CONSTIPATION

Source:  CONSTIPATION    Tag:  panhypopituitarism definition

First and far most constipation is not a disease is a symptom.


What is constipation?
Medically constipation is defined as follows ; A person is suffering from constipation if he or she has not been on laxatives and reports two(2) of the following:


1. Fewer then 3 bowel movement per week( You have defecated  less than 3 times in a week).


2. Hard stool in more than 25% per defaecate.


3. A sense/ feeling of incomplete evacuation in more than 25% per defaecate.


4.Excessive straining in more than 25% per defaecate.


5.A need for digital manipulation to facilitate evacuation.


NB: 25% can be estimated by noting time when you start feeling the urge to defaecate and when you have completed or stopped defecation,  that will be the 1/4 of the total time taken.


Causes  of constipation can be sub grouped as follows :


1. Extrinsic ( Not associated with your system/external causes)
• Inadequate dietary fiber, fluid (DRINK AT LEAST 2 LITERS PER DAY)
• Ignoring urge to defecate


Structural( Caused by defect either congenital or acquired)
• Colorectal: neoplasm, stricture, ischemia, volvulus, diverticular disease
• Anorectal: inflammation, prolapse, rectocele, fissure, stricture


Systemic(Caused by defect on your body systems apart from gastro- intestinal system)
• Hypokalemia
• Hypercalcemia
• Hyperparathyroidism
• Hypothyroidism
• Hyperthyroidism
• Diabetes mellitus
• Panhypopituitarism
• Addison’s disease
• Pheochromocytoma
• Porphyria
• Uremia
• Amyloidosis
• Scleroderma, polymyositis
• Pregnancy( especially late pregnancy)


Neurological( Defect on the central nervous system / brain and nerves )
• CNS: Parkinson’s disease, multiple sclerosis, trauma, ischemia, tumor
• Sacral nerves: trauma, tumor
• Autonomic neuropathy
• Aganglionosis (Hirschsprung’s disease)


Drugs
• Opiates
• Anticholinergics
• Antidepressants
• Antipsychotics
• Anticonvulsants
• Antacids (aluminum, calcium)
• Antihypertensives
• Calcium-channel blockers
• Diuretics
• Ganglionic blockers
• Iron supplements
• Nonsteroidal antiinflammatory drugs
• Cholestyramine


Uncertain pathophysiology
• Irritable bowel syndrome
• Slow-transit constipation
• Pelvic floor dysfunction


NB: Please your Doctor will know which cause because each of these causes has conjugal symptoms that you as a patient will complain or he might ask and pick them up. Best way is as soon you see you are suffering from constipation is visit your general doctor.




Risk situations, groups and factors:


• Infants and children
• People over the age of 55
• Recent abdominal or perianal/pelvic surgery
• Late pregnancy
• Limited mobility
• Inadequate diet (fluid or fiber)
• Medication (polypharmacy), especially in the elderly
• Laxative abuse (normal long-term use is not a problem)
• Known comorbidities (see Tables 1 and 2)
• Terminal care patients
• Travel
• History of chronic constipation


Here I am providing the basic treatment guideline for  a person presenting with constipation, still urge you to visit your doctor for further investigation;







Courtesy of  World Gastroenterology Organisation.