Constipation
is a general term covering various forms of uncomfortable passage
of stools. Generally the stools are infrequent and hard, difficult
to pass and accompanied by pain. Infrequency, by itself, is
not constipation. A person who passes a normal stool every four
days is not constipated, one who passes a hard uncomfortable
stool every day, is constipated. Babies who are breast fed,
for example, tend to pass stools less frequently than bottle
fed babies.
Often the stools in constipation are small, but they can be large. The most significant constipation is that which can occur, usually in the middle aged or older, when a person, who has had a very regular bowel action, suddenly becomes constipated. This change of bowel habit always necessitates a medical consultation because it can represent developing bowel pathology. Constipation in the otherwise well is often due to dietary problems (not enough roughage), inactivity (most commonly seen among sedentary workers) and insufficient fluid intake (often the elderly). Constipation can make people irritable, give them abdominal pain and make them feel nauseated. It is common amongst the chronically sick, the bed and chair bound. Constipation in younger adults can often be part of the irritable bowel syndrome, but is sometimes associated with other illnesses such as hypothyroidism. The over use of stimulant laxatives, such as senna, can result in a bowel that loses muscle tone and is unable to efficiently expel stool. Common analgesics and cough medicines, particularly those containing codeine can cause constipation, as can the use of opiate hard drugs. Diuretic drugs for heart failure can also cause the problem. Sometimes the presence of painful piles on a split in the anus will make a person reluctant to pass a stool and, thus, become constipated. Older patients, particularly, can become very anxious about not passing a stool every day and will take inappropriate laxatives. Constipation in its most severe form, usually in the elderly and infirm, occurs when the stool builds up and cannot be ejected. The faecal impaction can only be relieved by manual removal of the stool.
Constipation is a condition found almost only in Western Society mainly due to the diet of refined food from which much of the fibre has been taken. It is the addition of fibre to the diet, therefore, that so often cures the condition. Fibre is most satisfactorily found in those foods where there is a large amount of husk—whole grain bread, peas, beans, fibre rich cereals. Some vegetables contain little fibre, even those that appear to be “fibrous” such as carrots. Fibre is also available at the pharmacy in such concentrated forms as “Fybogel”. Lactulose syrup is a useful non-purging stool softener An increased fluid intake is always advised, as is regular exercise. If constipation is not just an occasional problem, for which there is no obvious cause, medical help should be sought. |
