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Pharmacy Clinic
Constipation
Definition
The passage of hard stools less frequently than the patient’s own normal pattern’. This takes into account the huge variation in bowel habits seen
across the population.
Causes
Constipation is a symptom, not a disease. Like a fever, constipation can be caused by many different conditions. Most people have experienced an
occasional brief bout of constipation that has corrected itself with diet and time. The following is a list of some of the most common causes of
constipation:
• Poor Diet - A main cause of constipation may be a diet high in animal fats (meats, dairy products, eggs) and refined sugar (rich desserts and
other sweets), but low in fiber (vegetables, fruits, whole grains). Some studies have suggested that high fiber diets result in larger stools, more
frequent bowel movements, and therefore less constipation.
• Imaginary Constipation - This is very common and results from misconceptions about what is normal and what is not. If recognized early
enough, this type of constipation can be cured by informing the sufferer that the frequency of his or her bowel movements is normal.
• Irritable Bowel Syndrome (IBS)- Also known as spastic colon, IBS is one of the most common causes of constipation in the United States.
Some people develop spasms of the colon that delay the speed with which the contents of the intestine move through the digestive tract, leading to
constipation.
• Poor Bowel Habits - A person can initiate a cycle of constipation by ignoring the urge to have a bowel movement. Some people do this to avoid
using public toilets, others because they are too busy. After a period of time a person may stop feeling the urge. This leads to progressive
constipation.
• Laxative Abuse - People who habitually take laxatives become dependent upon them and may require increasing dosages until, finally, the
intestine becomes insensitive and fails to work properly.
• Travel - People often experience constipation when traveling long distances, which may relate to changes in lifestyle, schedule, diet, and
drinking water.
• Hormonal Disturbances - Certain hormonal disturbances, such as an underactive thyroid gland, can produce constipation.
• Pregnancy - Pregnancy is another common cause of constipation. The reason may be partly mechanical, in that the pressure of the heavy
womb compresses the intestine, and may be partly due to hormonal changes during pregnancy.
• Fissures and Hemorrhoids - Painful conditions of the anus can produce a spasm of the anal sphincter muscle, which can delay a bowel
movement.
• Specific Diseases -Many diseases that affect the body tissues, such as scleroderma or lupus, and certain neurological or muscular diseases,
such as multiple sclerosis, Parkinson’s disease, and stroke, can be responsible for constipation.
• Loss of Body Salts - The loss of body salts through the kidneys or through vomiting or diarrhea is another cause of constipation.
• Mechanical Compression - Scarring, inflammation around diverticula, tumors, and cancer can produce mechanical compression of the intestine
and result in constipation.
• Nerve Damage - Injuries to the spinal cord and tumors pressing on the spinal cord can produce constipation by affecting the nerves that lead
to the intestine.
• Medications - Many medications can cause constipation. These include pain medications (especially narcotics), antacids that contain aluminum,
antispasmodic drugs, antidepressant drugs, tranquilizers, iron supplements, anticonvulsants for epilepsy, antiparkinsonism drugs, and
antihypertensive calcium channel blockers.
• Colonic Motility Disorders - The peristaltic activity of the intestine may be ineffective resulting in colonic inertia or outlet obstruction.
• Metabolic -
a. ï Hypercalcaemia
b. ï Hypothyroidism
In a small number of children, constipation may be the result of physical problems. Children with such defects as the absence of normal nerve
endings in portions of the bowel, abnormalities of the spinal cord, thyroid deficiency, mental retardation, and certain other inherited metabolic
disorders often suffer symptoms of constipation. Constipation in children, however, usually is due to poor bowel habits.
Older adults are five times more likely than younger adults to report problems with constipation. Poor diet, insufficient intake of fluids, lack of
exercise, the use of certain drugs to treat other conditions and poor bowel habits can result in constipation. Experts agree, however, that too often
older people become overly concerned with having a bowel movement and that constipation is frequently an imaginary ailment.
Diet and dietary habits can play a role in developing constipation. Lack of interest in eating - a problem common to many single or widowed
older people - may lead to heavy use of convenience foods, which tend to be low in fiber. In addition, loss of teeth may force older people to choose
soft, processed foods, which also tend to be low in fiber.
Older people sometimes cut back on fluids, especially if they are not eating regular or balanced meals. Water and other fluids add bulk to
stools, making bowel movements softer and easier to pass.
Prolonged bedrest, for example, after an accident or during an illness, and lack of exercise may contribute to constipation. Also, drugs
prescribed for other conditions, such as antidepressants, antacids containing aluminum or calcium, antihistamines, diuretics, and antiparkinsonism
drugs, can produce constipation in some people.
