiber, water, and liquids each day.
  • Get regular exercise.
  • Allow
    plenty of time for bowel movements. When you feel the urge to have a bowel movement,
    be sure to do it.
  • Try to have a bowel movement at the same time each day.
  • If another health problem makes you more likely to have constipation, take your healthcare
    provider’s advice for treating that problem.

When should I call my healthcare provider?

Most people have constipation at one time or another. But call your healthcare provider
if:

  • Constipation lasts longer than 3 weeks.
  • Constipation pain is stopping you from doing your daily activities.
  • You have symptoms of any of the complications of constipation.

Key points about
constipation

  • Constipation is the most common GI (gastrointestinal) problem.
  • You may be constipated when your stools are painful and happen less than 3 times a
    week.
  • Your stool will be hard, dry, and in small pieces.
  • Your stools get hard and dry when your colon absorbs too much water.
  • Constipation symptoms can include stomach cramps and feeling tired.
  • Constipation can cause other health problems such as hemorrhoids (red, swollen veins
    in the rectum).
  • Making diet and lifestyle changes can reduce constipation symptoms. These changes
    can also stop constipation from happening.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Before your visit, write down questions you want answered.
  • Bring
    someone with you to help you ask questions and remember what your healthcare provider
    tells you.
  • At the
    visit, write down the names of new medicines, treatments, or tests, and any new
    instructions your healthcare provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that
    visit.
  • Know
    how you can contact your healthcare provider if you have questions.

Medical Reviewer: Raymond Kent Turley BSN MSN RN

Medical Reviewer: L Renee Watson MSN RN

Medical Reviewer: L Renee Watson MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Constipation – Illnesses & conditions

Treatment for constipation depends on the cause, how long you’ve had it and how severe your symptoms are.

In many cases, it’s possible to relieve the symptoms by making dietary and lifestyle changes.

The various treatments for constipation are outlined below. 

Lifestyle advice

Changes to diet and lifestyle are often recommended as the first treatment for constipation. In many cases, this will improve the condition without the need for medication.

Some self-help methods of treating constipation are listed below:

  • Increase your daily intake of fibre. You should eat at least 18-30g of fibre a day. High-fibre foods include plenty of fresh fruit and vegetables and cereals.
  • Add some bulking agents, such as wheat bran, to your diet. This will help to make your stools softer and easier to pass.
  • Avoid dehydration by drinking plenty of water.
  • Exercise more regularly – for example, by going for a daily walk or run.
  • If constipation is causing pain or discomfort, you may want to take a painkiller, such as paracetamol. Always follow the dosage instructions carefully. Children under 16 shouldn’t take aspirin.
  • Keep to a routine (a place and time of day) when you’re able to spend time on the toilet. Respond to your bowel’s natural pattern: when you feel the urge, don’t delay.
  • Try resting your feet on a low stool while going to the toilet, so that your knees are above your hips; this can make passing stools easier.  
  • If medication you’re taking could be causing constipation, your GP may be able to prescribe an alternative.

Read about preventing constipation for more ways to change your diet and lifestyle.

Your pharmacist may recommend an oral laxative if diet and lifestyle changes don’t help.

Laxatives

Laxatives are a type of medicine that help you pass stools. There are several different types of laxative and each one has a different effect on your digestive system.

Bulk-forming laxatives

Your pharmacist will usually start you on a bulk-forming laxative. These work by helping your stools to retain fluid. This means they’re less likely to dry out, which can lead to faecal impaction. Bulk-forming laxatives also make your stools softer, which means they should be easier to pass.

Commonly prescribed bulk-forming laxatives include ispaghula husk, methylcellulose and sterculia. When taking this type of laxative, you must drink plenty of fluids, and don’t take them before going to bed. It will usually be 2 to 3 days before you feel the effects of a bulk-forming laxative.

Osmotic laxatives

If your stools remain hard after you’ve taken a bulk-forming laxative, your pharmacist may prescribe an osmotic laxative instead. Osmotic laxatives increase the amount of fluid in your bowels. This softens your stools and stimulates your body to pass them.

Commonly prescribed osmotic laxatives include lactulose and macrogols. As with bulk-forming laxatives, make sure you drink enough fluids. It will usually be 2 to 3 days before you feel the effect of the laxative.

Stimulant laxatives

If your stools are soft, but you still have difficulty passing them, your pharmacist may recommend a stimulant laxative. This type of laxative stimulates the muscles that line your digestive tract, helping them to move stools and waste products along your large intestine to your anus.

The most commonly prescribed stimulant laxatives are senna, bisacodyl and sodium picosulphate. These laxatives are usually only used on a short-term basis, and they start to work within 6 to 12 hours.

According to your individual preference and how quickly you need relief, your pharmacist may decide to combine different laxatives.

How long will I need to take laxatives for?

If you’ve had constipation for a short time, your pharmacist will usually advise you to stop taking the laxative once your stools are soft and easily passed.

However, if your constipation is caused by an underlying medical condition or a medicine you’re taking, your GP may advise you to take laxatives for much longer, possibly many months or even years.

If you’ve been taking laxatives for some time, you may have to gradually reduce your dose, rather than coming off them straight away. If you have been prescribed a combination of laxatives, you’ll normally have to reduce the dosage of each laxative, one at a time, before you can stop taking them. This can take several months.

Your GP will advise you about when it’s best to stop taking long-term laxatives. 

Treating faecal impaction

Faecal impaction occurs when stools become hard and dry and collect in your rectum. This obstructs the rectum, making it more difficult for stools to pass along.

Sometimes as a result of impaction, overflow diarrhoea may occur (where loose stools leak around the obstruction). You may have difficulty controlling this.

If you have faecal impaction, you’ll initially be treated with a high dose of the osmotic laxative macrogol. After a few days of using macrogol, you may also have to start taking a stimulant laxative.

If you don’t respond to these laxatives, and/or if you have overflow diarrhoea, you may need one of the medications described below.

  • Suppository – this type of medicine is inserted into your anus. The suppository gradually dissolves at body temperature and is then absorbed into your bloodstream. Bisacodyl is an example of a medication that can be given in suppository form.
  • Mini enema – where a medicine in fluid form is injected through your anus and into your large bowel. Docusate and sodium citrate can be given in this way.

Pregnancy or breastfeeding

If you’re pregnant, there are ways for you to safely treat constipation without harming you or your baby. Your pharmacist will first advise you to change your diet by increasing fibre and fluid intake. You’ll also be advised to do gentle exercise.

If dietary and lifestyle changes don’t work, you may be prescribed a laxative to help you pass stools more regularly.

Lots of laxatives are safe for pregnant women to use because most aren’t absorbed by the digestive system. This means that your baby won’t feel the effects of the laxative.

Laxatives that are safe to use during pregnancy include the osmotic laxatives lactulose and macrogols. If these don’t work, your pharmacist may recommend taking a small dose of bisacodyl or senna (stimulant laxatives).

However, senna may not be suitable if you’re in your third trimester of pregnancy, because it’s partially absorbed by your digestive system.

Read more about constipation and other common pregnancy problems.

Babies who haven’t been weaned

If your baby is constipated but hasn’t started to eat solid foods, the first way to treat them is to give them extra water between their normal feeds. If you’re using formula milk, make the formula as directed by the manufacturer and don’t dilute the mixture.

You may want to try gently moving your baby’s legs in a bicycling motion or carefully massaging their tummy to help stimulate their bowels.

Babies who are eating solids

If your baby is eating solid foods, give them plenty of water or diluted fruit juice. Try to encourage them to eat fruit, which can be puréed or chopped, depending on their ability to chew. The best fruits for babies to eat to treat constipation are:

  • apples
  • apricots
  • grapes
  • peaches
  • pears
  • plums
  • prunes
  • raspberries
  • strawberries

Never force your baby to eat food if they don’t want to. If you do, it can turn mealtimes into a battle and your child may start to think of eating as a negative and stressful experience.

If your baby is still constipated after a change in diet, they may have to be prescribed a laxative. Bulk-forming laxatives aren’t suitable for babies, so they’ll usually be given an osmotic laxative. However, if this doesn’t work, they can be prescribed a stimulant laxative.

Children

For children, laxatives are often recommended alongside changes to diet. Osmotic laxatives are usually tried first, followed by a stimulant laxative if necessary.

As well as eating fruit, older children should have a healthy, balanced diet, which also contains vegetables and wholegrain foods, such as wholemeal bread and pasta.

Try to minimise stress or conflict associated with meal times or using the toilet. It’s important to be positive and encouraging when it comes to establishing a toilet routine. Allow your child at least 10 minutes on the toilet, to make sure they’ve passed as many stools as possible.

To encourage a positive toilet routine, try making a diary of your child’s bowel movements linked to a reward system. This can help them focus on using the toilet successfully.

Symptoms, Treatment and When to Call a Doctor

Constipation (con-sta-PA-shun) in infants less than one year of age is common, but it can be a source of concern for parents. Sometimes your baby is not really constipated, but must be given time to set his own schedule for having a bowel movement. Normally, an infant’s stool is soft and easily passed. Even if an infant is not constipated, his bowel movements may be irregular.

In rare cases, constipation may be caused by a lack of nerves or by structural problems in the lower large intestine. Your baby can be tested for these conditions if your doctor feels it is necessary.

