Constipation

What is constipation?

Constipation is the infrequent and difficult passage of stool. The stool may be too hard, infrequent, small or difficult to expel. In some people, constipation is sudden and often a manifestation of another abdominal problem, such a bowel obstruction. The incidence of constipation increases with age, and is most common after 60. A change in bowel habit (without change in diet) is a significant symptom which should be brought to the attention of your doctor.

What causes constipation?

Constipation may be caused by various medications such as general anaesthesia or iron, analgesics, tranquillisers and sedatives.

Other causes include:

  • Diet low in fibre content.
  • Colon cancer.
  • Irritable bowel syndrome.
  • Colonic diverticulosis.

What are the symptoms of constipation?

  • Infrequent bowel movements.
  • Feeling that the rectum is full, after you have had a bowel movement.
  • Dry, hard stool.
  • Difficulty in passing stool.

How is constipation treated?

This depends on the cause of constipation.

  • Dietary adjustments may be required, such as increasing fibre and/or fluid intake.
  • Stool softeners help by adding moisture to the stool.
  • Enemas may be required in the short term, which is a quantity of fluid infused into the rectum through a tube passed into the anus to relieve impaction.
  • Laxatives should be taken as a last resort, and only on a doctor’s recommendation and on a temporary basis.
  • Cessation if possible of the offending drug e.g. codeine and its derivatives are frequently included in pain medication and cause constipation as a side effect,
  • In severe cases where there is structural abnormality causing a blockage, surgery may be required.

How is constipation evaluated?

  • A thorough examination is done to rule out other illness of which constipation is a symptom.
  • Blood tests may reveal anaemia.
  • Stool can be chemically tested for the presence of blood.
  • Visualisation of the colon can be achieved by enema x-rays, flexible sigmoidoscopies and colonoscopies.
  • Specific tests can measure speed of transit of stool through the colon, as well as the pressure inside.

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