Constipation (Qabz) : Stool frequency less than 3 stool in a day
Definition : Stool frequency less than 3 times a day,
Associated symptoms
Difficult to pass stool
Hard stool
Feeling of blockage
Incomplete evacuation
Using hand to press pelvis or removing stool with finger
Risk factors
Old age : constipation is more common in old age
Female has more chance of constipation
Low fiber diet : predispose to constipation
Poor intake of fluid leads to constipation and qabz
Caffeine : Tea and coffee intake leads to constiaption and qabz
Low physical activity and mental stress leads to constipation and qabz
Causes
Slow transit constipation : Reduced motility of large intestine
Pelvic floor obstruction : Reduced contraction of rectum and poor relaxation of anus leads to functional blockade at anus
Nerve weakness - diabetes mellitus : leads to poor colonic contractions
Parkinson diseases
Spinal cord trauma
Stroke : Paralysis in past can lead to constipation
Thyroid problem : Thyroid hormone deficiency can lead to constiaption
Increase calcium can lead to qabz and constipation
Blockade in large bowel
Tumor. : Large polyp and colon cancer can lead to constipation
Ulcerative colitis : Proctitis can lead to constipation
Medication
Complications
Fissure
Hemorrhoids
Fecal impaction
Alarming symptoms : Indicate underlying serious disease
Bleed per rectum
First time in old age
Weight loss
Pain abdomen
Investigation
Blood test Hb, calcium, TSH
Colonoscopy
MR defecography
Anorectal manometry : Tube is passes through the anus in the rectum to measure the pressure
Prevention
Include plenty of high-fiber foods in diet : Fruit and vegetable are rich in fiber, whole wheat is good source
Plenty of fluids : Take 3-4 extra glass of water
yoga/ meditation : Help in reducing stress
Avoid stress
Don't postpone bowel movement : One should go immediately to toilet at first urge
Food diary : Avoid food causing constipation
Exercise : Increases the bowel movement
Good squatting position by bending forward
No mobile/newspaper in toilet
Biofeedback therapy : Treats anorectal dyssynergia, a small balloon is passes in rectum, garphs on computer guide the patient to evacuate the bowel
Correction of thyroid, calcium
Changing underline culprit medicine
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