Signs of Constipation

  • Infrequent stools that are difficult to pass
  • Straining more than normal to have a bowel movement
  • Stools formed like small, hard small pebbles, stools that are soft and mushy; stools that are wide and large
  • Liquid stool (like diarrhea) that may be passing around solid stool that stays inside
  • Abdomen (belly) swollen with gas
  • Painful cramps 

Treatment

  • If your baby is old enough to eat strained foods, you may give him fruits and vegetables.
  • If your baby is not eating jar baby food yet, you may give 2 to 4 ounces of fruit juices (prune, pear, cherry, or apple) per day. If his stools become too loose, give less juice to your baby.
  • If your baby is eating rice cereal, it may help to switch to oatmeal or barley cereal. Rice cereal can cause constipation in some children.
  • Do not give your baby enemas, laxatives, or suppositories unless you are told to do so by the doctor.

Medical Therapy

Your doctor has ordered the following treatments:

  • Give your child the following medicine: _______________________.
  • Check your child’s temperature by rectum using a lubricated rectal thermometer. This may stimulate the baby to pass stool. 

When to Call the Doctor

Call your child’s doctor if any of the following occurs:

  • Your baby is irritable and seems to be having abdominal pain.
  • You see blood in your baby’s stool.
  • Your baby’s constipation does not improve with current treatment.

If you have any questions or concerns, call your baby’s doctor at ___________________. 

Constipation: Infant (PDF)

HH-I-14 7/84, Revised 3/14 Copyright 1984, Nationwide Children’s Hospital

Constipation in Children – HealthyChildren.org

Constipation is a common problem in children. Children with constipation have stools (also called poops or bowel movements—BMs) that are hard, dry, and difficult or painful to get out. Some children with constipation have infrequent stools. Although constipation can cause discomfort and pain, it’s usually temporary. If left untreated, symptoms could get worse.

Read on for more information about constipation (signs and symptoms, causes, treatment) and how to help your child develop good bowel habits.

What is a normal bowel pattern?

Bowel patterns (when and how often stools are passed) vary from child to child just as they do in adults. What’s normal for your child may be different from what’s normal for another child. Most children have BMs 1 or 2 times a day. Other children may have BMs every 2 to 3 days.

What are signs and symptoms of constipation?

Signs and symptoms of constipation may include

  • Hard or painful stools

  • Many days between BMs​

  • Bleeding from the child’s bottom where stool comes out

  • Stomachaches, cramping, and nausea

  • Soiling (brownish wet spots in the underwear) (See “What is encopresis?” below.)

Your child may also

  • Have BMs that stop up the toilet.

  • Make faces while they pass a BM, as if they are in pain.

  • Clench their bottom when having a BM. Although this behavior may look like your child is trying to push the stool out, they may be really trying to hold it in because it hurts to come out.

Call or schedule a visit with your child’s doctor if your child doesn’t have a BM at least every 2 to 3 days or if passing a stool hurts your child.

What is encopresis?

Sometimes a child with bad constipation may pass BMs that look like diarrhea. When a child holds back stools, the stools build up and get bigger. They may get so big that the rectum stretches. Then the child may not feel the urge to go to the bathroom. The stool gets too big to pass without an enema, laxative, or other treatment.

Sometimes only liquid stool or solid smears can come out, and they leak onto the underwear. This is called

encopresis. Talk with your child’s doctor about treatment. It can get better, but it takes months.

What causes constipation?

Here are some causes of constipation.


  • Holding back, or withholding, stool.

    • Your child may not want to have a BM for different reasons.

    • Your child may try not to go because it hurts to pass a hard stool. (Diaper rashes can make this worse.)

    • Children aged 2 to 5 years may want to show they can decide things for themselves. Holding back their stools may be their way of taking control. This is why it is best not to push children into toilet training.

    • Sometimes children don’t want to stop playing to go to the bathroom.

    • Older children may hold back their stools when away from home (such as camp or school). They may be afraid of or not like using public toilets.


  • Illness. If your child is sick and loses his appetite, a change in his diet can throw off his system and cause him to be constipated. Constipation may be a side effect of some medicines or may result from certain medical conditions, such as
    hypothyroidism (underactive thyroid gland).


  • Diet. Not enough fiber or liquid in your child’s diet doesn’t cause constipation. However, not consuming enough of the recommended amounts of healthy foods from the 5 food groups, including foods that are good sources of fiber, may affect your child’s bowel patterns. (See the How much fiber does my child need? section.)


  • Other changes. In general, any changes in your child’s routine, such as traveling, hot weather, or stressful situations, may affect his overall health and how his bowels function.

How is constipation treated?

Treatment is based on your child’s age and how bad the problem is. Usually no special tests are needed.

Constipation can get worse if it isn’t treated. The longer stool stays inside the large intestine (or colon), the larger and drier it gets. Then it hurts to pass it. This starts a cycle. The child becomes afraid to have a BM and holds it in even more.

For babies

Constipation is not commonly a problem in babies. It may become a problem when starting solid foods, and your doctor may suggest changes in diet or prescribe a medicine to help soften and pass the stools. Inability to pass stools in a newborn (younger than 1 month) can be a serious concern, and you should see your baby’s doctor.

For children and teens

Your child’s doctor may prescribe medicine to soften or remove the stool. Do not give your child laxatives or enemas unless you check with the doctor. These drugs can be harmful to children if used wrong.

After the stool is removed, your child’s doctor may suggest ways you can help your child develop good bowel habits to prevent stools from backing up again.

How can I help my child develop good bowel habits?

Here are tips to help your child develop good bowel habits.

  • Help your child set a toilet routine. Pick a regular time to remind your child to sit on the toilet daily (such as after breakfast). Put something under your child’s feet to press on. This makes it easier to push BMs out.

  • Make sure your child is consuming the recommended amounts of healthy foods from the 5 food groups, including foods that are good sources of fiber.

  • Encourage your child to play and be active.

How much fiber does my child need?

There are different fiber recommendations for children based on energy needs, age, and weight. A normal fiber intake is recommended in children with constipation. The following can be useful strategies:


  • Eat 5! A simple way to make sure your child is getting enough fiber is by making healthful food choices. If your child is eating at least 5 servings of fruits and vegetables each day along with other foods that are good sources of fiber, there is really no need to count fiber grams.


  • Add 5! If you find it helpful to keep track of total grams of fiber that your child is eating, add 5 to your child’s age. For example, a 5-year-old would need about 10 grams of fiber each day. (The total daily recommended amount of up to 25 grams for adults can be used as a general guideline for children.) Some foods are high in fiber. Beans, vegetables, fruits, and whole grains are good sources of fiber.

Remember

If you have any questions or concerns about your child’s health, contact your child’s doctor.

More information


The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Constipated Diarrhea – About IBS

Can a person have “constipated diarrhea”?

Question – Has anyone else experienced ‘constipated diarrhea’? I have been dealing with IBS for about 10 years. My symptoms are constant and occur daily and include bloating, gas, and constipation. Strangely enough, more times than not I experience what I refer to as ‘constipated diarrhea.’ I found it disturbing that the doctors I visited wanted to know if I was either constipated or if I experienced diarrhea. My IBS (as I’m sure is most of yours) cannot be so easily classified as one or the other. [Taken from ‘Personal Stories,’ a feature on IFFGD’s web sites; this question and story appeared on www.aboutIBS.org.]

Answer – “Pain and/or discomfort related to a change in bowel habits are the main symptoms of irritable bowel syndrome (IBS). These changes are described by the terms “diarrhea” and “constipation”. The commonly used terms diarrhea and constipation mean different things to different people and this applies to healthcare providers as well. However, bowel symptoms affect treatment choices. It is important that you and your healthcare provider communicate clearly about your symptoms and how they affect your life.”

– Douglas A. Drossman, MD

How do we ‘translate’ bowel symptoms in a meaningful way?

Constipation is a cluster of symptoms which can mean having infrequent stools of any kind. Constipation is commonly described by the passing of hard pellet-like stools.

This can also include bowel movements (BMs) that happen less often, or three or fewer times in a week. People often have difficulty or straining when passing a BM, feel unable to completely empty during a BM, or they feel that they need to go but are not able to have a BM. The rectum is the final section of the large intestine where BMs are stored before being emptied.

Diarrhea is defined as loose, watery, or frequent bowel movements. Everyone has had experience with diarrhea, the passage of liquid stools. For most people, it is a symptom that lasts for a couple days, then resolves suddenly, typically within one week. These acute episodes usually are due to infections resulting from consuming contaminated food or drink. The average American has an episode of acute diarrhea every few years. For other people, diarrhea may be a more chronic problem, occurring for months to years. About 5% of the population has diarrhea lasting more than a month in any year

So, while it may seem strange to have “constipated diarrhea,” it is not that uncommon. If you have loose stools, but also have difficulty having a BM or feel you have trouble completely emptying, then it makes sense.

It is important to note that some people will experience “constipated diarrhea” due solely to constipation. “Loose stool overflow” occurs when hard stool becomes impacted (stuck) in the rectum and is not easily passed. The stool in the higher portion of the colon remains soft and leaks around the hard stool. The person experiences what they recognize as diarrhea since the stools are loose. 

It is also important to remember that your bowel patterns may change over time. One person’s IBS might be different from another individual’s IBS. It is always important to maintain a working relationship with medical and support teams to obtain help when symptoms change.

Learn more about ways to talk to your healthcare provider

 

Adapted from IFFGD Publication #265 “Constipated Diarrhea” By: Douglas A. Drossman, M.D., Drossman Gastroenterology PLLC, Chapel Hill, NC; Updated by: Eric D. Shah, MD, MBA Assistant Professor of Medicine, Geisel School of Medicine, Dartmouth, Lebanon, NH; Edited by: Darren Brenner, MD, Associate Professor of Medicine and Surgery, Northwestern University, Chicago, IL

Constipation in Children | Causes and Treatment

Your child’s bowels – what is normal?

