Constipation (also known as costiveness or dysphasia) refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation. Severe constipation includes obstipation (failure to pass stools or gas) and fecal impaction, which can progress to bowel obstruction and become life-threatening.
Children Constipation in children usually occurs at three distinct points in time: after starting formula or processed foods (while an infant), during toilet training in toddlerhood, and soon after starting school (as in at kindergarten)
After birth, most infants pass 4-5 soft liquid bowel movements a day. Breast-fed infants usually tend to have more bowel movements compared to formula-fed infants. Some breast-fed infants have a bowel movement after each feed, whereas others have only one every 2–3 days. Infants who are breast-fed rarely develop constipation. By the age of two years, a child will usually have 1–2 bowel movements per day and by four years of age, a child will have one bowel movement per day
Constipation is a symptom with many causes. These causes are of two types: obstructed defecation and colonic slow transit (or hypomobility). About 50% of patients evaluated for constipation at tertiary referral hospitals have obstructed defecation. This type of constipation has mechanical and functional causes. Causes of colonic slow transit constipation include diet, hormonal disorders such as hypothyroidism, side effects of medications, and rarely heavy metal toxicity. Because constipation is a symptom, not a disease, effective treatment of constipation may require first determining the cause. Treatments include changes in dietary habits, laxatives, enemas, biofeedback, and in particular situations surgery may be required.
Constipation is common; in the general population incidence of constipation varies from 2 to 30%. In the United States expenditures on medications for constipation are greater than $250 million per year
The causes of constipation can be divided into congenital, primary, and secondary. The most common cause is primary and not life-threatening. In the elderly, causes include: insufficient dietary fiber intake, inadequate fluid intake and decreased physical activity, side effects of medications, hypothyroidism, and obstruction by colorectal cancer.
Constipation with no known organic cause, i.e. no medical explanation, exhibits gender differences in prevalence: females are more often affected than males.
Primary or functional constipation is ongoing symptoms for greater than six months not due to any underlying cause such as medication side effects or an underlying medical condition. It is not associated with abdominal pain, thus distinguishing it from irritable bowel syndrome. It is the most common cause of constipation.
Constipation can be caused or exacerbated by a low fiber diet, low liquid intake, or dieting.
Many medications have constipation as a side effect. Some include (but are not limited to); opioids (e.g. common pain killers), diuretics, antidepressants, antihistamines, antispasmodics, anticonvulsants, and aluminum antacids.
Metabolic and muscular
Metabolic and endocrine problems which may lead to constipation include: hypercalcemia, hypothyroidism, diabetes mellitus, cystic fibrosis, and celiac disease. Constipation is also common in individuals with muscular and myotonic dystrophy.
Structural and functional abnormalities
Constipation has a number of structural (mechanical, morphological, anatomical) causes, including: spinal cord lesions, Parkinsons, colon cancer, anal fissures, proctitis, and pelvic floor dysfunction.
Constipation also has functional (neurological) causes, including anismus, descending perineum syndrome, and Hirschsprung's disease. In infants, Hirschsprung's disease is the most common medical disorder associated with constipation. Anismus occurs in a small minority of persons with chronic constipation or obstructed defecation.
Voluntary withholding of the stool is a common cause of constipation. The choice to withhold can be due to factors such as fear of pain, fear of public restrooms, or laziness. When a child holds in the stool a combination of encouragement, fluids, fiber, and laxatives may be useful to overcome the problem.
Please refer to constipation
Eat fiber-rich food. You’ve probably heard that fiber is good for you, but do you make it a priority to eat fiber at every meal? Doing so will go a long way toward helping you prevent constipation. Fiber adds bulk to your stools, making them easier to pass. You need 24 to 36 grams per day. These foods contain high levels of fiber and will prevent you from getting constipated. Try incorporated at least one at every meal:
Cabbage, cauliflower, broccoli, and other cruciferous vegetables.
Lentils, black beans kidney beans and other beans.
Peaches, strawberries, blueberries, papaya
Almonds, walnuts, peanuts.
Wheat, bran and other whole grains flaxseeds.
Drink plenty of water. Constipation happens in part when your stools don’t contain enough water to easily pass through your body. When you're a bit dehydrated, you can easily become constipated. Make sure you drink water with every meal and any time you're thirsty to stay well hydrated. Aim to get eight to 10 cups of liquids each day. When you feel constipated, increase your water consumption immediately. It can prevent the constipation from getting worse. Start your day with a big glass of warm water and lemon for better digestive health.
Avoid processed foods. Foods that have been processed and combined with white flour and sugar are completely stripped of their healthy fiber content. Eating foods without fiber is hard on digestive system and can lead to constipation. These foods are common culprits: White bread, snack foods, fast foods, fried foods, dairy candy.
Drink less alcohol. Alcoholic beverages like wine, beer, whisky and others have a dehydrating effect being dehydrated can make it much more difficult to pass stools. If you tend to get constipated often, you might want to consider cutting back on alcohol. Stick with just a glass per evening, or eliminate it entirely. When you do decide to drink, make sure you have a glass of water for every glass of alcohol.
Cut back on caffeine. Caffeine can sometimes help with mild constipation, since it’s a diuretic, but it can make prolonged constipation worse, since it’s dehydrating. If you have a three cup a day habit, you might want to cut back for a while to see if it helps you avoid constipation. Try drinking just one cup per day, or switch to a low-caffeine tea.
Be physically active. Running, yoga, and other physical activities improve digestion. If you’re feeling constipated, try going for a brisk jog or walk to get things moving again. Exercising three or four times a week will help you stay regular and prevent constipation.