Common causes of constipation

Constipation means different things to different people. For many people, it simply means a rare chair. For others, constipation means hard feces, difficulty passing through the rectum, or a feeling of incomplete emptying after a bowel movement. The causes of each of these types of constipation are different, and the treatment approach must be adapted to each specific type of constipation.

Constipation

Constipation can alternate with diarrhea. This pattern of body behavior usually bothers a person as part of irritable bowel syndrome (IBS). The end result is a stagnation of fecal masses, a condition in which the feces solidifies in the rectum and does not go out through the anus.

The number of bowel movements usually decreases with age. Ninety-five percent of adults perform bowel movements three to 21 times a week, and this will be considered normal. The most common pattern is one bowel movement per day, but this is observed in less than 50% of people. In addition, most bowel movements are irregular and do not occur every day.

[1]

Defecation and toxins

From a medical point of view, constipation is usually defined as a condition of less than three bowel movements per week. Severe constipation is defined as a condition of less than one bowel movement per week. There is no medical reason to have a bowel movement every day. The inability to empty the intestines for two or three days does not cause physical discomfort, but only mental distress in some people.

Contrary to popular belief, there is no evidence that the “toxins” that accumulate during defecation are rare, and also lead to constipation and cancer.

[2], [3], [4], [5], [6], [7]

Constipation and visit to the doctor

It is important to distinguish between acute constipation (the effects of the disease) and chronic constipation (prolonged). Acute constipation requires urgent medical examination and can be the cause of some serious illness (for example, a colon tumor). Constipation also requires an immediate visit to the doctor if it is accompanied by unpleasant symptoms, such as rectal bleeding, abdominal pain and cramps, nausea and vomiting and involuntary weight loss.

In contrast to non-persistent and acute, chronic constipation may require a non-urgent nature of seeking medical attention, especially if simple measures of treatment (enema, laxative) can bring relief.

[8], [9]

The three most common underlying causes of constipation

1. Too much water is absorbed from the feces when they pass through the rectum, resulting in stiff, dry stools.
2. There are changes in the ability to coordinate contractions of the rectal muscles necessary for the excretion of feces from the rectum and anus, and then the stool gets stuck in the anus
3. In the intestines, stool blocking something, such as a tumor.

There are various reasons why one of these three things can happen and lead to constipation. Common causes of temporary constipation — that is, what many people experience from time to time include

• There is not enough fiber in the menu.
• Not enough drinking water and other liquids.
• Lack of exercise
• The patient does not pay attention to the urge to defecate until a more appropriate time.
• Frequent use of laxatives, and then a sudden cessation
• The use of certain drugs, in particular, some chemotherapy drugs and those used to get rid of pain (opiates), nausea and depression

Constipation as a symptom of cancer

When the stool comes out of the colon, it appears to be a thick liquid that can be partially blocked, but stuck in narrow areas. As the stool goes out through the rectum and more water is removed from it, the stool becomes thicker. This limits its ability to circumvent all the bends of the rectum, and especially in its narrow areas. A tumor in the middle and in the lower part of the colon or at the beginning of the rectum can make stool passage difficult and leads to constipation.

If you suffer from chronic or recurrent constipation, the sooner you see your doctor for a diagnosis, the better. Patients with colon cancer should be diagnosed first by a doctor. Studies show that if a cancer is diagnosed in its early stages, patient survival is over 90%. If cancer is diagnosed late and has spread beyond the colon, the survival rate drops sharply.

If you notice changes in the behavior of your intestines, consult a doctor as soon as possible. In many cases, you will find that you do not have colon cancer, and something less serious causes you constipation. But it is better to err on the side of lesser danger than to miss the big one.

Constipation occurs when the large intestine absorbs too much water, or if muscle contractions in the rectum pass too slowly and sluggishly, causing the stool to move too slowly. As a result, feces may become too dry and hard.

[10]

Common causes of chronic constipation are

• Lack of fiber in the diet lack of physical activity (especially in old age)
• Medication, especially for multiple sclerosis and antidepressants
• Milk in large quantities
• Irritable Bowel Syndrome
• Changes in life, such as pregnancy, old age and traveling to a country with a different climate
• Laxative abuse
• When a person does not pay attention to the need for defecation
• Dehydration
• Specific diseases or conditions, such as stroke (the most common cause of constipation)
• Problems with the state of the colon and rectum
• Intestinal problems (chronic idiopathic constipation)

[11], [12]

What medications can cause constipation?

Some medicines can cause constipation, including

• pain medication (especially drugs)
• antacids containing aluminum and calcium
• drugs for regulating blood pressure (calcium channel blockers)
• antidepressants
• iron supplements
• diuretics
• anticonvulsants
• sleeping pills

Decipher in more detail the main causes of constipation.