Parents often become very worried about their child’s bowel habit. This anxiety can start when the child is a baby, with concern over the number of dirty nappies. The main thing to realise is that every child is different. Normal can vary quite a bit. Often, it is a change in what is normal for your child that suggests a problem.

Babies will open their bowels anything from several times per day, to once every few days. The frequency of bowel movements is not very important. What is important is that the stools (faeces) are soft and easily passed.

Breast-fed babies tend to pass runnier, mustard yellow-coloured stools. This is because breast milk is better digested than bottle feeds (infant formula). Newborn breast-fed babies may open their bowels with every feed. However, it is also normal for a breast-fed baby to go up to a week without a bowel movement.

Bottle-fed babies often need to open their bowels daily, as the stools are bulkier. Bottle-fed baby stools smell worse (more like an adult’s).

It is not uncommon for your baby’s stools to vary in colour and consistency from day to day. Any prolonged change to harder, less frequent stools might mean constipation.

As babies are weaned to solid foods, their stools will change in colour and smell. The frequency may again change. Generally, the stools become thicker, darker and a lot more smelly. You will notice that your baby’s stools will alter depending upon what you have fed him or her. Some high-fibre foods, such as raisins, may even pass through your baby’s bowels virtually unchanged, appearing in the nappy at the next change.

As your baby grows up, into a toddler and then a young child, you may see further changes in their stool frequency and consistency, often dependent on what they are eating.

Your child’s bowels – what is abnormal?

As you can see, there is great variation in a child’s bowel habit, dependent on their age and what they are fed. As already mentioned, it is often a change in what is normal for your child that suggests a problem. Anything from three times a day to once every other day is common and normal. Less often than every other day means that constipation is likely. However, it can still be normal if the stools (faeces) are soft, well formed and passed easily.

It may be normal for your baby to go a bit red in the face when straining to pass a stool. This on its own does not necessarily mean they are constipated. Breast-fed babies seldom become constipated, as breast milk contains exactly the right balance of nutrients to keep the stools soft and easily passed.

Diarrhoea usually means very runny stools, often passed more frequently than normal. Breast-fed babies have diarrhoea less frequently than other babies, as breast milk has a protective effect against the germs that can cause diarrhoea.

What are the symptoms of constipation?

Constipation in children or babies can mean any, or all, of the following:

  • Difficulty or straining when passing stools.
  • Pain when passing stools, sometimes with a tiny amount of blood in the nappy or on the toilet paper, due to a small tear in the skin of the back passage (anus).
  • Passing stools less often than normal. Generally, this is less than three complete (proper) stools per week.
  • Stools that are hard and perhaps very large, or pellet-like and small, like rabbit droppings.

As well as less frequent, hard (and perhaps painful) stools, constipation can cause:

  • Tummy ache (abdominal pain).
  • Poor appetite.
  • Feeling ‘off colour’ (general malaise).
  • Behavioural changes, such as being more irritable or unhappy.
  • Fidgeting, restlessness and other signs that the child needs to go to the toilet.
  • Feeling sick (nausea).

Severe constipation can cause impaction, where a very large stool is stuck in the lower gut, usually just above the anus, in the section called the rectum. This can cause further symptoms. In particular, this can cause a child to soil their pants regularly with very soft faeces, or with faecal-stained mucus. This is often mistaken by parents as diarrhoea. Impaction is discussed in detail later.

What is the treatment for constipation in children?

(Note: this section refers to treatment of idiopathic constipation – the most common type of constipation in children, where there is no known cause. Other types of constipation are explained later.)

Dr Sarah Jarvis MBE

Laxatives

Idiopathic constipation that has lasted for more than a few days is usually treated with laxatives. Your doctor will advise on the type and strength needed. This may depend on factors such as the age of the child, the severity of the constipation and the response to the treatment. Laxatives for children commonly come either as sachets or a powder that is made up into a drink, or as liquid/syrup. The laxatives used for children are broadly divided into two types.

  • Macrogols (also called polyethylene glycols) are a type of laxative that pulls fluid into the bowel, keeping the stools (faeces) soft. They are also known as osmotic laxatives. For example, Movicol® Paediatric Plain is one brand that is commonly used first. This is mixed into water to make a drink to which cordial, such as blackcurrant squash, can be added to make it taste nicer. Lactulose is another type of osmotic laxative, acting as a stool softener.
  • Stimulant laxatives. These encourage (stimulate) the bowel to pass the stools out. There are several different types of stimulant laxative. Sodium picosulfate, bisacodyl, senna and docusate sodium are all examples. Docusate works as a stool softener as well as a stimulant. A stimulant laxative tends to be added in addition to a macrogol if the macrogol is not sufficient on its own.

Laxatives are normally continued for several weeks after the constipation has eased and a regular bowel habit has been established. This is called maintenance treatment. So, in total, the duration of treatment may be for several months. Do not stop the prescribed laxatives abruptly. Stopping laxatives abruptly might cause the constipation to quickly recur. Your doctor will normally advise a gradual reduction in the dose over a period of time, depending on how the stools have become in their consistency and frequency. Some children may even require treatment with laxatives for several years.

Treatment of impaction – if needed

Similar treatments to those listed above are used. The main difference is that higher doses of laxatives are needed initially to clear the large amount of faeces blocking the last part of the bowel (the rectum). Secondly, laxatives are also usually needed for much longer, as maintenance treatment. The aim is to prevent a build-up of hard stools recurring again, which will prevent impaction returning. The enlarged rectum can gradually get back to a normal size and function properly again.

If laxatives are stopped too soon, a large stool is likely to recur again in the weakened ‘floppy’ rectum which has not had time to get back to a normal size and strength.

Treatment to clear impacted stools from the rectum can be a difficult time for you and your child. It is likely that your child will actually have a few more tummy pains than before and that there will be more soiled pants. It is important to persevere, as these problems are only temporary. Clearing the impacted stools is an essential part of treatment.

In rare instances, where treatment of impacted stools has failed, a child may be treated in hospital. In hospital, stronger medicines to empty the bowel, called enemas, can be given via the rectum. For very hard to treat cases, a child can have a general anaesthetic and the bowel can be cleared out manually by a surgeon.

Diet

Dietary measures should not be used on their own to treat idiopathic constipation, as it will be unlikely to solve the problem. However, it is still important to get a child into a habit of eating a good balanced diet. This is to include plenty of drinks (mainly water) and foods with fibre. This will help to prevent a recurrence of constipation once it has cleared.

Does my child need any tests?

Tests are not normally needed to diagnose idiopathic constipation. Your GP is likely to ask various questions and do a general examination to rule out secondary causes of constipation. By examining your child’s tummy (abdomen), a GP can tell if there are lots of stools (faeces) in the bowel. This can give an indication if blockage (impaction – discussed later) has developed. If an underlying cause of constipation is suspected, your GP will refer your child to a children’s doctor (a paediatrician) and further tests may be done. 

How can constipation in children be prevented?

Eating foods with plenty of fibre and drinking plenty makes stools (faeces) that are bulky but soft and easy to pass out. Getting plenty of exercise is also thought to help.

Food and fibre

This advice applies to babies who are weaned and to children. Foods which are high in fibre are fruit, vegetables, cereals and wholemeal bread. A change to a high-fibre diet is often ‘easier said than done’, as many children are fussy eaters. However, any change is better than none. Listed below are some ideas to try to increase your child’s fibre intake:

  • A meal of jacket potatoes with baked beans, or vegetable soup with bread.
  • Dried (or semi-dried) apricots or raisins for snacks.
  • Porridge or other high-fibre cereals (such as Weetabix®, Shredded Wheat® or All Bran®) for breakfast.
  • Offer fruit with every meal – perhaps cut up into little chunks to make it look more appealing.
  • Add extra vegetables to dishes being blitzed with a blender or food processor (for example, Bolognese sauces or soups.
  • Use wholemeal/brown versions of bread, pasta and rice.
  • Add powdered bran to yoghurt. The yoghurt will feel grainy, but powdered bran is tasteless.

The Association of UK Dietitians recommends normal daily fibre intake (from the age of 2 years) should be as follows:

  • Age 2-5: 15 g fibre per day
  • Age 6-11: 20 g fibre per day
  • Age 12-15: 25 g fibre per day
  • Age 16+: 30 g fibre per day

If you aim for a healthy balanced diet, using wholemeal versions of carbohydrates and 5 portions of fruit/vegetables per day, you should achieve this without having to count.

Drink

If a bottle-fed baby has a tendency to become constipated, you can try offering water between feeds. (Never dilute infant formula milk that is given to bottle-fed babies.) Although it is unusual for a breast-fed baby to become constipated, you can also offer water between feeds. Older, weaned babies can be given diluted fruit juice (preferably without added sugar). Puréed fruit and vegetables are the usual starting points for weaning, after baby rice, and these are good for preventing constipation.

Encourage children to drink plenty. However, some children get into the habit of only drinking squash, fizzy drinks or milk to quench their thirst. These may fill them up and make them less likely to eat proper meals with food that contains plenty of fibre. Try to limit these kinds of drinks. Give water as the main drink. However, fruit juices that contain fructose or sorbitol have a laxative action (such as prune, pear, or apple juice). These may be useful from time to time (at meal times) if the stools become harder than usual and you suspect constipation may be developing.

