CONSTIPATION

A decrease in the frequency, size, consistency and ease of bowel movements, and the complaint depends upon the individual’s perception.

1. One of the most common complaints encountered in practice.
2. It is important to determine what the patient implies by the complaint, because it is made on a subjective impression, which might mean decreased frequency of bowel movement, sensation of incomplete evacuation, painful defecation, or presence of hard stool.
3. A variety of complaints accrue from the sufferer with no obvious explanation-including lassitude, chest fullness, headache, ‘indigestion’ etc.
4. Medically diagnosis may be made if the patient has less than 3 bowel movements in a week or, has to strain excessively at defecation.
5. Could be the result of one of many causes which would include poor lifestyle (Low dietary fibre, inadequate water intake, inadequate exercise, poor bowel habit), Systemic diseases (hypothyroidism, chronic renal failure,) Anorectal outlet disorders (tumours, piles, rectocoele), structural abnormalities (strictures, cancer), Colonic inertia, Neurologic lesions (cord lesions, Parkinson’s disease, multiple sclerosis etc) and drugs (Antacids, anticholinergics, calcium channel blockers, opiates, laxative abuse, etc).
6. lt is important to determine the cause by a thorough history, clinical examination and appropriate investigations. The possibility of an organic cause superimposing in a known case with habitual constipation, should not be lost sight of.