What is constipation?
Constipation is infrequent bowel movements or straining. Patients may develop abdominal pain or distension or firm or dry stools and passing stools may cause pain.
What causes constipation?
Constipation can result from increased water absorption in the colon, low fiber intake or slow colon muscle contractions. Conditions associated with constipation include certain medications, irritable bowel syndrome, lack of physical activity, dehydration, ignoring the urge to defecate, neurologic problems or low thyroid activity.
How is constipation evaluated?
In order to determine the cause of constipation, your doctor may recommend checking particular labs (blood tests) to evaluate your electrolytes and thyroid function. Your doctor may also recommend performing colonoscopy in order to rule out a colon or rectal tumor or lesion. In order to determine how quickly stool moves through different parts of the gastrointestinal tract, a sitz marker study may be recommended. In this study a patient swallows small metal beads and then a series of abdominal x-rays are taken over several days. Anorectal manometry may also be recommended. Anorectal manometry is an outpatient procedure that examines the muscular function of your rectum and anus. A thin tube with pressure sensors is inserted into the rectum in order to measure pressures of the anal sphincter muscles, the sensation of the rectum and the reflexes needed for defecation. Defecography may also be recommended. During this test the doctor fills the rectum with a soft paste that is the same consistency as stool. The patient then sits on a toilet positioned inside an x-ray machine, and then expels the paste. The doctor studies the x rays for problems that occur as the patient expels the paste.
What is the treatment for constipation?
Depending on the cause and severity of constipation, your doctor may recommend to stop one or more medications that cause constipation. Regular water intake can improve chronic dehydration that may cause constipation. Daily fiber supplementation increases water content in the stool and can thereby soften stool. Regular exercise may improve stool frequency. Several medications may improve stool frequency and consistency. Examples of medications your doctor may recommend include miralax, lactulose, stool softeners, dulcolax, suppositories, lubiprostone or others.