The passage of hard stools less frequently than the patient’s own normal pattern’. This takes into account the huge variation in bowel habits seen
across the population.
Causes
Constipation is a symptom, not a disease. Like a fever, constipation can be caused by many different conditions. Most people have experienced an
occasional brief bout of constipation that has corrected itself with diet and time. The following is a list of some of the most common causes of
constipation:
• Poor Diet - A main cause of constipation may be a diet high in animal fats (meats, dairy products, eggs) and refined sugar (rich desserts and
other sweets), but low in fiber (vegetables, fruits, whole grains). Some studies have suggested that high fiber diets result in larger stools, more
frequent bowel movements, and therefore less constipation.
• Imaginary Constipation - This is very common and results from misconceptions about what is normal and what is not. If recognized early
enough, this type of constipation can be cured by informing the sufferer that the frequency of his or her bowel movements is normal.
• Irritable Bowel Syndrome (IBS)- Also known as spastic colon, IBS is one of the most common causes of constipation in the United States.
Some people develop spasms of the colon that delay the speed with which the contents of the intestine move through the digestive tract, leading to
constipation.
• Poor Bowel Habits - A person can initiate a cycle of constipation by ignoring the urge to have a bowel movement. Some people do this to avoid
using public toilets, others because they are too busy. After a period of time a person may stop feeling the urge. This leads to progressive
constipation.
• Laxative Abuse - People who habitually take laxatives become dependent upon them and may require increasing dosages until, finally, the
intestine becomes insensitive and fails to work properly.
• Travel - People often experience constipation when traveling long distances, which may relate to changes in lifestyle, schedule, diet, and
drinking water.
• Hormonal Disturbances - Certain hormonal disturbances, such as an underactive thyroid gland, can produce constipation.
• Pregnancy - Pregnancy is another common cause of constipation. The reason may be partly mechanical, in that the pressure of the heavy
womb compresses the intestine, and may be partly due to hormonal changes during pregnancy.
• Fissures and Hemorrhoids - Painful conditions of the anus can produce a spasm of the anal sphincter muscle, which can delay a bowel
movement.
• Specific Diseases -Many diseases that affect the body tissues, such as scleroderma or lupus, and certain neurological or muscular diseases,
such as multiple sclerosis, Parkinson’s disease, and stroke, can be responsible for constipation.
• Loss of Body Salts - The loss of body salts through the kidneys or through vomiting or diarrhea is another cause of constipation.
• Mechanical Compression - Scarring, inflammation around diverticula, tumors, and cancer can produce mechanical compression of the intestine
and result in constipation.
• Nerve Damage - Injuries to the spinal cord and tumors pressing on the spinal cord can produce constipation by affecting the nerves that lead
to the intestine.
• Medications - Many medications can cause constipation. These include pain medications (especially narcotics), antacids that contain aluminum,
antispasmodic drugs, antidepressant drugs, tranquilizers, iron supplements, anticonvulsants for epilepsy, antiparkinsonism drugs, and
antihypertensive calcium channel blockers.
• Colonic Motility Disorders - The peristaltic activity of the intestine may be ineffective resulting in colonic inertia or outlet obstruction.
• Metabolic -
a. ï Hypercalcaemia
b. ï Hypothyroidism
In a small number of children, constipation may be the result of physical problems. Children with such defects as the absence of normal nerve
endings in portions of the bowel, abnormalities of the spinal cord, thyroid deficiency, mental retardation, and certain other inherited metabolic
disorders often suffer symptoms of constipation. Constipation in children, however, usually is due to poor bowel habits.
Older adults are five times more likely than younger adults to report problems with constipation. Poor diet, insufficient intake of fluids, lack of
exercise, the use of certain drugs to treat other conditions and poor bowel habits can result in constipation. Experts agree, however, that too often
older people become overly concerned with having a bowel movement and that constipation is frequently an imaginary ailment.
Diet and dietary habits can play a role in developing constipation. Lack of interest in eating - a problem common to many single or widowed
older people - may lead to heavy use of convenience foods, which tend to be low in fiber. In addition, loss of teeth may force older people to choose
soft, processed foods, which also tend to be low in fiber.
Older people sometimes cut back on fluids, especially if they are not eating regular or balanced meals. Water and other fluids add bulk to
stools, making bowel movements softer and easier to pass.
Prolonged bedrest, for example, after an accident or during an illness, and lack of exercise may contribute to constipation. Also, drugs
prescribed for other conditions, such as antidepressants, antacids containing aluminum or calcium, antihistamines, diuretics, and antiparkinsonism
drugs, can produce constipation in some people.