| Constipation | |
|---|---|
| Other names | Costiveness,[1] dyschezia[2] |
 | |
| Constipation in a young child seen on X-ray. Circles represent areas of fecal matter (stool is white surrounded by black bowel gas). | |
| Specialty | Gastroenterology |
| Symptoms | Infrequent or hard to pass bowel movements, abdominal pain, bloating[2][3] |
| Complications | Hemorrhoids, anal fissure, fecal impaction[4] |
| Causes | Slow movement of stool within the colon, irritable bowel syndrome, celiac disease, non-celiac gluten sensitivity, pelvic floor disorders[4][5][6] |
| Risk factors | Hypothyroidism, diabetes, Parkinson's disease, gluten-related disorders, colon cancer, diverticulitis, inflammatory bowel disease, certain medications[4][5][6] |
| Treatment | Drinking enough fluids, eating more fiber, exercise[4] |
| Medication | Laxatives of the bulk forming agent, osmotic agent, stool softener, or lubricant type[4] |
| Frequency | 2–30%[7] |
Constipation refers to bowel movements that are infrequent or hard to pass.[2] The stool is often hard and dry.[4] Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement.[3] Complications from constipation may include hemorrhoids, anal fissure or fecal impaction.[4] The normal frequency of bowel movements in adults is between three per day and three per week.[4] Babies often have three to four bowel movements per day while young children typically have two to three per day.[8]
Constipation has many causes.[4] Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders.[4] Underlying associated diseases include hypothyroidism, diabetes, Parkinson's disease, celiac disease, non-celiac gluten sensitivity, colon cancer, diverticulitis, and inflammatory bowel disease.[4][5][6][9] Medications associated with constipation include opioids, certain antacids, calcium channel blockers, and anticholinergics.[4] Of those taking opioids about 90% develop constipation.[10] Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older.[11]
Treatment of constipation depends on the underlying cause and the duration that it has been present.[4] Measures that may help include drinking enough fluids, eating more fiber, and exercise.[4] If this is not effective, laxatives of the bulk forming agent, osmotic agent, stool softener, or lubricant type may be recommended.[4] Stimulant laxatives are generally reserved for when other types are not effective.[4] Other treatments may include biofeedback or in rare cases surgery.[4]
In the general population rates of constipation are 2–30 percent.[7] Among elderly people living in a care home the rate of constipation is 50–75 percent.[10] People spend, in the United States, more than US$250 million on medications for constipation a year.[12]
References
edit- ^ "Costiveness – Definition and More from the Free Merriam-Webster Dictionary". Archived from the original on 11 April 2010.
- ^ a b c Chatoor D, Emmnauel A (2009). "Constipation and evacuation disorders". Best Pract Res Clin Gastroenterol. 23 (4): 517–30. doi:10.1016/j.bpg.2009.05.001. PMID 19647687.
- ^ a b American Gastroenterological Association; Bharucha, AE; Dorn, SD; Lembo, A; Pressman, A (January 2013). "American Gastroenterological Association medical position statement on constipation". Gastroenterology (Review). 144 (1): 211–217. doi:10.1053/j.gastro.2012.10.029. PMID 23261064.
- ^ a b c d e f g h i j k l m n o p q "Constipation". National Institute of Diabetes and Digestive and Kidney Diseases. February 2015. Archived from the original on 15 March 2017. Retrieved 14 March 2017.
- ^ a b c "Symptoms & Causes of Celiac Disease | NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. June 2016. Archived from the original on 24 April 2017. Retrieved 24 April 2017.
- ^ a b c Cite error: The named reference
MakhariaCatassi2015was invoked but never defined (see the help page). - ^ a b Andromanakos N, Skandalakis P, Troupis T, Filippou D (2006). "Constipation of anorectal outlet obstruction: Pathophysiology, evaluation and management". Journal of Gastroenterology and Hepatology. 21 (4): 638–646. doi:10.1111/j.1440-1746.2006.04333.x. PMID 16677147.
- ^ Colombo, Jennifer M.; Wassom, Matthew C.; Rosen, John M. (2015-09-01). "Constipation and Encopresis in Childhood". Pediatrics in Review. 36 (9): 392–401, quiz 402. doi:10.1542/pir.36-9-392. ISSN 1526-3347. PMID 26330473.
- ^ Bharucha, AE; Pemberton, JH; Locke GR, 3rd (January 2013). "American Gastroenterological Association technical review on constipation". Gastroenterology. 144 (1): 218–38. doi:10.1053/j.gastro.2012.10.028. PMC 3531555. PMID 23261065.
{{cite journal}}: CS1 maint: numeric names: authors list (link) - ^ a b Canadian Agency for Drugs and Technologies in Health (26 June 2014). "Dioctyl Sulfosuccinate or Docusate (Calcium or Sodium) for the Prevention or Management of Constipation: A Review of the Clinical Effectiveness". Dioctyl Sulfosuccinate or Docusate (Calcium or Sodium) for the Prevention or Management of Constipation: A Review of the Clinical Effectiveness. PMID 25520993.
- ^ Brenner, DM; Shah, M (June 2016). "Chronic Constipation". Gastroenterology Clinics of North America. 45 (2): 205–16. doi:10.1016/j.gtc.2016.02.013. PMID 27261894.
- ^ Avunduk, Canan (2008). Manual of gastroenterology : diagnosis and therapy (4th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 240. ISBN 9780781769747. Archived from the original on 11 September 2016.