Constipation, which is also known as constipatio or obstipatio, is a gastrointestinal condition which is characterized by infrequent bowel movement, difficulty passing stools, or both. Medically, it is often described as having fewer than three bowel movements per week. The stools are typically hard, dry, and small, which can cause straining and discomfort during the process of defecation.
Generally, constipation can be classified as Primary( functional) and secondary:
1. Primary constipation includes normal transit constipation, slow transit constipation, and defecatory disorders.
- Normal transit constipation: despite normal colonic transit time, patients experience difficulty with defecation, often due to psychosocial factors or dietary habits.
- slow transit time, leading to infrequent bowel movements.
- Defecatory disorders: problems with pelvic floor muscles or anorectal function, like dyssynergia.
2. Secondary constipation arises from underlying medical conditions, medications, or lifestyle factors, such as:
- Medical conditions: Hypothyroidism, diabetes, Parkinson's disease, multiple Sclerosis, irritable bowel syndrome, and colorectal cancer.
- Medications: antidepressants, certain antacids, opioids, and anticholinergics.
Symptoms of Constipation include:
- Fewer than three bowel movements per week.
- Straining during defecation.
- Need for manual maneuvers to facilitate defecation.
- Sensation of incomplete evacuation.
- Sensation of anorectal Obstruction.
Management
Treatment of constipation depends on its type, cause, and severity:
1. Lifestyle Modifications: increased dietary fiber, adequate hydration, and regular exercise.
2. Medications include:
- Stimulant laxatives: Bisacodyl, Senna
- Stool Softener: Docusate.
- Prokinetic agents: Prucalopride.
- Osmotic Laxatives: Polyethylene glycol, Lactulose.
- Surgery: rarely indicated, usually for severe, refractory cases or specific conditions like rectal prolapse.
Proper management and treatment can help to improve symptoms and quality of life for individuals experiencing constipation.