Constipation in Adults

Constipation Overview

Constipation refers to a decrease in the frequency of bowel movements. For some people, it may mean difficulty in passing stools. A constipated stool is hard because it contains less water than normal. Constipation is a symptom, not a disease.

Generally, constipation is difficult to define clearly because as a symptom it varies from person to person.

• The frequency of bowel movements also varies greatly, ranging from 3 movements per day to 3 per week. Generally, if your bowel has not opened for 3 successive days, the intestinal contents harden, and you may have difficulty or even pain during defecation.

• A common misconception about constipation is that wastes stored in your body are absorbed, are dangerous to your health, and may shorten your lifespan. Some people have an underlying fear that they will be "poisoned" by their own intestinal wastes (feces) if they retain the waste in their bodies for more than a certain length of time. None of this is true.

• Older people are 5 times more likely than younger people to develop constipation. But experts believe that older people become too concerned with having a daily bowel movement and that constipation in this age group is overestimated.

Constipation Causes

Constipation may result from a poor diet, poor bowel habits, or problems in elimination of stool, whether physical, functional, or voluntary.

These are the most common causes of constipation:

• Poor diet: Eating foods rich in animal fats (dairy products, meats, and eggs) or refined sugar but low in fiber (whole grains, fruits, and vegetables) may cause constipation.

• Poor bowel habits: Ignoring the desire to have bowel movements may initiate a cycle of constipation.
  
  
  • After a period of time, you may stop feeling the desire for opening your bowel.
    
    
  • This leads to progressive constipation. For example, some people may avoid using public toilets or ignore going to the toilet because they are busy.

• Medications: Many medications can cause constipation.
  
  
  • Antacids - Those containing aluminum hydroxide and calcium carbonate
    
    
  • Antispasmodic drugs
    
    
  • Antidepressants
    
    
  • Iron tablets
    
    
  • Anticonvulsant drugs

• Painkillers: Narcotic-containing drugs, for instance, may interfere with bowel functions.

• Travel: Changes in lifestyle, low fluid intake, and eating fast food may cause constipation.

• Irritable bowel syndrome (spastic colon): This is one of the most common causes of constipation. Because of changes in bowel function, if you have this disorder, you may have crampy abdominal pain, excessive gas, bloating, and constipation.

• Laxative abuse: Habitually using laxatives gradually will produce dependency on them.
  
  • You may eventually require increasing amounts of laxatives to move your bowels.
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  • In some instances, the bowel will become insensitive to laxatives and fail to open.

• Pregnancy: Constipation during pregnancy may be due to several factors. Each of the following conditions produces severe pain on defecation, which may trigger a reflex spasm of the anal sphincter muscle. The spasm may delay bowel movement and decrease the desire for bowel opening as a means to avoid the anal pain.
  
  
  • Mechanical pressure on your bowel by the heavy womb
    
    
  • Hormonal changes during pregnancy
    
    
  • Changes in food and fluid intake
    
    
  • Anal fissure (cracks in the anus)
    
    
  • Hemorrhoids (piles)
    
    
  • Anal stenosis (narrow anus)

• Intestinal obstruction: Mechanical compression and interference with the normal functions of the bowel may occur in the following ways:
  
  
  • Inflammatory adhesions and joining of tissues
    
    
  • Intestinal tumors or foreign bodies
    
    
  • Gallstones that have become immovably wedged in the intestine
    
    
  • Twisting of the intestine upon itself (volvulus)
    
    
  • Intussusception – "Telescoping of the intestine" in which one part of your intestine slips or is drawn onto another part just below it (This occurs mainly in children.)
    
    
  • Abdominal hernia - Loops of the intestine become obstructed
    
    
  • Damage to nerves within your intestine - (Spinal cord tumors, multiple sclerosis, or spinal cord injuries may produce constipation by interfering with the function of the nerves supplying the intestine.)
    
    
  • Connective tissue diseases – Conditions such as scleroderma and lupus
    
    
  • Poor-functioning thyroid gland - A low production of thyroxin, a hormone produced by the thyroid gland, hypothyroidism, causing constipation
    
    
  • Lead poisoning and other metabolic disorders

• Age: Older adults are more likely to have constipation for these reasons:
  
  
  • Poor diet and insufficient intake of fluids
    
    
  • Lack of exercise
    
    
  • Side effects of prescription drugs used to treat other conditions
    
    
  • Poor bowel habits
    
    
  • Prolonged bed rest, for example after an accident or during an illness
    
    
  • Habitual use of enemas and laxatives