The word constipation brings up varied experience for different persons. For most of them it means hard stools, difficulty in passing stools or infrequent stools. Medically speaking constipation is defined as lesser than three bowel movements per week and less than one bowel movement, it is classified as severe constipation. Generally speaking there is no reason to have bowel movement daily. It is a common myth people believe that two to three days absence of bowel movements may cause toxic accumulation or prone to cancer, there is no medical evidence proving the same.



The type of constipation is different in each case and treated as for that type of constipation. In Irritable Bowel Syndrome, constipation may alternate with diarrhoea. In fecal impaction, the stool hardens in the rectum and prevents passage of the stool. The most common causative factors for constipation are low fiber diet and dehydration.

Depending on the onset, constipation is categorized into acute and chronic constipation. For acute constipation, immediate risk assessment is necessary and more attention should be paid if accompanied by bleeding, cramps, nausea and loss of weight. Chronic constipation may not require immediate assessment if simple measures provide adequate relief.

Some of the underlying cause for constipation includes; insufficient intake of dietary fiber, dehydration, hypothyroidism, hypokalemia, lead poisoning, stenosis and medications like loperamide.

The diagnosis is made on the basis of patient symptoms. Bowels those are hard to pass, less bowel movements, or pain while passing stools qualify as constipation. Physical examination is done by pressing the abdomen for scybala (palpable lumps of stool), Rectal examination gives an idea about the sphincter tone and presence of stool in the rectum.

Normal Constipation without any medical problems may be treated by taking more fluids and increase the dietary fiber content (vegetables, fruits, wholesome bread). Addition of linseed oil is excellent way to increase dietary fiber. For routine non medical constipation, laxatives should be avoided as it may cause dependency.

Laxative treatment is recommended when the above measures are inappropriate or insufficient. Most of the laxatives are available over the counter. Hydrating agents (lactulose or glycols) are widely available. In severe cases enema or clysters are to be used, in some cases phosphate solutions are introduced as enemas.

The best method is to prevent constipation rather than treating it and this can be achieved by proper diet, exercise and good intake of fiber (fresh vegetables and fruits) and fluids.