constipation

(kon″stĭ-pā′shŏn )

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[L. constipare, to press together]
Decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool.

INCIDENCE
Between one sixth and one third of the American population reports having constipation. People of lower socioeconomic status, women, and older Americans have higher rates of constipation than other members of the public.

ETIOLOGY
Predisposing factors in healthy people include a diet that lacks fiber, inadequate consumption of fluids, a sedentary lifestyle, and advancing age. Many drugs, including opiates, antidepressants, calcium channel blockers, antiemetics, and anticholinergics cause constipation. Among metabolic illnesses, hypothyroidism and disorders of calcium metabolism occasionally contribute to difficulty with the passage of stools. Pathological lesions of the bowel (such as diverticular disease, anorectal gonorrhea, hemorrhoids, or obstructions due to tumors, adhesions, or incarcerated hernias) may also be responsible.

NOTE
Normal bowel frequency varies from person to person. Some people normally have three bowel movements daily, while others have a normal pattern of one or two bowel movements a week.

A change in frequency of bowel movements may be a sign of serious intestinal or colonic disease (such as a malignancy). A change in bowel habits should be discussed with a physician.

TREATMENT
Consumption of fresh vegetables, fruits, and whole grains helps prevent constipation. Medications to alleviate constipation include docusate, bulk-forming laxatives (such as psyllium), compounds containing magnesium, lactulose, and a variety of enemas.

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