Toileting tips

  • Try to get children into a regular toilet habit. After breakfast, before school or nursery, is often best. Try to allow plenty of time so they don’t feel rushed.
  • Toilet training should be relaxed. Talk with your child about what is happening, explain what you are doing when changing nappies or pants so they understand about ‘wee’ and ‘poo’. Explain what the potty is for. Try to avoid getting upset if they have an accident.
  • Encouraging your child is helpful. Some kind of reward system is sometimes useful in younger children prone to holding on to stools. You could give a small treat, or use stickers or star charts to reinforce the message.
  • Praise your child for passing a stool in the potty or toilet but do not punish accidents. It is easy to become frustrated with soiled pants or a child who refuses to pass a stool.
  • Try to keep calm and not make a fuss over the toilet issue. If your child can see that you are stressed or upset, they will pick up on this feeling; the toileting issue can then become even more of a fraught battle. The aim is to be ‘matter of fact’ and relaxed about it.
  • Once they move on to sitting on the toilet, make sure this is manageable – steps and training seats are available. Boys may need to be reminded to sit on the toilet every day to do a poo if they have started to stand to do a wee.

Types of constipation in children and babies

  • Idiopathic constipation. This is common. The word idiopathic means of unknown cause. Various factors may be involved (discussed later) but many children become constipated for no known reason:
    • Short bouts of constipation. It is common for children and babies to have a bout of mild constipation for a day or so. This may settle quickly, often without the need for medical treatment.
    • Long-term constipation. In about 1 in 3 children who become constipated, the problem becomes more long-term (persistent). This is also called chronic idiopathic constipation.
  • Constipation due to an underlying disease or condition. This is uncommon. The constipation is said to be secondary to this other problem. Some examples of conditions and problems that can cause constipation are:

Treatment may involve treating the underlying condition (if that is possible) in addition to tackling the constipation. Worrying symptoms or signs that may indicate a secondary cause include the following. These should be mentioned to your GP. It is also possible that some of these symptoms could mean your child is more seriously unwell:

  • Being sick (vomiting).
  • Weight loss or failure to gain weight (thrive).
  • A swollen, stretched tummy.
  • Severe pain.
  • A baby who does not pass a first stool (called meconium) within the first 48 hours of life.
  • Abnormalities of the back passage (anus) – for example, if it is closed over.
  • Nervous system (neurological) problems such as weak or paralysed legs.
  • Sores or ulcers near the anus.
  • Excessive thirst.
  • Urinary symptoms – such as passing huge volumes of urine, urine that is very dark or painful urination with smelly urine.
  • Very pale-coloured stools (especially if the urine is very dark too)

What causes idiopathic constipation?

Idiopathic means that there is no disease or known cause for the constipation. However, it is thought that various factors may contribute to constipation developing, or may make it worse. These include diet, stool (faeces) holding and emotional factors.

Diet

Dietary factors that may play a part in constipation are:

  • Not eating enough foods with fibre (the roughage part of the food that is not digested and stays in the gut).
  • Not having enough to drink.

Stools tend to become harder, drier, and more difficult to pass if there is little fibre and fluid in the gut.

Stool holding or withholding behaviour

This means the child has the feeling of needing the toilet but resists it. The child holds on to the stool, trying to ignore the desire to empty the bowels. This is quite common. You may see your child crossing their legs, sitting on the back of the heels, or doing similar things to help resist the feeling of needing the toilet. Your child may clench his or her buttocks to try to stop the stool from coming out and may seem quite fidgety. Sometimes it seems as though your child is straining to poo, whereas in fact they are straining to hold it in. You may notice smudges of stool on your child’s pants, often when they are unable to hold on any longer. The longer the child holds on, the bigger the stool gets. Eventually the child has to go but the large stool is more difficult to pass and often more painful. This may lead to a bit of a vicious cycle where the child is even more reluctant to open his or her bowels the next time. There are a number of reasons why children may hold on to stools:

  • A previous stool that they passed may have been a struggle or painful. So, they try to put off doing it again.
  • Their back passage (anus) may be sore or have a crack (anal fissure) from passing a previous large stool. It is then painful to pass further stools. So, the child may resist the urge to pass a stool.
  • They may have a dislike of unfamiliar or smelly toilets, such as at school or on holiday. The child may want to put things off until they get home.

Emotional problems

Constipation problems may be made worse with upset due to change in surroundings or routine. Common examples are moving house and starting nursery. Potty training may be a factor if a child becomes scared of using the potty. Fears and phobias are usually the underlying reasons for these problems.

What is idiopathic constipation with impaction?

Impaction means that the bowel is, in effect, blocked by a large amount of hard stool (faeces). Idiopathic constipation with impaction most commonly develops in children between the ages of 2 and 4 years; however, older or younger children can be affected. Symptoms and features include:

  • Recurrent episodes when the child is uncomfortable or distressed trying to pass a stool.
  • The child soils their pants regularly with very soft faeces, or with faecal-stained mucus. This is often mistaken by parents as diarrhoea.
  • The child may also become irritable, not eat much, feel sick, have tummy pains from time to time and generally be out of sorts.
  • A doctor can often feel a backlog of hard, lumpy stools when he or she examines the child’s tummy (abdomen).  

The diagram below shows how a child may develop impaction, and the symptoms this may cause.

 

  • Normally, stools build up in the lowest part of the bowel.
  • When stools accumulate, they start to pass into the last part of the bowel (the rectum), which stretches. This sends nerve messages to the brain, telling you that you need to empty your bowels.
  • If the stool is not passed out then more stools from higher up also reach the rectum.
  • Eventually, large hard stools may build up in the rectum.
  • The rectum may then stretch and enlarge (dilate) much more than normal, to cope with the excessive amount of stools.
  • A very large stool may develop and become stuck (impacted) in an enlarged rectum.
  • If the rectum remains enlarged then the normal sensation of needing the toilet is reduced. The power to pass out a large stool is also reduced (the rectum becomes ‘floppy’).
  • More stools build up in the colon behind the impacted stool in the rectum.
  • The lowest part of an impacted stool lies just above the back passage (anus). Some of this stool becomes runny (liquefies) and leaks out of the anus. This soils the child’s pants or bedclothes. Also, some softer, more liquid stools from higher up the colon may bypass around the impacted hard stool. This also leaks out and soils the pants or bedclothes and can be mistaken for diarrhoea. The child has no control of this leaking and soiling.
  • When a stool is eventually passed, because the rectum is distended and weakened, it simply fills up fairly quickly again with more hard stool from the backlog behind.

For information on constipation affecting adults, see the separate leaflet called Constipation.

90,000 Constipation: how to recognize and what to do? | STADA

Constipation: how to recognize and what to do?

Constipation is considered probable if there are two or more symptoms within three months:

  • A person struggles in more than a quarter of cases;
  • At least a quarter of the time, the stool is hard and lumpy;
  • In at least a quarter of cases, there is a feeling of incomplete emptying of the intestines;
  • In at least a quarter of cases, the rectum appears to be blocked;
  • At least in a quarter of cases, it is necessary to perform some kind of manipulation in order for the defecation to be successful;
  • A person goes to the toilet less than three times a week.

When to see a doctor

Most of the time, a little lifestyle change is enough for regular bowel movements. However, constipation can be a sign of various medical conditions, so it is important not to ignore the unpleasant symptoms. Be sure to consult a doctor to clarify the diagnosis if:

  • There is an unexplained change in bowel movement;
  • They last longer than three weeks;
  • Are accompanied by unexplained weight loss, fever, weakness, rectal bleeding.

Lifestyle

To cope with constipation on your own, it is recommended not to postpone going to the toilet (the intestines are most active in the morning and after meals) and eat more fiber (foods that contain a lot of dietary fiber). Fruits and vegetables, legumes, and whole grain foods are good choices. For example, prunes, apples, lentils, bran bread. The recommended amount of fiber is 20-35 grams per day. It is not uncommon for food packaging to indicate how much fiber it contains. Eating a lot of fiber can cause gas and bloating. Therefore, the fiber content in the diet should be increased gradually.

Over-the-counter laxatives can also be effective, but it’s important to use them exactly as directed and see your doctor if they don’t work for a few days. Women who are pregnant or breastfeeding should discuss the use of laxatives with their doctor.

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90,000 Constipation symptoms – signs and symptoms of constipation in adults

Views: 239 558

Date of last update: 16. 11.2021

Average Read Time: 17 minutes

Contents:

What is constipation
Causes of constipation
Why constipation is dangerous
Diagnostics and examination for constipation
Treatment methods

According to surveys, 32% of gastroenterologists’ patients are sure that bowel movements should be daily, and consider the absence of stool during the day as a delay 1 .Approximately 44% pay attention to the compaction of feces, 52% – the need to strain to empty the rectum 1 . What really counts as constipation, what symptoms require intervention – about this in the article.

What is constipation

To understand what symptoms characterize constipation, or, as doctors say, colostasis, you need to determine the physiological norms of defecation. They depend on individual characteristics: functional activity and state of the microflora of the digestive tract, the nature of nutrition. A number of external conditions also play a role.

Gastroenterologists consider the norm to be 1 :

  • emptying of the rectum from three times a day to 1 time in three days;
  • 90,017 daily stool volume from 200 g to 40 g;

  • soft feces in the form of a cylinder;
  • no need for prolonged straining (more than 25% of the time of bowel movement) when visiting the toilet “in a big way”.

Of course, the concept of the norm is individual, but still there are general signs that indicate a violation of the stool.

Constipation symptoms in adults 1 :

  • stools less than every three days;
  • 90,017 daily stool volume less than 35 g;

  • dry fragmented (“sheep”) feces;
  • Strong and prolonged straining, which takes more than 25% of the time from the moment the urge to defecate occurs to the bowel movement 1 .

