Central Indiana Proctology
Constipation
Constipation can be defined as infrequent or hard pellet stools, or difficulty in evacuating stool. Passing one or more soft, bulky stools every day is a desirable goal. While troublesome, constipation is not usually a serious disorder. However, there may be other underlying problems causing constipation and, therefore, testing is often recommended.What Causes Constipation?
The stomach churns and mixes food so it can be digested. The near liquid food
then enters the small intestine which extracts calories, minerals and
vitamins. The small intestine ends in the right lower abdomen where it enters
the colon. The colon, or large bowel, is 5 to 6 feet long. Its function is to
withdraw water from the liquid stool, so that by the time it reaches the
rectum there is a soft formed stool. If an excessive amount of water is
extracted, the stool can become hard and difficult to expel.
Constipation is often caused by a lazy colon that does not contract properly and fails to move the stool to the rectum. The colon also can become spastic and remain contracted for a prolonged time. In this case, stool cannot move along. Too much water is absorbed and hard pellet like stool develops. Constipation also can result from a mechanical obstruction, such as tumors or advanced diverticulosis, a disorder which can distort and narrow the lower left colon. Other conditions that can produce a sluggish, poorly contracting bowel include: pregnancy, anal fissures and hemorrhoids, certain drugs, thyroid hormone deficiency, the abuse of laxatives, travel, and stress.
Diagnosis
The patient's medical history is the most important factor in diagnosing constipation. The physician will perform a physical exam and obtain certain blood tests. A sigmoidoscopic exam ( using a lighted, flexible endoscope) is necessary to rule out a mechanical blockage of the lower bowel, such as a tumor. This exam allows the physician to view the bowel wall and obtain biopsies ( tissue samples) of any suspicious areas. Colonoscopy may be indicated. This is the visual exam of the inside of the entire colon using a flexible fiber optic colonoscope. The exam is usually performed under mild sedation.Treatment
Because there are many causes of constipation, treatment depends on the physician's findings and diagnosis. After serious problems are excluded, chronic constipation usually responds to simple measures, such as adding fiber, bran, or a bulking agent to the diet.General guidelines for treating constipation include: eating regularly, drinking plenty of liquids each day, regular walking, and performing aerobic exercise if approved by your family doctor. In particular, patients should respond to the urge to defecate. Retaining the stool at this point will aggravate the condition.
Diet
Foods that are high in roughage and fiber are essential in correcting and preventing constipation. The following food be eaten daily in adequate amounts:Whole grain breads ( whole wheat) .Bran cereals Vegetables - Roots (potatoes, carrots, turnips), leafy green (lettuce, celery, spinach), or cooked high residue (cabbage) Fruit - Cooked or stewed (prunes, applesauce) or fresh fruit (skin and pulp )
