Constipation

Constipation may occur in many gastrointestinal and other medical disorders.

Demography

According to northern Indian community study, 555/4767 (11.6%) reported symptoms of constipation. Likewise in the former group, 1404 (53%) had self-perceived constipation. And in the latter, 846 (18%), 1030 (23%) reported straining at stools, and incomplete stool evacuation, respectively. Similarly in another community survey in rural northern India, the prevalence of constipation-predominant irritable bowel syndrome (IBS-C) was 2.4%.

Two smaller community surveys from Chandigarh and Bangalore reported the prevalence of constipation of 24.8% and 8.6%, respectively. Though the latter study was conducted exclusively among elderly population, in an eastern Indian study, of 331 consecutive patients with Chronic Constipation. In which 65% were older than 60 years.

• Either emotional or psychological problems
• Sedentary life
• Eating too much of meat also dairy products
• Chronic abuse of laxatives
• Bottle fed babies
• Pregnancy
• Drugs for instance; antacids, iron, calcium, blood pressure medications
• Certain digestive tract diseases
• Some School going children develop a habit to ignore the urge
• Cooking in aluminium, iron vessel

Careful examination contributes more to the diagnosis than extensive investigation

First visit

Digital rectal examination

Proctoscopy and sigmoidoscopy (especially for detect anorectal disease)

Routine biochemistry including serum calcium and thyroid function tests

Full blood count should be carried out

If these are normal, a 1-month trial of dietary fibre and/or laxatives is justified

Next visit

If symptoms persist, then examination of the colon by barium enema or CT colonography is indicated to look for structural disease.

Further investigation

Generally, If no cause is found and disabling symptoms are present, then specialist referral for investigation of possible dysmotility may be necessary

• Increased fluid intake
• Exercise
• Judicious use of laxatives.
• Eat high fibre diet – whole grains, bran, oat, green leafy vegetables, peas, beans, potatoes, raw vegetables, salads, dried fruits also fresh fruits
• Eat fruits also vegetables with the skin
• Avoid food that can cause constipation like pomegranate etc
• You can take one spoon Isabagul (e.g. fibre, Psyllium) in water before retiring to bed
• Walk after every meal

• Haemorrhoids
•  Anal fissure
• Faecal impaction
• Rectal bleeding after continually straining to pass stools

In the majority of cases, constipation resolves itself without any treatment or risk to health.

According to underlying cause

Stimulants: 

These make the muscles in the intestines contract rhythmically. Additionally, These include Correctol, Dulcolax, and Senokot.

Lubricants:

These help the stool move down the colon more easily. Furthermore, These include mineral oil and Fleet

Stool softeners:

These moisten the stool. Stool softeners include Colace also Surfak.

Fiber supplements:

In detail, These are perhaps the safest laxatives. Additionally, They are also called bulk laxatives. They include Fiber Con, Metamucil, Konsyl, Serutan, also Citrucel and should be taken with plenty of water. Lastly, If you want to buy bulk laxatives, then there is an excellent selection online with thousands of customer reviews

Osmotics:

These facilitate the movement of fluids through the colon. These include Cephulac, Sorbitol, also Miralax

Saline laxatives:

In brief, These draw water into the colon and include milk of magnesia

Chloride channel activators:

These require a prescription and include lubiprostone (specifically, Amitiza)

5-HT-4 agonists:

They increase the secretion of fluid in the intestines and speed up the rate at which food passes through the colon. Additionally, They include Prucalopride

Opium

An inclination to evacuate but feeling as if the orifice were closed; no regular pressure; sensation as if a load on abdomen; heavy drowsy feeling; dry mouth, thirst, want of appetite. Stool hard round black balls like marbles.

Nux vomica

In sedentary persons and those accustomed to drink spirits. Bad taste in the mouth, want of appetite, especially in the morning, slimy tongue, irritability, headache; frequent urging, little or nothing passes

Pulsatilla

After taking rich or fat food; with moroseness also taciturnity.

Bryonia

With indigestion, weight at stomach after food also  pain between shoulders; patient irritable, feels chilly, subject to rheumatism. Furthermore, Stool hard, large, light-coloured, and dry.

Lycopodium

Constipation with sadness, complete loss of appetite. Moreover, When there is much flatulence and gravelly urine.

Plumbum met.

Constipation of hard round balls; colic; abdomen drawn in; also constipation of children with large bellies in mesenteric disease

Aesculus hip.

In brief, Constipation of hard round balls, backache aggravated by walking.

Nat. mur

Constipation in chilly subjects; earthy complexion; feeling of contraction at the anus; and as if something were lodged in the rectum (in other words, lower bowel).

Sulphur

Frequent disposition to go to stool with ineffectual efforts. Sinking sensation at stomach, hot flushes, and faintly spells.