In addition, subjective sensations are necessarily taken into account in the diagnosis of colostasis 1 :

  • pain when visiting the toilet “in a big way” – dense feces injure the mucous membrane of the anus, which causes its inflammation;
  • feeling of incomplete bowel movement;
  • the inability to empty the rectum and the feeling of its “blockage”;
  • the need for prolonged attempts during bowel movements, even despite soft feces;
  • Forced use of fingers (pressure on the perineum) to successfully remove feces 1 .

It is important to understand that constipation cannot be diagnosed by one of the above symptoms 1.2 . For example, the release of small portions of dense feces and the feeling of incomplete emptying of the rectum, even with daily bowel movements, indicate the presence of colostasis, and soft, profuse stools every four days in the absence of discomfort can be attributed to the norm.

Stool disorder can be chronic. According to international experts in the field of gastroenterology, for the diagnosis of chronic constipation, it is enough that two of the above signs are observed in a quarter of defecation cases during the year for three months in a quarter of cases 1.2 :

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Causes of constipation

Stool retention is a widespread problem.According to statistics, in developed countries, up to 50% of adults and up to 20% of children have problems with defecation in one way or another, and up to 20% of children 90,095 2 90,096. Moreover, stool retention can occur for a variety of reasons.

Stool retention can be caused by external factors, various diseases and conditions of the body. The most common ones are the following.

1. Lifestyle and Nutrition
  • The predominance in the diet of refined products with a low content of dietary fiber (flour, meat dishes, cereals from refined grains, etc.)leads to the death of the normal microflora of the digestive tract, which makes up almost half of the dry residue of feces 2 and a decrease in intestinal motility due to a decrease in the volume of feces.
  • Insufficient fluid intake is usually accompanied by compaction of feces, slowing of peristalsis.
  • Low physical activity and sedentary work can lead to weakening of the abdominal muscles involved in the act of defecation 1 .
2.Physiological conditions
  • Symptoms of constipation during pregnancy are associated with a physiological increase in the level of the hormone progesterone, which reduces the tone of intestinal smooth muscles and its motor activity, as well as with difficult movement of feces as a result of compression of the colon by the growing uterus.
  • Difficulty defecation in older people is twice as likely as in young people 2 . Most likely, this is due to such age-related changes as a general weakening of the muscles, slowing down of peristalsis and digestion, prolapse of organs and other processes.
3. Endocrine disorders

Constipation in adults and children can be a sign of endocrine disorders and accompany such conditions 2 , such as:

  • diabetes mellitus, characterized by impaired carbohydrate metabolism;
  • hypothyroidism, or decreased thyroid function;
  • hyperparathyroidism – excessive hormonal activity of the parathyroid glands;
  • hypercalcemia – an increase in the level of calcium in the blood;
  • hypokalemia – a decrease in the level of potassium in the blood;
  • uremia – an increase in the level of toxic products of protein metabolism in the blood as a result of renal failure 2 .
4. Neurological diseases

Since intestinal peristalsis is regulated by the nervous system, symptoms of constipation in adults can occur as one of the manifestations of stroke, chronic cerebrovascular accident, Parkinson’s disease, multiple sclerosis and other neurotic diseases 1 .

5. Psycho-emotional disorders

The influence of the psyche of the digestive system is traced in acute and chronic stress, anxiety disorder, depressive states 2 .Defecation disorder in the form of colostasis occurs as a symptom of irritable bowel, among the causes of which doctors first of all single out psychological problems 2 .

6. Impaired patency of the digestive tract

Stool retention can occur when there are mechanical obstacles to the movement of intestinal contents, for example, as a result of postoperative complications, adhesive disease, colon tumors 2 .

7. Side effects of drugs

Colostasis can be the result of side effects of certain drugs: antihypertensive, diuretic and non-steroidal anti-inflammatory drugs, antidepressants, anticonvulsants and antiulcer drugs, antispasmodics 1. 2 .

8. Functional problems of the pelvic floor

Stool retention can be caused by muscle weakness and rectal prolapse, uncoordinated work of anal sphincters, increased tone and paradoxical contraction when the urge to defecate occurs and other factors.

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Why constipation is dangerous

Long-term retention of feces in the large intestine is accompanied by the development of processes of putrefaction and fermentation, which proceed with the formation of a large amount of gases and the release of toxic decomposition products of proteins and carbohydrates 1.2 .Excessive accumulation of gases is accompanied by the development of flatulence, the appearance of a feeling of heaviness, distention and pain in the abdomen. Absorption of toxins leads to nausea, “dirty” plaque on the tongue, bad breath, headache, weakness and decreased performance 1.2 . The mucous membrane of the large intestine becomes inflamed, polyps can appear on it, which are dangerous for degeneration into malignant tumors.

From the point of view of the development of colon cancer, alarming signs for constipation are 2 :

  • Progression of problems with defecation in the absence of them in the past;
  • 90,017 age 50 and over;

  • the appearance of scarlet or dark blood in the stool;
  • pallor of the skin and visible mucous membranes, which may indicate the development of anemia;
  • weight loss without changing food habits and diet;
  • 90,017 cases of colon cancer in close relatives 90,095 2 90,096.

In case of chronic problems with bowel movement, especially when the above-described alarming symptoms appear, a doctor’s consultation and examination are required to clarify the causes of defecation disorders and exclude cancer.

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Diagnosis and examination for constipation

Diagnosis of constipation begins with determining its nature 4 . A detailed questioning and examination of the patient allows the doctor to determine whether colostasis is acute or chronic, to exclude alimentary, that is, nutrition-related causes of stool disorders, and if they are identified, to choose a diet to normalize the stool 4 .

If the absence of food causes of stool retention is stated, first of all, it is necessary to exclude the most dangerous tumor diseases 4 . For this purpose, X-ray examination of the intestine is performed, as well as sigmoidoscopy and colonoscopy – examination of all parts of the colon using special endoscopic equipment.

Diagnosis of diseases of internal organs and endocrine diseases, accompanied by problems with defecation, help ultrasound, MRI and laboratory tests of blood, urine, feces.

Taking into account the fact that stool retention can be associated with psychoemotional disorders, diseases of the nervous, endocrine, reproductive systems, consultations of a psychotherapist, neurologist, endocrinologist, gynecologist (for women), urologist or andrologist (for men) 4 are mandatory.

In the absence of diseases of internal organs, the doctor may prescribe a general treatment for constipation, including diet, taking laxatives that thin and soften stool 4 .

The duration of treatment usually does not exceed 1-2 months. 4 . If the problem remains unresolved, a further in-depth examination is carried out aimed at completely eliminating intestinal pathology, establishing the nature of intestinal motor disorders, assessing the composition of the intestinal microflora, the state of the pelvic floor and the work of the anal sphincters. After analyzing the results, the doctor selects the necessary treatment.

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Treatment methods

Treatment of defecation disorders depends on the reasons that caused them.

Therapy of constipation, which is a symptom of the disease, implies, first of all, the fight against this disease 3 . For example, the restoration of the function of the thyroid gland and the balance of its hormones have a beneficial effect on intestinal peristalsis and the nature of the stool, and the normalization of the psycho-emotional state helps to cope with irritable bowel syndrome.

Lifestyle and dietary changes

Recommendations regarding lifestyle and nutritional adjustments apply in all cases of constipation.

1. The nature of the diet

Changing the nature of the diet implies expanding the diet due to foods that contain a large amount of indigestible dietary fiber: greens, raw coarse vegetables and fruits, bran, mushrooms, whole grain bread and cereals 3 .

Experts recommend to consume up to 25-30 g of dietary fiber per day 1.3 . They bind water, retain it in the digestive tract, increase the volume of intestinal contents, thereby stimulating intestinal peristalsis and the movement of feces into the rectum.

Since it is problematic to cover the need for dietary fiber exclusively through nutrition, doctors recommend that patients take concentrated fiber 3 : wheat bran, agar-agar, flaxseed, psyllium husk, milk thistle meal 1, 2.

Psyllium has the greatest ability to bind and retain water. 1 . However, when taking it, you must consume a sufficient amount of liquid, otherwise the opposite effect is possible.In addition, you should not wait for a quick stool normalization – for this you need to take fiber for 1-2 weeks 1.2 .

2. Compulsory breakfast

To normalize the stool, it is important not only to change the nature of the diet, but also to make adjustments to the food intake. Breakfast must be hearty 3 . Foods rich in fats are best suited for him 3 – acting on the stomach, they reflexively increase the motility of the digestive tract, which contributes to defecation.

3. Compliance with the water regime

An adult needs to consume 30-40 mg of liquid per 1 kilogram of body weight per day to maintain water and electrolyte balance. 1.2 . Basic needs should be covered by drinking water 2 or still mineral water.

In addition, for constipation symptoms, adults are advised to limit their consumption of coffee and tea, as they have a diuretic effect and lead to thickening of feces 1 .

4. Physiotherapy exercises

An active lifestyle and special exercises aimed at strengthening the anterior abdominal wall and mechanical stimulation of peristalsis help to solve the problems of defecation 1 .

5. Correct habits

To develop a regular reflex urge to defecate, experts recommend emptying the rectum in the morning at the same time 1.3 . The preferred time is 15-45 minutes after breakfast, when food intake into the stomach stimulates intestinal motility and promotes intestinal emptying 3 .

Drug therapy

It is prescribed by a doctor in accordance with the type of constipation in order to empty the rectum, alleviate the condition and normalize the digestive tract.

