By: Kristy Annely
Constipation describes situations wherein patients have difficulty moving their bowels. From most of the persons complaining of Constipation, only a very few have any serious underlying disease that needs specialized tests and treatment by a gastroenterologist.
Educating the patient about worrying too much about bowel patterns can treat most of the cases. Bowel training – attempting a bowel movement everyday at the same time, preferably early mornings when colon activity is high - can be practiced. The food habits form the important part of the remedy. Eating high-fiber foods like cereals, vegetables and fruits helps a great deal. Limiting foods like ice cream, cheese, meat and processed foods is also preferable. Drinking 1.5 – 2 liters of water per day is essential, as is avoiding dehydrating drinks containing caffeine and alcohol. Regular exercise, besides having other health benefits, is a must for avoiding Constipation.
The diagnosis of Constipation is done using methods like physical examination, colorectal transit study, anorectal function tests, barium enema x ray and sigmoidoscopy or colonoscopy.
If no appreciable improvement takes place with the lifestyle changes, then a bulk-forming laxative is indicated. Psyllium and methylcellulose are bulk-forming laxatives which can be used for a long time without side effects. Next in line are medications like hyprosmotics, lactulose, Polyethylene glycol, Glycerin and Sorbitol, and Salines like magnesium hydroxide, magnesium citrate and sodium phosphate. The third-line medications are Anthraquinones like Cascara sagrada, Emollients such as Docusates, Senna and mineral oil, and stimulants such as Phenolpthalein, castor oil or Bisacodyl.
The use of the above medicines must be under strict supervision by healthcare professionals, and only done as a short-term measure, since most of them have side effects. Patients under the administration of laxatives should aim at stopping them slowly. In most cases, the ability of the colon to contract will be restored after some time. Enemas and suppositories are used as an emergency treatment. Surgery should be considered as a last resort when all other measures fail.