Changes in life that cause constipation

During pregnancy, a woman may become constipated due to hormonal changes or because the uterus constricts the intestines. Aging can also affect the patterns of intestinal function, because slower metabolism leads to poorer intestinal function and less active muscle tone. In addition, people often suffer from constipation when they travel, because their usual diet and daily routine is disturbed.

[13]

Laxative abuse

The general belief that people should have daily bowel movements led to the abuse of laxative drugs. Although people may feel relieved when using laxatives, as a rule, they should increase the amount of time they spend in the toilet. As a result, laxatives may not be needed when the intestine itself performs its role.

[14], [15]

Ignoring the desire to have a bowel movement.

People who ignore the urge to defecate can ultimately aggravate their condition, which can lead to constipation. Some people delay bowel movements because they do not want to use the toilet outside the house. Others ignore the desire to throw fecal matter out of the intestines due to emotional stress or because they are too busy. Children may have a bowel movement because of stressful toilet preparations or because they do not want to interrupt the game.

[16], [17]

Specific diseases as a cause of constipation

Diseases that cause constipation include neurological disorders, metabolic disorders and diseases of the endocrine system, as well as systemic diseases that affect the organs. These disorders can slow the movement of the stool through the rectum or anus.

The diseases that can cause constipation are listed below.

Neurological disorders

• multiple sclerosis
• Parkinson's disease
• chronic idiopathic bowel deformity (pseudo-obstruction for feces)
• stroke
• spinal cord injury

Metabolic and endocrine diseases

• diabetes
• uremia
• hypercalcemia
• low glycemic control
• hypothyroidism

Systemic disorders of the body

• amyloidosis
• lupus
• scleroderma

Problems with the colon and rectum

Intestinal obstruction, scar tissue, also called adic-diverticulosis (diverticulosis), tumors, colorectal cancer, abnormal contractions of the intestine and rectum can cause constipation.

[18], [19]

Intestinal problems

There are two types of constipation: idiopathic constipation and functional constipation. Irritable bowel syndrome (IBS), with predominant symptoms of constipation, is isolated separately.

Idiopathic type of constipation is constipation of unknown origin - they are not amenable to standard treatment.

Functional constipation means that the intestines are healthy, but not working properly. Functional constipation is often the result of poor nutrition and poor lifestyle choices. It occurs in both children and adults, and is most common among women.

Problems with rectum and colon, with delayed transit of feces, pelvic dysfunction are a type of functional constipation. They lead to a weakening of the muscle activity of the rectum. These syndromes can affect the condition of the entire colon, or can relate to the lower or sigmoid colon, the large intestine.

Pelvic dysfunction is caused by weakness of the muscles in the pelvic region around the anus and rectum. However, since this muscle group is voluntarily controlled, to some extent, bio-feedback (biofeedback) can be successful in retraining the muscles for their normal functioning and improving the ability to defecate.

Functional constipation is associated with problems in the structure of the anus and rectum and is known as anorectal dysfunction, or anismus. These disorders result in the inability to relax the rectum and the anal muscle, which allow the chair to normally exit.

Can constipation lead to complications?

Sometimes constipation can actually lead to complications. These complications include hemorrhoids caused by muscle tension in the rectum to defecate, or anal fissures. They occur in the skin around the anus when hard stool stretches the muscles of the anal sphincter. As a result, rectal bleeding may occur, visually discernible as bright red stripes on the surface of the stool.

Hemorrhoid treatment may include sitting in a warm bath, ice packs on the anus area and application of a special cream on the affected area. Treatment of anal fissures may include stretching the sphincter muscles or surgical removal of tissue in the area of the hemorrhoidal lumps.

Sometimes the tension of the rectum causes the loss of its part, when the chair is pushed out of the anus. This condition, known as prolapse of the rectum, can lead to the secretion of mucus from the anus.

Usually, to eliminate the causes of prolapse, which manifests itself even when a person coughs, you need serious treatment. Severe or chronic prolapse requires surgical intervention to strengthen and tighten the muscles of the anal sphincter or filing the rectum that has prolapsed.

Constipation can also cause hard stools that clog the intestines and rectum so tightly that the normal pushing effects of the colon are not enough to remove feces from it. This condition, called fecal stagnation, is most common in children and the elderly. Fecal masses can be softened with mineral oil, which the patient takes either orally or through an enema.

After softening the blockage of the stool, the doctor can break up and remove part of the feces by inserting one or two fingers into the patient's anus.

[20],