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Published by Nader Smadi

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Published by: Nader Smadi on Feb 07, 2009
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Constipation is a common digestive system problem in which you have infrequent
bowel movements, pass hard stools, or strain during bowel movements.

In terms of frequency, what constitutes constipation for one person may be normal for
someone else. That's because the normal frequency of bowel movements varies
widely \u2014 from three a day to three a week. What's normal for you may not be normal
for someone else.

In general, though, you're probably experiencing constipation if you pass hard and dry
stools less than three times a week. In some cases, constipation also may make you
feel bloated or sluggish or experience discomfort or pain.

Fortunately, a few common-sense lifestyle changes, including getting more exercise,
eating high-fiber foods and drinking plenty of water, can go a long way toward
preventing or alleviating constipation.

Not having a bowel movement every day doesn't necessarily mean you're constipated.
You're likely constipated, however, if you:
Pass a hard stool fewer than three times a week
Strain frequently during bowel movements
Have abdominal bloating or discomfort

Normally, the waste products of digestion are propelled through your intestines by muscle contractions. In the large intestine, most of the water and salt in this mixture are reabsorbed because they're essential for many of your body's functions.

If too much water is absorbed or if the waste moves too slowly, you may become
constipated. You may also experience constipation if the muscles you use to move
your bowels aren't coordinated. This problem is called pelvic floor dysfunction
(anismus) and it causes you to strain with most bowel movements, even soft ones.
Stool moves through your colon but gets hung up in the rectum because of a lack of
muscle coordination to empty your bowels.

A number of factors can cause an intestinal slowdown, including:
Inadequate fluid intake
A low-fiber diet
Inattention to bowel habits
Lack of physical activity
Many medications, including those used to treat Parkinson's disease, high blood
pressure and depression, also can cause constipation. The same is true of many
narcotics. And frequent use of laxatives often aggravates and may even eventually
cause constipation.
In rare cases, constipation may signal more serious medical conditions, such as
colorectal cancer, hormonal disturbances or autoimmune diseases.

Sometimes young children are constipated because they forget to take time to use the toilet. And your toddler might become constipated during toilet training if he or she is afraid or unwilling to use the toilet.

Risk factors

You're more likely to have problems with constipation if you're an older adult, are
sedentary or bedridden, eat a diet that's low in fiber or don't drink enough fluids.
You're also at risk if you take certain medications, including sedatives or narcotics, or
you're receiving chemotherapy.

If you're pregnant, you may have bouts of constipation because of hormonal changes. Later in your pregnancy, pressure on your intestines from your uterus also can cause constipation.

When to seek medical advice

See your doctor if you experience a recent, unexplained onset of constipation or change in bowel habits, or any of the following signs or symptoms, which might indicate a more serious health condition:

Bowel movements just once or twice a week, despite corrective changes in
diet or exercise
Intense abdominal pain
Blood in your stool
Constipation that alternates with diarrhea
Rectal pain
Thin, pencil-like stools
Unexplained weight loss
Tests and diagnosis
A diagnosis of constipation generally depends on your medical history and a physical

exam. Your doctor will first want to make sure you don't have a blockage in your
small intestine or colon (intestinal obstruction), an endocrine condition, such as
hypothyroidism, or an electrolyte disturbance, such as excessive calcium in the blood
(hypercalcemia). He or she will also want to check your medications in case they may
be causing your constipation.

You may undergo these diagnostic procedures:

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