Constipation is usually defined by a delay in intestinal transit, generating a decrease in frequency of bowel movements, and also creating an appearance of dehydration. The person will have difficulty defecating or not be able to go at all. We can distinguish constipation due to a disorder of the movement of stool, the most common case, from another type of constipation referred to as "terminal" constipation or dyschezia, which is a difficulty in emptying one's bowels. Constipation can be a one-time phenomenon, in connection with a particular disease or a temporary deficit of hydration, or be continuous over time. This disorder is arbitrarily defined by clinical signs of constipation over a total of at least 12 weeks a year.
Constipation is considered to be when a person has a bowel movement less than three times per week, but the latter can be constipated even with a greater frequency of defecation. Constipation can also be considered a necessity to push in order to defecate, a sensation of stool remaining even after a bowel movement or the need to use one's fingers to complete the evacuation. An episode of acute constipation will be determined by factors occurring in a timely manner for a few days or weeks: the stool is hard, dry, small in volume or nonexistent. Evacuation is not effective. Chronic constipation will have the same events, but over a much more prolonged time.
The diagnosis will be based on an examination looking for the signs mentioned above. It can also be made with an X-ray of the abdomen in case of doubt, which will show a stagnation of contents, or by a digital rectal exam that shows fecal impaction. A physical examination is also performed with palpation of the abdomen, which will be hard and distended, stools able to be felt on palpation.
The first line of treatment is to establish a high-fiber diet with adequate hydration. In the case of stools being found in the terminal part of the digestive tract, an enema (Normacol Æ) may be performed to evacuate feces and restore transit. The use of glycerin (suppository) can also facilitate bowel movements. A laxative oral treatment (macrogol, lactulose ...) will be implemented in cases of chronic constipation, and it may take several weeks to restore proper transit.
As a precaution, it is best to eat well (a balanced, high-fiber diet), to remain properly hydrated (drink about 1.5 liters of water per day) and to move about sufficiently so as to maintain good intestinal transit and thus avoid bouts of constipation. In general, dietary changes are enough to restore transit.
Published by Jeff
Latest update on June 22, 2013 at 05:58 AM by Jeff.