Diagnosis of Chronic Constipation

Symptoms of constipation

Physical Examination

Palpation of the left side of abdomen, especially the lower part (in children in lower-mid part) may reveal lumps of stool. In children inspection of anal area may reveal skin tears - anal fissure or fistulae, hemorrhoids, rectal prolapse. Causes of constipation in children. Digital rectal examination gives an impression of the anal sphincter tone, anal stenosis and presence of feces in the rectum. In women posterior vaginal wall palpation may give evidence of internal rectal prolapse or rectocele.

Laboratory Findings

CBC - Complete blood count (low red cells may indicate occult bleeding, raised leukocytes may show inflammation). Blood glucose is increased in diabetes, electrolyte levels may be deranged in renal disease. Fecal occult blood test may be done in chronically obstipated patients after age of 50 (eventual colon cancer).

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Complications of Severe Constipation

Severe constipation, acute or chronic, has to be treated promptly, otherwise below mentioned complications may develop.

Bloating

Bloating is common in constipated persons; prolonged stool passage enables colonic bacteria to break down more fibres and hence produce more gas. Finding appropriate food and avoiding carbonated drinks may help. Tiredness may be related to constant annoying abdominal discomfort.

Lazy Colon

Lazy colon is a term which denotes slow colonic transit time or in extreme cases colon inactivity. It is a result of long term laxatives abuse, postponing bowel movements or prolonged bed rest. Colonic peristalsis react only weakly on presence of stool and even on laxatives. Affected person often doesn’t feel the urge for defecation. Lazy colon is a kind of synonym for a severe chronic constipation. Eliminating the cause is the only solution.

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Definition of Constipation

Constipation (from lat. constipare = to press together) is evacuating the bowel with difficulty, or less than three times a week. There is no need to have a bowel movement every day if someone doesn’t feel the need for it.

Symptoms of Constipation

One or more of the following symptoms may be present in constipation:

• straining or pain at passing the stool, feeling of incomplete bowel emptying;
• hard and dry stool;
• bloating - excessive gas in the gut;
• coated tongue, bad taste, offensive breath, headache, fatigue, and loss of appetite and weight may follow.

Causes of Constipation

Constipation in adults is mostly a consequence of inappropriate food or stress. In infants it is almost always caused by congenital disorders. In children psychological factors are important. In old people inactivity is the main cause. Constipation may also be caused by a disease, medications or hospitalization.

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