Laxatives

There are several groups of drugs that have a laxative effect. Only a doctor can determine which one is best for certain symptoms of constipation in an adult. Despite the generality of indications for use, such drugs have different mechanisms of action and side effects – this must always be taken into account.

  • Osmotic laxatives (saline laxatives, lactulose, macrogol) act throughout the entire intestine 2 . They are practically not absorbed inside and, remaining in the lumen of the intestine, attract water to themselves 3 . Liquefaction and an increase in the volume of feces stimulates peristalsis, accelerates and facilitates defecation. The downside is that often the use of drugs in this group can lead to dehydration and leaching of the necessary trace elements from the body 3.4 .
  • Drugs that irritate the intestines and thereby enhance its contractions can act in the small (eg castor oil) and large (senna, buckthorn, sodium picosulfate and others) intestine 2.3 . Negative point: with prolonged and frequent use, irritating laxatives are addictive, can damage the intestinal mucosa and disrupt its functions 3 .
  • Emollients , such as vaseline and almond oil, act at the rectal level and facilitate bowel movements, mainly by moisturizing and “lubricating” the mucous membrane 1 .
  • Combination laxatives , which act on the rectal and end-sigmoid colon, can be used to combat constipation 3 . An example of such drugs is the micro enema MICROLAX ® , the main active ingredients of which are sodium citrate, sodium lauryl sulfoacetate and sorbitol 5 . Sodium citrate displaces bound water from the intestinal contents, sorbitol attracts it into the intestinal lumen, and sodium lauryl sulfoacetate liquefies feces and facilitates their excretion.The action can begin within 5-15 minutes after the introduction of microclysters 5 . The high safety profile allows the drug to be used for symptoms of acute and chronic constipation in adults, including pregnant women 5 .

It is important to understand that in the fight against colostasis it is not necessary to achieve daily bowel emptying – it is necessary to “teach” him to work independently 2 .

Motor regulators

In case of constipation associated with increased or decreased tone of the colon, the doctor may recommend taking antispasmodic (reducing the contractility of the intestinal musculature), or prokinetic (activating peristalsis) drugs 3 .

Probiotics

The influence of the microflora of the colon on peristalsis was proved by research 1 . Therefore, probiotic preparations based on live bifidobacteria, lactobacilli and their combinations can promote recovery 2.3 . If necessary, the doctor prescribes them.

Biofeedback therapy

Biofeedback therapy is used for constipation associated with pelvic floor dysfunction, including anal sphincters 2.3.4 . Its purpose is to teach the patient to relax the muscles of the anus and at the same time to strain the abdominal muscles when the urge to defecate occurs.

The treatment is based on the principle of biofeedback, is carried out in the form of training using special equipment and is considered quite effective. 3 .

Surgical treatment

Surgical treatment of colostasis is an exceptional measure used when other methods are ineffective 3 .

In order to restore regular bowel movements, various bowel surgeries are performed. But as studies show, a quarter of patients after the intervention remain dissatisfied with the results of 1 .

Constipation is a complex problem in gastroenterology, the solution of which largely depends on the timely diagnosis and treatment. Taking into account the fact that obstructed defecation can be a symptom of a serious illness, if constipation recurs, a doctor’s consultation is required.

Up to table of contents

The information in this article is for guidance only and does not replace professional advice from a physician. Consult a qualified professional for diagnosis and treatment.

Literature

  1. E.N. Baryshnikov, V.G. Rumyantsev. Constipation in the practice of a gastroenterologist. Consilium Medicum. 2007; 7: p. 38-43.
  2. E. Yu. Plotnikova. Modern concepts of constipation. Attending physician. No. 8, 2015.
  3. Shulpekova YO .. Algorithm for the treatment of constipation of various origins. Regular issues of “RMZh” №15 from 19.08.2007. With. 1165.
  4. A.A. Samsonov. Modern algorithms for the diagnosis and treatment of chronic constipation. Consilium Medicum. Gastroenterology.(Suppl.) 2012; 1: p. 68-74.
  5. Instructions for use of the microclysters preparation MICROLAX ® .

Causes of constipation – how to treat, what disease symptom is constipation – Clinic “Doctor near”

Most often, a symptom of constipation manifests itself in the following diseases:

Constipation – a digestive disorder characterized by the absence of stool for more than two days or incomplete emptying of the intestines. According to medical statistics, today it is one of the most common phenomena, which is considered to be an independent disease in the World Health Organization.This fact may seem interesting, since a number of gastroenterologists consider bowel constipation a symptom of certain pathological conditions.

Be that as it may, constipation requires timely seeking professional medical help, as it can cause the development of serious proctological diseases. By itself, it affects the patient’s quality of life, significantly reducing it. At the same time, it is important for patients to know that the normal frequency of bowel movements varies from three times within 24 hours to three times a week (and not every day, as many believe).This must be taken into account when deciding to contact a specialist.

Causes of constipation

Constipation in adults can develop for a variety of reasons. Based on them, there are:

  • Primary constipation – may be congenital or acquired due to bowel abnormalities;
  • Secondary constipation – develops with uncontrolled medication or due to illness;
  • Idiopathic constipation – occurs due to disturbances in the motility of the large intestine, which develops for unknown reasons.

It should be noted that elderly patients suffer from constipation 5 times more often than young patients. This is due to a decrease in the function of producing digestive enzymes in the intestinal microflora as we age. As for other reasons, they are as follows:

  • Improper nutrition, lack of clean water and dietary fiber;
  • Polyposis, adhesions, structures, neoplasms of malignant intestinal etiology;
  • Frequent restraint of urge to defecate due to heavy work schedules, long-distance travel, bed rest;
  • Constant stress and psychoemotional stress affecting the bowel function;
  • Regular use of laxatives due to the fact that the patient mistakenly believes that a bowel movement should occur every day;
  • The presence of anal fissures and hemorrhoids, provoking severe pain during bowel movements and causing fear of it.

Classification of constipation

If the question of how to get rid of intestinal constipation is also relevant for you – seek professional medical help. A specialist will find out the cause of the problem and help you cope with it. He will determine the type of constipation and will be able to choose an adequate treatment, which will definitely give the desired result.

Classification of constipation

Type of constipation Highlights

By the nature of development

Spicy

Can be triggered by:

  • mechanical obstruction due to formations of various nature;
  • dynamic obstruction due to inflammatory processes of the mucous membrane;
  • taking pharmacological preparations.
Chronic

It lasts about six months and is manifested by the following symptoms:

  • Very hard and dry stools;
  • Less than three bowel movements per week;
  • Often a feeling that the bowel has not been emptied completely;
  • Strong straining to release the masses.

By the mechanism of origin

Alimentary Due to diets, lack of water, too small portions of food.
Dyskinetic It is provoked by dysfunctions of the organs of the gastrointestinal tract or their innervation.
Mechanical There are tumors or strictures in the intestines.
Neurogenic Due to impaired neuroreflex function.
Psychogenic Stress, constant psycho-emotional stress.
Proctogenic Dysfunction of the pelvic floor muscles.
Spastic Provoked by spasms of intestinal smooth muscles.
Iatrogenic After surgery or uncontrolled use of medications.
With pathologies of the anus Cracks, hemorrhoids, inflammation.

Symptoms of intestinal constipation

Clinical manifestations can be different and are often due to the reasons that led to the development of constipation. At the same time, it can be exclusively constipation: such a diagnosis is also possible if defecation occurs every two to three days and requires serious straining from the patient. There are times when patients suffer from the following symptoms:

  • Intense pain sensations;
  • Bad breath;
  • Feeling of heaviness in the lower abdomen, which disappears after having a bowel movement;
  • Decreased appetite;
  • Sleep disorders.

Diagnosis of constipation

Treatment of intestinal constipation is selected individually, exclusively after conducting diagnostic tests. They are prescribed by a gastroenterologist in order to find out the exact cause of the problem. First of all, he will listen to the patient’s complaints, collect anamnesis and determine the presence of a connection between the patient’s usual lifestyle and constipation.

Further actions include an examination: in the process, palpation will be carried out and its swelling, if any, will be determined.To identify cracks in the anus, hemorrhoids, intestinal polyps, a proctological examination is performed. Further tactics of diagnostic studies are determined based on the results obtained from the above examinations and data from general analyzes. Instrumental studies can be as follows:

  • Colonoscopy – allows you to obtain data on the state of the intestinal mucosa and take samples for histology if neoplasms are detected;
  • Rectoscopy – makes it possible to examine part of the sigmoid and the entire rectum in order to exclude the presence of polyps, other tumors and inflammation;
  • Anorectal manometry – allows you to determine the functionality and tone of the sphincter muscles, their contractile ability;
  • Electrogastroenterography – aimed at determining the motor-evacuation function of the gastrointestinal tract by registering the biopotentials of its departments.

Constipation treatment

Treatment of constipation requires an integrated approach and does not only involve taking medications in the form of laxatives. However, even they must be selected individually and prescribed by a doctor. This is especially important given the fact that constipation can be a symptom of a serious medical condition. Moreover, a laxative can cause addiction and loss of independent urge to empty. That is why taking pharmacological drugs should be carried out under the supervision of a physician.There are three groups of laxatives, each of which has a specific effect. So:

  • Osmotic increase the osmotic pressure in the intestine by retaining water and increasing the volume of the contents;
  • Sliders provide stimulation of the movement of contents through the intestine;
  • Combined effects use both the first and second effects.

