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Chronic Constipation

Also known as lazy colon, colonic stasis, colonic inertia, and atonic constipation, chronic constipation may lead to fecal impaction if left untreated. It's common in elderly and disabled people because of their inactivity and is often relieved with diet and exercise.

Constipation is a symptom, not a disease. Almost everyone experiences constipation at some point in their life, and a poor diet typically is the cause. Most constipation is temporary and not serious. Understanding its causes, prevention, and treatment will help most people find relief.

Causes

Chronic constipation usually results from some deficiency in the three elements necessary for normal bowel activity: dietary bulk, fluid intake, and exercise. Other possible causes can include habitual disregard of the impulse to defecate, emotional conflicts, chronic use of laxatives, or prolonged dependence on enemas, which dull rectal sensitivity to the presence of stool.

Signs and symptoms

The symptoms of constipation include:

• Needing to open the bowels less often than usual
• Hard, dry stools that may be painful to pass
• Straining to pass the motion
• Having to sit on the toilet for much longer than usual
• The sensation afterwards that the bowel hasn't fully emptied
• Bloated abdomen
• Abdominal cramps.

Diagnosis

A patient history of dry, hard stool and infrequent bowel movements suggests chronic constipation due to inactive colon. A digital rectal examination reveals stool in the lower portion of the rectum and a palpable colon. Analoscopy may show an unusually small colon lumen, prominent veins, and an abnormal amount of mucus. Diagnostic tests to rule out other causes include an upper GI series, barium enema, and examination of stool for occult blood from neoplasms.

Treatment

Effective treatment varies with the patient's age and condition. A diet higher in fiber, sufficient exercise, and increased fluid intake often relieve constipation.

Treatment for severe constipation may include bulk-forming laxatives, such as psyllium, or well-lubricated glycerin suppositories; for fecal impaction, manual removal of stool is necessary. Administration of an oil-retention enema usually precedes stool removal; an enema is also necessary afterward. For lasting relief of constipation, the patient with inactive colon must modify his bowel habits.

Dietary changes

Increasing the amount of fibre in the daily diet. Good sources of fibre include wholegrain cereals, fruits, vegetables and legumes. The intake of foods such as milk, cheese, white rice, white flour and red meat should be restricted, because they tend to contribute to constipation.

Prevention

• A well-balanced diet high in fibre , including bran, fruits and vegetables, is often helpful.
• Drinking at least 8 to 10 glasses of water a day. Hot beverages, such as coffee, tea or hot water may stimulate bowel movements.
• Regular exercise improves digestion and reduces stress .
• Eat a normal breakfast