Constipation


We all know what constipation has to do with an enema.  Most often when constipation is a problem,  people go to the store and buy laxatives.  They take the laxative and wait for an indeterminate time, until it decides to work, which is usually at a very inconvenient time, while a simple enema, can eliminate the constipation in just a few minutes, at a time which is convenient for them.

Constipation does not have one simple answer as it's different for different people. Some people have infrequent stools, but for others, constipation means hard stools, difficulty passing stools (straining), or the sensation of not completely emptying after a bowel movement. The causes are  likely to be very different, and the solution to each should be tailored to the individual.

Sometimes, constipation alternates with bouts of diarrhea and most often this occurs as part of the irritable bowel syndrome (IBS). At the extreme end of this unhappy spectrum is fecal impaction, in which stool hardens in the rectum or colon and prevents the passage of any stool.

Clinically speaking, constipation is usually defined as fewer than three bowel movements per week. Severe constipation is defined as less than one bowel movement per week. There is no medical reason to have a bowel movement every day and going without a bowel movement for two or three days usually does not cause physical discomfort, only mental distress for some people.

Distinguishing between acute (a recent problem) and a chronic problem (long duration) is important. There are people who are more prone to constipation than others and struggle with the problem throughout their lives.  For these people, a regimen of enemas would bring reliable relief of the problem. Acute constipation requires urgent assessment because a serious medical illness may be the underlying cause (for example, tumors of the colon). Constipation also requires an immediate assessment if it is accompanied by worrisome symptoms such as rectal bleeding, abdominal pain and cramps, nausea and vomiting, or weight loss. In contrast, the evaluation of chronic constipation may not be urgent, particularly if simple measures bring relief.

There are several things you can do to help deal with constipation.

  • Eating more fruits, vegetables and grains, which are high in fiber
  • Drinking plenty of water or other non-carbonated liquids
  • Getting enough exercise
  • Taking time to have a bowel movement when you need to.
  • Using an enema.
  • Ask your doctor if medicines you take may be causing constipation
 Bowel movements are under voluntary control. This means that the normal urge people feel when they need to have a bowel movement can be suppressed. Sometimes for one reason or another, suppression is necessary, doing this too frequently can lead to a disappearance of urges and result in constipation.  In children, this is very common.  They get busy doing 'children' things and haven't the patience to 'sit' or hardened stool may be painful causing them to suppress normal function.

Diet

Fiber is important in maintaining a soft, bulky stool. Diets that are low in fiber can, therefore, cause constipation. The best natural sources of fiber are fruits, vegetables, and whole grains.

Laxatives

One suspected cause of severe constipation is the over-use of stimulant laxatives and castor oil. An association has been shown between the chronic use of stimulant laxatives and damage to the nerves and muscles of the colon, and it is believed by some that the damage may be responsible for the constipation. It is not clear, however, whether the laxatives have caused the damage or whether the damage existed prior to the use of laxatives and, indeed, has caused the laxatives to be used. Nevertheless, because of the possibility that stimulant laxatives can damage the colon, most experts recommend that stimulant laxatives be used as a last resort after non-stimulant treatments have failed.

Hormonal disorders

Hormones can affect bowel movements. For example:

Too little thyroid hormone (hypothyroidism) and too much parathyroid hormone (by raising the calcium levels in the blood) can cause constipation.
At the time of a woman's menstrual periods, estrogen and progesterone levels are high and may cause constipation. However, this is rarely a prolonged problem.
High levels of estrogen and progesterone during pregnancy also can cause constipation.
Diseases that affect the colon

There are many diseases that can affect the function of the muscles and/or nerves of the colon. These include diabetes, scleroderma, intestinal pseudo-obstruction, Hirschsprung's disease, and Chagas disease. Cancer or narrowing (stricture) of the colon that blocks the colon likewise can cause a decrease in the flow of stool.

Central nervous system diseases

Some diseases of the brain and spinal cord may cause constipation, including Parkinson's disease, multiple sclerosis, and spinal cord injuries.

Colonic inertia

Colonic inertia is a condition in which the nerves and/or muscles of the colon do not work normally. As a result, the contents of the colon are not propelled through the colon normally. The cause of colonic inertia is unclear. In some cases, the muscles or nerves of the colon are diseased. Colonic inertia also may be the result of the chronic use of stimulant laxatives as described above. In most cases, however, there is no clear cause for the constipation.

Pelvic floor dysfunction

Pelvic floor dysfunction (also known as outlet obstruction or outlet delay) refers to a condition in which the muscles of the lower pelvis that surround the rectum (the pelvic floor muscles) do not work normally. These muscles are critical for defecation (bowel movement). It is not known why these muscles fail to work properly in some people, but they can make the passage of stools difficult even when everything else is normal.

A frequently over-looked cause of constipation is medications. The most common offending medications include:

Narcotic: pain medications such as codeine (for example, Tylenol #3), oxycodone (for example, Percocet), and hydromorphone (Dilaudid);
Antidepressants: such as amitriptyline (Elavil, Endep) and imipramine (Tofranil)
Anticonvulsants: such as phenytoin (Dilantin) and carbamazepine (Tegretol)
Iron supplements:
Calcium channel blocking drugs: such as diltiazem (Cardizem) and nifedipine (Procardia)
Aluminum-containing antacids: such as aluminum hydroxide suspension (Amphojel) and aluminum carbonate (Basaljel)

In addition to the medications listed above, there are many others that can cause constipation. Simple measures (an enema, increasing fiber, fluids and more exercise) for treating the constipation caused by medications are often are effective, and discontinuing the medication is not necessary. If simple measures don't work, it may be possible to substitute a less constipating medication.

What is interesting is the broad variety of symptoms that can be caused by constipation, and relieved by an enema.
More serious causes, like irritable bowel syndrome {IBS}, colon cancer, are much less common. Constipation in children often occurs if they hold back bowel movements because they are afraid of it, maybe it hurts when it passes.  Mostly because they have other priorities, kid things to do.

    Constipation is a very common and frustrating problem for anyone. Constipation is usually defined as the passage of hard and painful stools or going then after a few days without a bowel movement. Constipation is often caused by a diet that is low in fiber and not enough non-carbonated liquids, but can also be caused by drinking too many carbonated beverages and milk products (more than 32oz/a day), or waiting too long to try and produce a bowel movement.

    Once a child develops constipation and has hard and painful stools, they will then begin to hold in their bowel movements to prevent it from causing pain. This creates a cycle that makes the constipation continue and become worse.
Constipation is best treated by making dietary changes. Until the constipation has improved with a non-constipating diet, your child will most likely also need to be on stool softeners. A good goal of treatment is for your child to have one or more bowel movements per day.

Many people try to force hard dry feces out when they are constipated.   About the only thing you accomplish from this is a good start on hemorrhoids.   However, by using a small volume enema and retaining this for a while.  You can soften this feces and have a comfortable bowel movement.  Usually retention is anywhere between 30 minutes to an hour to accomplish this.

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This information is strictly educational and is not, in any way, meant to prescribe or to constitute medical advice. The information provided is designed to be used in conjunction with the guidance of a healthcare professional. The author assumes no responsibility for any presumed health effects associated with using this information.

 

 

 

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