Only a doctor can know which remedy from which group is best suited for each individual case, and will be able to choose the right one. Diet for intestinal constipation is a mandatory component of treatment. The diet should contain only those foods that facilitate bowel movement. Food is consumed in small portions five to six times a day, thereby achieving an even filling of the intestines.

Serving sizes should be small and fit easily in two palms. It is not recommended to fast for more than four hours in a row, as the need for food will be greater, as well as its volume, which will result in constipation.Food should not be too boiled, as this contributes to the lethargy of the intestines. The diet should include meat, vegetables, salads, fruits; There should be plenty of plant foods to provide enough fiber. It is recommended to combine meat with vegetables, fruits with cereals.

A network of clinics “Doctor near” invites you to undergo diagnostics and a course of treatment of constipation in Moscow. We have at our disposal a modern diagnostic base that allows us to correctly present a problem, its cause and find ways to eliminate it.Our staff is staffed by highly qualified doctors with many years of practical experience. They will individually develop treatment tactics and diet and achieve a complete recovery! Make an appointment with them by filling out and sending the form online, or by calling us: +7 (495) 154-92-31!

Constipation – when to see a doctor?

Constipation is a very common symptom. Constipation can occur within hours, as a result of slow bowel movements, travel, or changes in daily habits.This problem is very uncomfortable but not serious. Keeping a healthy lifestyle and eating right is essential to prevent constipation, and laxatives can sometimes be helpful after consulting a doctor. But constipation is not always just a passing problem, sometimes you should see a doctor. When is the doctor’s help needed?

Alarming symptoms that should make you see a doctor

In some cases, constipation can be a sign of a more serious medical condition.Of course, this is a rare situation regarding the total number of people suffering from constipation. However, some symptoms should not be ignored.
In case of severe abdominal pain, vomiting and lack of gas discharge, emergency may be required. You must immediately call an ambulance by calling 112 (1) .
In case of high fever and severe pain in the abdomen against the background of sudden constipation, it is necessary to see a doctor quickly (within one day) (2) .
And finally, if there is blood in your stool, involuntary weight loss (if you are not losing weight), or other symptoms associated with constipation (diarrhea alternating with constipation, persistent pain, mucus in the stool or fecal incontinence), you must sign up for an appointment with a doctor one of the next days. It is also worth consulting your doctor if you have a chronic medical condition, are taking medication, or if you are over 50 and usually do not suffer from constipation (1).

Chronic constipation

Sometimes constipation does not go away within a few days, but remains for a long time.Chronic constipation is characterized by the presence of a symptom most of the time for 6 months. In this case, it is important to see a doctor. In such cases, it is recommended to determine the cause of the constipation, which can sometimes be a symptom of another medical condition (for example, a malfunction of the thyroid gland, colon cancer or brain disease) or an unwanted effect of medications. Often it is required to conduct additional examinations and seek the advice of a specialist.The doctor may also prescribe medications to try and relieve symptoms. (3) .

What else is important to know: Laxatives

Literature:
1: What to do and when to see a doctor for constipation (Good gestures and advice in case of constipation). Article link: https://www.ameli.fr/assure/sante/themes/constipation-adulte/bons-reflexes
2: Dumont A. Chembin O. Pillon F. About the laxatives available in the pharmacy (Many laxatives are available in the pharmacy).January 2010. Pharmaceutical news. Volume 49, Number 492, pp. 12-16.
3: Degena L. et al. Constipation: Myths and Reality (Reality and Myths about Constipation) – State of the Art. Q: Swiss Medical Forum. 2008. p. 913-918.

90,000 Constipation: symptoms, causes, diagnosis

Constipation can occur in any person, regardless of the strength of his health. It can be caused by stress, the inclusion of incompatible foods in the diet, unhealthy diet, and the use of small amounts of liquid.If this is a one-time occurrence, then most likely there is no cause for concern. However, if constipation recurs often or becomes chronic, it is necessary to consult a doctor, as they can be a symptom of pathologies. Make an appointment at the Otradnoe Polyclinic, go through all the necessary examinations and receive comprehensive advice on lifestyle correction to eliminate intestinal problems.

In this article, you will learn about the types of constipation, their causes and treatment.Since this condition can lead to complications, it should not be taken lightly.

What is constipation

If we talk about the norms of defecation, then here it is impossible to come to an unambiguous and relevant indicator for all. Much depends on the individual characteristics of the organism of a particular person, as well as his diet and even the region of residence. But in general, the limits of the norm are:

  • bowel movements from 3 times a day to 3 times a week;
  • soft feces, containing at least 70% liquid;
  • feces come out in the form of a cylinder;
  • on average, at least 40 g of feces are excreted per day (usually about 100-200).

Help! By no means always going beyond these indicators is a deviation. For some people, defecation less than 3 times a week is considered normal: they do not have difficulty with bowel movement, they do not have symptoms of constipation , their body is just that way.

You can talk about constipation if the act of defecation occurs less than 3 times a week (or is delayed for more than 48 hours) and is accompanied by other signs:

  • dry and hard feces;
  • long, difficult straining;
  • stool weight – less than 40 g.per day.

For children, other norms of defecation are relevant, depending on age and nutrition:

  • For bottle-fed children – 1-2 times a day, up to a year of life.
  • For babies feeding on breast milk – 1-7 times a day.
  • After the introduction of complementary foods and up to 3 years – 5-6 times a week.
  • After 3 years – as in adults, at least 3 times a week.

Help! If a breastfed baby has no stool for 2-5 days, this may not be a sign of constipation, but a lack of milk.

Varieties and symptoms of constipation

Constipation can be acute or chronic.

Acute constipation is a condition in which there is no bowel movement for several days and in which at least two of the following signs are observed:

  • bloating, bloating, flatulence;
  • the need for strong straining;
  • pain or discomfort during bowel movements;
  • feeling of under-emptying of the intestines after a bowel movement;
  • Sensation of a plug in the rectum after a bowel movement.

These symptoms may be accompanied by:

  • nausea;
  • 90,017 dizziness;

  • by the appearance of a white plaque in the language;
  • decreased appetite;
  • 90,017 headaches;

    90,017 insomnia;

  • pallor and laxity of the skin;
  • heartburn.

The condition is considered chronic if symptoms persist for at least 12 weeks during the year.

Constipation is also classified according to the causes and mechanisms of development. Based on the reasons, the condition can be:

  • Primary – is a consequence of congenital or acquired bowel anomalies.
  • Secondary – develops against the background of diseases, injuries, taking medications.
  • Idiopathic – occurs when the motor function of the intestine is impaired for unknown reasons (it is diagnosed most often).

According to the mechanism of development, constipation is:

  • Alimentary – develop due to insufficient intake of fluid or fiber, a decrease in the amount of food taken.
  • Mechanical – their cause is the organic narrowing of the intestinal lumen.
  • Dyskinetic – occur with dysfunction of the digestive tract.

Constipation is also divided into varieties, based on intestinal tone:

  • Spastic – develops due to spasms of the muscles of the intestines, usually against the background of stress or illness.
  • Atonic – with a reduced intestinal tone, occur due to a sedentary lifestyle, malnutrition.

Causes of constipation

The causes of acute constipation can be:

  • fast food, convenience foods;
  • insufficient fluid intake;
  • lack of fiber-rich foods in the diet;
  • 90,017 stress;

  • abuse of enemas and laxatives.

Chronic constipation can occur due to the following factors:

  • sedentary lifestyle;
  • curvature of the spine;
  • The presence of fecal stones (accumulation of hardened feces in the large intestine).

Constipation is common during pregnancy.

Also, chronic constipation develops in the presence of diseases:

  • Anus and rectum – hemorrhoids, anal fissures, narrowing of the anus, rectal prolapse, paraproctitis, etc.d.
  • Large intestine – cancer, hernia, volvulus, narrowing due to tuberculosis, Crohn’s disease and other inflammatory pathologies.
  • Peripheral nervous system – intestinal pseudo-obstruction, autonomic neuropathy, Chagas disease, Hirschsprung’s disease.
  • Central nervous system – multiple sclerosis, tumors and spinal cord injuries, Parkinson’s disease, brain damage.
  • Small pelvis – endometriosis, tumors of the uterus, ovaries.
  • Connective tissue – dermatopolymyositis, systemic scleroderma.
  • Endocrine system – hypothyroidism, uremia, diabetes mellitus, porphyria, etc.

Chronic constipation can occur with mental disorders – anorexia, depression.

Help! Acute and chronic constipation can be triggered by taking medications: anticonvulsants, antidepressants, some analgesics, oral contraceptives, iron preparations.

The reasons for constipation in children under one year old can be as follows:

  • rickets;
  • malnutrition of a nursing mother;
  • lack of fluid intake;
  • Introduction of complementary foods too early;
  • food allergies;
  • abrupt change in artificial mixtures;
  • Immaturity of the nervous system;
  • muscular dystonia;
  • unbalanced complementary foods with a predominance of proteins and fats.

Diagnosis of constipation

To find out the cause of constipation, you need:

  • Consultation of a doctor (proctologist or gastroenterologist).
  • Irrigoscopy – X-ray examination of the intestine using a contrast agent.
  • Colonoscopy – examination of the intestines using a colonoscope device.

Women may also need a pelvic exam.

To develop a treatment plan, you may additionally need:

  • stool analysis;
  • ultrasound of the abdominal organs;
  • Study of the motor function of the rectum.

Constipation Treatment

Many patients consider this condition “frivolous” and do not see the need for seeking medical help. However, if it often recurs or becomes chronic, a doctor’s consultation is necessary, since constipation can be a symptom of many diseases, and if untreated, it can cause the development of a number of pathologies. For example, intestinal obstruction or inflammation, polyps, hemorrhoids, dysbiosis, etc.

