Constipation
Bowel dysfunction / From Wikipedia, the free encyclopedia
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Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass.[2] The stool is often hard and dry.[4] Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement.[3] Complications from constipation may include hemorrhoids, anal fissure or fecal impaction.[4] The normal frequency of bowel movements in adults is between three per day and three per week.[4] Babies often have three to four bowel movements per day while young children typically have two to three per day.[8]
Constipation | |
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Other names | Costiveness,[1] dyschezia[2] |
Constipation in a young child seen on X-ray. Circles represent areas of fecal matter (stool is white surrounded by black bowel gas). | |
Specialty | Gastroenterology |
Symptoms | Infrequent or hard to pass bowel movements, abdominal pain, bloating[2][3] |
Complications | Hemorrhoids, anal fissure, fecal impaction[4] |
Causes | Slow movement of stool within the colon, irritable bowel syndrome, celiac disease, non-celiac gluten sensitivity, pelvic floor disorders[4][5][6] |
Risk factors | Hypothyroidism, diabetes, Parkinson's disease, gluten-related disorders, colon cancer, ovarian cancer, diverticulitis, inflammatory bowel disease, certain medications[4][5][6] |
Treatment | Drinking enough fluids, eating more fiber, exercise[4] |
Medication | Laxatives of the bulk forming agent, osmotic agent, stool softener, or lubricant type[4] |
Frequency | 2–30%[7] |
Constipation has many causes.[4] Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders.[4] Underlying associated diseases include hypothyroidism, diabetes, Parkinson's disease, celiac disease, non-celiac gluten sensitivity, vitamin B12 deficiency, colon cancer, diverticulitis, and inflammatory bowel disease.[4][5][6][9][10] Medications associated with constipation include opioids, certain antacids, calcium channel blockers, and anticholinergics.[4] Of those taking opioids about 90% develop constipation.[11] Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older.[12]
Treatment of constipation depends on the underlying cause and the duration that it has been present.[4] Measures that may help include drinking enough fluids, eating more fiber, consumption of honey[13] and exercise.[4] If this is not effective, laxatives of the bulk-forming agent, osmotic agent, stool softener, or lubricant type may be recommended.[4] Stimulant laxatives are generally reserved for when other types are not effective.[4] Other treatments may include biofeedback or in rare cases surgery.[4]
In the general population rates of constipation are 2–30 percent.[7] Among elderly people living in a care home the rate of constipation is 50–75 percent.[11] People spend, in the United States, more than US$250 million on medications for constipation a year.[14]