Constipation
Constipation (also known as costiveness, dyschezia, and dyssynergic defaecation) 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 (see also Bowel obstruction).
Constipation is common; in the general population incidence of constipation varies from 2 to 30%.
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, hormones, side effects of medications, and heavy metal toxicity.
Treatments include changes in dietary habits, laxatives, enemas, biofeedback, andsurgery. Because constipation is a symptom, not a disease, effective treatment of constipation may require first determining the cause.
TreatmentThe main treatment of constipation involves the increased intake of water and fiber (either dietary or as supplements). The routine use of laxatives is discouraged, as having bowel movements may come to be dependent upon their use. Enemas can be used to provide a form of mechanical stimulation. However, enemas are generally useful only for stool in the rectum, not in the intestinal tract.
LaxativesIf laxatives are used, milk of magnesia is recommended as a first-line agent due to its low cost and safety. Stimulants should only be used if this is not effective. In cases of chronic constipation, prokinetics may be used to improve gastrointestinal motility. A number of new agents have shown positive outcomes in chronic constipation; these include prucalopride, and lubiprostone.
Physical interventionConstipation that resists the above measures may require physical intervention such as manual disimpaction (the physical removal of impacted stool using the hands; see Fecal impaction).
PediatricLactulose and milk of magnesia have been compared with polyethylene glycol (PEG) in children. All had similar side effects, but PEG was more effective at treating constipation. Osmotic laxatives are recommended over stimulant laxatives.o Due to PROGESTERONE = fluid reabsorption due to ¯ GIT motility
o Nursing intervention
· Fluid
· Fiber
· Exercise
Constipation is common; in the general population incidence of constipation varies from 2 to 30%.
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, hormones, side effects of medications, and heavy metal toxicity.
Treatments include changes in dietary habits, laxatives, enemas, biofeedback, andsurgery. Because constipation is a symptom, not a disease, effective treatment of constipation may require first determining the cause.
TreatmentThe main treatment of constipation involves the increased intake of water and fiber (either dietary or as supplements). The routine use of laxatives is discouraged, as having bowel movements may come to be dependent upon their use. Enemas can be used to provide a form of mechanical stimulation. However, enemas are generally useful only for stool in the rectum, not in the intestinal tract.
LaxativesIf laxatives are used, milk of magnesia is recommended as a first-line agent due to its low cost and safety. Stimulants should only be used if this is not effective. In cases of chronic constipation, prokinetics may be used to improve gastrointestinal motility. A number of new agents have shown positive outcomes in chronic constipation; these include prucalopride, and lubiprostone.
Physical interventionConstipation that resists the above measures may require physical intervention such as manual disimpaction (the physical removal of impacted stool using the hands; see Fecal impaction).
PediatricLactulose and milk of magnesia have been compared with polyethylene glycol (PEG) in children. All had similar side effects, but PEG was more effective at treating constipation. Osmotic laxatives are recommended over stimulant laxatives.o Due to PROGESTERONE = fluid reabsorption due to ¯ GIT motility
o Nursing intervention
· Fluid
· Fiber
· Exercise