Chronic constipation can occur in diseases such
as hypothyroidism, diabetes mellitus, Parkinson's disease, dementia,
depression, or as side effects of drugs (opioid analgesics, medicines used to
treat ischemic heart disease or hypertension).
Chronic Constipation: Causes
According to gastroenterologists, chronic
constipation may be an isolated condition linked to eating style or a colon of
greater length or caliber, or with motility disorders.
When intestinal transit suddenly changes and
constipation occurs, we need to see it as an alarm signal that requires
colonoscopy, as the newly installed constipation, especially in an elderly
person, may be due to a tumor in the colon.
Also, when constipation is associated with
anemia, with unexplained weight loss, and severe abdominal pain, thorough
investigation is recommended, indicating a structural colon disease.
Causes related to diet and lifestyle:
l Advanced age
l Delay to the moment when the sensation occurs
l Lack of physical activity
l Diet poor in fiber
l Low fluid consumption
l Pregnancy
l Stress or anxiety
l Travel (travel constipation)
Gastrointestinal causes of constipation:
l Anal fistula
l Bowel obstruction
l Colon inertia (abnormal functioning of nerves and colon muscles)
l Colorectal cancer
l Dehydration due to excessive vomiting or diarrhea
l Surgery in the digestive tract
l Diverticulitis (inflammation of a diverticula, an abnormal
"pocket" in the colon wall)
l Food intolerance or allergies
l Hirschprung disease (caused by a congenital neurological defect
resulting in severe constipation and intestinal obstruction in newborn and
infant)
l Irritable bowel syndrome (digestive discomfort that does not cause
lesions or intestinal diseases)
l Dysfunction of the pelvic floor
Other causes of constipation:
l Depression
l Diabetes
l Eating disorders
l Hypercalcemia (elevated blood calcium)
l Hypothyroidism (decrease in thyroid hormone levels)
l Multiple sclerosis (a disease that affects the brain and spinal cord
leading to weakness, balance disorders and coordination)
l Parkinson's disease (a brain disorder affecting movement and
coordination)
l Spinal cord injuries
l Stroke
l Systemic lupus erythematosus (a condition in which the body attacks its
own healthy cells and tissues)
l Uremia (increase in nitrogen metabolism)
Medicines that cause constipation:
l Anesthetics
l Antacids containing calcium or aluminum
l Anticonvulsants
l Antidepressants;
l Calcium channel blockers used to treat high blood pressure
l Diuretics
l Iron supplements;
l Abuse of laxatives
l Narcotics
l Medicines to treat Parkinson's disease
l Tranquilizers
Chronic Constipation: Symptoms
Chronic Constipation may persist for a long time
when it is produced by the poor diet in fibers and liquids.
Digestive symptoms that may appear alongside
constipation are:
l Cramps or abdominal pain
l Bloating, abdominal distension
l Changing habits in terms of defecation
l Fecal incontinence
l Flatulence, gases, or indigestion
l Feeling full
l Liquid leakage without having a stool
l Nausea or vomiting
l Rectal pain or burns
l Difficulties at the level of intestinal transit
Other symptoms that may appear alongside
constipation are:
l Flu-like symptoms (fatigue, fever, sore throat, headache, cough,
generalized pain)
l Decreased appetite
l Stress or anxiety
l Weakness
l Unexplained weight loss
Chronic Constipation: Treatment
The first rules in the treatment of constipation
are to respect healthy lifestyle and diet.
It is necessary to consume 1.5-2 liters of
fluids every day and have a diet rich in fruits, vegetables, salads, cereals,
and whole cereals bread.
Physical activity is also essential because
constipation occurs more frequently in people living a sedentary lifestyle.
Many people skip over the breakfast. Colonial
motility stimulation, however, is maximal after breakfast and exceeds the
stimulation caused by coffee consumption. Thus, resuming breakfast is important
for people suffering from constipation.
When constipation is associated with certain
conditions, their treatment may improve the symptoms.
Chronic Constipation: Natural Remedies or Pills?
If these measures do not solve the problem,
medication is needed, usually with fiber supplements (methylcellulose,
psyllium) or osmotic laxatives (lactulose, polyethylene glycol, magnesium
salts).
Fiber supplements and lactulose may have side
effects of bloating and flatulence. However, the effect of osmotic laxatives
does not occur immediately, and may occur after 2-3 days, time in which they
only retain water in the intestine and soften the intestinal content, which is
easily eliminated by the colon movements.
Irritant laxatives - senna, cascara, aloe,
bisacodyl - stimulate intestinal movement and secretion and have a rapid
effect. However, they cause abdominal cramps and diarrhea, which can not be
controlled by dose modification, so it can lead to a decrease in colon motility
over time.
Suppository administration cause evacuation,
either through the distension it performs or through osmotic effect, but can
cause lesions of the rectal mucosa.
Many of the supplements on the market are
actually irritating laxatives, so their composition should be carefully studied
before administration.
Also, pills containing senna, cascara or aloe
are considered 'natural'. These are, however, irritating laxatives and are not
the first line of treatment in chronic constipation. Irritant laxatives can be
used in people with severe constipation who are not responding to any
treatment.
'Supplements can solve the problem of
constipation in people who have a poor diet in fiber. For this to happen, it is
important that they are associated with proper hydration. Half of the weight of
the stool is bacteria, so modulation of intestinal flora by prebiotics and
probiotics may play a role in the treatment of chronic constipation,' says gastroeneterologists.
Chronic Constipation: How much nutrition counts in chronic constipation?
In light constipation, diet, proper hydration,
and high fiber foods can be sufficient. In severe forms, however, medical
treatment is almost always needed.
A diet based on animal protein from meat,
cheese, and low in fiber, with low fluid intake, can lead to constipation. If
we leave the constipation untreated, the reabsorption of water and electrolytes
make the colon debris gain a high consistency and become more and more
difficult to be eliminated.
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