Solving the problem yourself with the help of a laxative is not recommended; it can be taken only as a one-time measure.If you use a laxative for a long time, the cause of constipation will not be eliminated, and uncontrolled use of such drugs can only aggravate constipation, so you need to consult a doctor.

If, according to the results of the diagnosis, no diseases were detected, then the patient is prescribed:

  • Individual diet.
  • Moderate physical activity.
  • Exclusion from the diet of semi-finished products, fast food, carbonated drinks.
  • Enemas.
  • Preparations that improve the functioning of the digestive tract.

If the patient takes medications that cause a weakening of intestinal contractions (some antidepressants, atropine, etc.), then they are canceled and an alternative is found.

In the presence of diseases that provoked the development of constipation, medical or surgical treatment of these pathologies will be prescribed.

Constipation. Symptoms and Treatment | Health Clinic

Constipation is a chronic delay in bowel movement for more than 48 hours, incomplete bowel movement with a small amount and increased hardness of feces.

Types of constipation:

“Functional constipation”.

The main reasons for “functional” constipation include a diet low in dietary fiber, and sometimes drugs (opiates, antacids with aluminum, anticholinergics, antidepressants, etc.).

Constipation associated with impaired anorectal transit .

The primary disorders of this zone include: anismus, anorectal sensory disorders, and Hirschsprung’s disease (congenital hereditary disease).

Primary motor disorders of the colon.

These include: irritable bowel syndrome, hypomotor dyskinesia of the colon (“inert” colon), chronic idiopathic intestinal pseudo-obstruction.

Secondary motor disorders of the colon.

They arise as a result of various diseases. Due to various diseases, either hypomotor or spastic dyskinesia of the colon occurs.

It is important to determine the cause of the constipation in order to carry out the correct treatment!

Treatment
  • Drug treatment.

Drug therapy depends on the type of functional disorder.

It is necessary to determine which parts of the intestine are associated with constipation (colon, rectal or anorectal zone).

The goal of treatment is for the patient to have soft stools every 1 to 2 days.

For constipation, with hypomotor dyskinesia, drugs that enhance intestinal motility are used:

  • Prokinetics
  • Choleretic preparations

In case of spastic dyskinesia of the colon, including irritable colon, it is indicated:

  • M-holinoblokator
  • Myogenic antispasmodics.

Must be eliminated:

  • small intestine bacterial overgrowth,
  • colon dysbiosis and diseases of the anorectal zone.

Laxatives

There are several groups of laxatives:

– oils, saline laxatives act at the level of the small intestine, so the laxative effect occurs in 4-5 hours.

– biphenyl derivatives, osmotic, etc. – at the level of the large intestine, their effect manifests itself after 8-12 hours;

– contact agents (glycerin suppositories, oil enemas) act in the rectum, so their effect occurs in 10-20 minutes.

For a long time, you can take drugs that are not addictive and abdominal pain: lactulose (up to 1-2 months, it is also possible for any dysbacteriosis), dulcolax, guttalax.

Medicines and doses must be selected individually.

Long-term use of laxatives leads to addiction, intermuscular nerve plexuses are affected.

You can not take laxatives uncontrollably and in large doses.

When taking some laxatives, there may be intestinal obstruction, as blockages form in the intestines (when taking a large amount of fiber).

Only a doctor can prescribe treatment!

Consultation can be obtained by phone: +7 (495) 961-27-67


– after the onset of remission, it is necessary to engage in remedial gymnastics, physical education. Any kind of sport activates the intestines.

Diet for constipation:

Meals should be at least 4 times a day.

NOT RECOMMENDED!

Legumes, cabbage, sorrel, spinach, apple and grape juices, milk, green apples, raw, canned vegetables, seasonings, high-grade flour bread, pastry, fatty meats, smoked meats, spicy foods, chocolate, strong coffee, tea, garlic, turnip, radish.

Limit porridge from semolina, rice, noodles, potatoes.

Coffee, tea, alcohol can provoke diarrhea with Irritable Bowel Syndrome (IBS).

With IBS, constipation and diarrhea alternate, rumbling, transfusion in the abdomen, bloating, flatulence are characteristic.

RECOMMENDED:

For hypomotor dyskinesia of the colon, foods rich in plant fiber are used:

Carrots, beets, zucchini, pumpkin, bread made from rye and whole wheat flour, diet breads with bran, cereals from wheat, buckwheat, pearl barley, oatmeal, vegetable and fruit juices, as well as figs, dates, prunes, dried apricots, non-acidic apples.

MANDATORY: Lactic acid products: fresh kefir, yogurt, acidophilus.

The total amount of free liquid must be at least 1.5 liters per day.


SPECIAL RECOMMENDATIONS:


In the morning on an empty stomach, you can drink cold honey water (if there is no gastritis).

For breakfast you can have Boiled beetroot salad.

Add Wheat bran to food, if intolerance does not occur.You need to start with 1-2 teaspoons, then gradually bring to 2-3 tablespoons so that there is no swelling. Can be added to cereals, soups, yogurt, kefir, salads.

Vegetable oils (sunflower, olive, corn, etc.). Can be taken up to 2-4 table. spoons per day.

Special mixtures:

Oatmeal with milk;

Cream with fruits and nuts;

1-2 hoursflaxseed in a glass of fruit juice.

A glass of Matsuni or Kefir with 1-2 table. tablespoons of unrefined olive oil.

Mineral water. Patients with constipation are shown “Essentuki” No. 4, 17, “Baltic”, “Jermuk”, “Slavyanskaya”, “Batalinskaya”.

For constipation with hypomotor dyskinesia, more mineralized water (“Essentuki” No. 17, etc.) is prescribed, 150-200 ml cold 2-3 times a day without gas.

In case of hypermotor dyskinesia, less mineralized waters (“Essentuki” No. 4, etc.) are shown, 150-200 ml in a warm form.

Expanding the diet is possible only against the background of remission of the disease, lasting at least 12 months.

A gastroenterologist at the Health Clinic will help you with any form of constipation.

Why are our gastroenterologists better than others?
  • The knowledge and experience of the doctors of our clinic allow us to achieve amazing success in the treatment of gastroenterological diseases.

  • The Health Clinic has the most modern diagnostic equipment, which allows an accurate diagnosis and treatment to begin.

  • Location in the very center of Moscow, within walking distance from two metro stations.

  • Attractive prices

  • Convenient time to visit the doctor.

We are working to keep you healthy.

Consultation can be obtained by phone: +7 (495) 961-27-67


90,000 symptoms, causes, danger of the disease, how to treat

Constipation – symptoms, causes, danger of disease, how to treat

What is constipation

Today we are not talking about the well-known small car “Zaporozhets”, which the people jokingly called “constipation”, but about the painful condition of the organs of the gastrointestinal tract.So, constipation in the medical sense is too rare or insufficient bowel movement. In this case, constipation is not considered an independent disease. It is referred to as a symptom that allows one to talk about diseases, dysfunctions of body systems and even its pathologies.

According to statistics, half of the adult population of the planet suffers from this unpleasant symptom. However, some do not take the issue seriously enough. But in vain!

The main symptoms of constipation

It is safe to say that an adult has constipation if there are such signs:

  • bowel movements occur less than 3 times a week;
  • when visiting the toilet, a person makes “inhuman” efforts to perform a bowel movement;
  • What ends up in the toilet are tight, dry lumps.

Yes, there is little pleasant. Add sensations such as bloating, bloating, pain during emptying, constant urge to go to the toilet, feeling of incomplete cleaning of the intestines and other delights of constipation, and it becomes clear that it is better to avoid such conditions.

Sometimes people suffering from constipation cannot understand why there is nausea, lack of appetite, often headaches, heartburn and bad breath. And the reason, let’s say, is on the surface.

There are several types of constipation, but we will tell you about them in the following materials.

Causes of constipation

  • Insufficient intake of fiber, both soluble, which accumulates water, and insoluble, which increases the volume of feces.
  • Physical inactivity, slowing down and weakening the contraction of the muscles of the digestive tract.
  • Insufficient water intake
  • Constipation-causing foods. These include mainly protein foods – eggs, cheese, meat, as well as sweets and too fatty foods.
  • Abuse of coffee and alcohol.
  • Restraining urge, for example, at work or on the road.
  • Some types of drugs and vitamin complexes.
  • Abuse of laxatives. In this case, there is a lazy bowel effect.
  • Certain diseases, eg hypothyroidism, diabetes mellitus, neurological problems, cancer.
  • Psychological problems.
  • Wrong lifestyle – lack of a daily routine, sports, proper nutrition.

What is the danger of constipation

Chronic intoxication of the body occurs . Harmful substances penetrate into the intestinal wall from stagnant feces.

Reflux. This means that feces can return to the small intestine, causing inflammation.

Fecal stones. This is a very unpleasant symptom – during bowel movements, people experience pain when trying to get rid of stones and even injure the intestinal mucosa.

Proctological problems. From strong straining and hard feces, hemorrhoids and anal fissures occur. If problems with the toilet continue, then they become chronic and are treated only by surgery.

Avitaminosis. With constipation, appetite may suffer and various anemias or vitamin deficiencies may occur.

Decreased immunity. It is becoming more and more difficult for the body to cope with bacteria and viruses.

Can constipation be cured

If constipation is not associated with any serious disease of the gastrointestinal tract or other diseases, you can get rid of it with the help of proper nutrition, exercise, normalization of the psychological state.