Why Choose Cedars-Sinai Marina del Rey Hospital for Constipation Treatment?
Although it might not seem very serious, constipation can often signal underlying conditions that require prompt medical attention. The well-trained doctors and specialists at Cedars-Sinai Marina del Rey Hospital can provide accurate and reliable diagnostic methods in order to discover the primary cause of constipation, as well as to offer efficient and individualized treatment options.
Constipation is a very common syndrome that affects people of all ages. A patient with constipation is not passing stools regularly and is unable to totally empty the bowel due to infrequent bowel movements (fewer than three per week). Stools may also be hard or lumpy and unusually big or small. Constipation can be a short-term condition, but many suffer from long-term constipation (several weeks or longer). Some acute cases pass without medical intervention, while others can require treatment for years.
Patients suffering from constipation should adopt diet and lifestyle changes. When those are not effective, medication or, in extreme cases, surgery is recommended.
Patients with constipation should be mindful of adopting healthy habits. Slowly increasing water and fiber intake (whole grains, fruits, and vegetables) is recommended. Patients are also encouraged to exercise regularly, though exercise should always be performed under a doctor’s recommendation. The majority of patients suffering from constipation should be able to perform a light exercise (e.g. a daily walk).
Constipation patients should keep a routine bathroom regimen and never rush.
When behavioral changes are not enough to reduce constipation symptoms, a doctor may prescribe laxatives. Some laxative medication varieties include:
- Fiber supplements
- Osmotic laxatives (which increase the liquids in the bowel so the stool is softened, like lactulose and macrogols)
- Stimulant laxatives, which stimulate contractions (like senna)
- Lubricants (like mineral oil)
- Stool softeners
- Enemas (where medication in fluid form is inserted through the anus into the bowel)
- Suppositories (where medicine is inserted into the anus)
In acute cases, laxatives are administrated until the stool is soft and the defecation occurs normally. In chronic cases, laxative administration might be necessary for months or years.
In rare cases (like strictures, anal fissures, blockage, or rectocele) surgical removal of part or all of the colon is necessary.
Constipation as a Result of Prescribed Medication
The patient should talk to the prescribing doctor about replacing any medication that causes constipation.
Constipation in Pregnancy
A lot of laxatives are safe to be taken during pregnancy, but some could be harmful. As such, a doctor’s recommendation is always necessary.
Constipation in Babies
Increasing water intake may be the first way to treat constipation in babies. Leg exercises and abdominal massage may also be recommended.
Besides the behavioral changes listed above, parents should consider:
Constipation can occur occasionally, for a short period of time, as an acute condition.
Chronic constipation can be categorized as:
Primary or Idiopathic »
Symptoms of Constipation
Constipation is defined by:
- Difficulty in passing stool
- Hard, lumpy stools
- Decreased frequency of defecation (less than three stools per week)
Other symptoms might include:
- Straining instead of bowel movements
- Pain and discomfort during defecation
- A sensation of blockage in the rectum
- Need for help with hand on the abdomen to remove stool
- Nausea, loss of appetite, anorexia, weight loss
- Stomach ache, cramps
Chronic constipation is defined as experiencing some of the above symptoms for around three months.
Children might present additional symptoms, such as:
- Anal fissures (open lesions in the anal canal)
- Hemorrhoids (swollen blood vessels around or inside the anus, which could cause pain, swelling, and itching)
Visit your doctor immediately in any case of anal bleeding, which could signal the above complications, as well as other severe diseases, such as:
- Fecal impaction: When hard, dried stool becomes blocked (immobile) in the bowel
- Rectal prolapse: When a part of the intestine protrudes from the anus
Diagnosis of Constipation
Constipation is a very common condition. No tests are needed; the diagnosis will be based on a patient's medical history and the symptoms discussed above. Additionally, a doctor will ask about the patient's habits and any recent changes in diet and exercise routines.
A constipation diagnosis is established by:
- Less than three passes of stool per week
- Need to strain in more than one-quarter of cases
- Hard stool in more than one-quarter of cases
The doctor could also perform a physical examination (especially of fecal impaction suspicion) by:
In case of severe symptoms, additional tests might be performed to detect any other conditions:
- Abdominal X-ray: X-rays produce images of the interior abdomen.
- Transit study examination: A special capsule that can be seen on X-rays is followed during its passage through the digestive tract.
- Scintigraphy: The patient ingests radiocarbon-activated food and a camera records its passage through the intestines in order to detect any deviations from normal function.
- Anorectal manometry: A small device containing a balloon is inserted into the rectum and inflated. The patient squeezes, relaxes, or pushes the rectum muscles while a machine measures the pressure.
- Defecography: An X-ray examination of the rectum during defecation, which includes soft barium paste being inserted into the rectum and then passed like stool.
- MRI defecography: A contrast gel is inserted into the rectum to assess the patient's muscle activity.
- Blood tests: Blood tests can help exclude some diseases, like hypothyroidism.
- Computer tomography scan (CT): CT scans use a combination of X-rays and computer technology to create a three-dimensional representation of the organs.
- Colonoscopy: The entire colon is examined with a flexible tube outfitted with a camera.
- Sigmoidoscopy: The rectum and the lower portion of the colon are examined with a flexible tube.
Other tests are often done to rule out bowel cancer in older adults and patients who have an increased risk.
Constipation occurs when the stool becomes dry and hard because it's moving too slowly through the large intestine, causing water to be absorbed in the colon, or because it can't be eliminated from the rectum.
Risk factors for constipation include:
Women who are pregnant often suffer from constipation.
Progesterone, which is produced during pregnancy, can cause muscle relaxation, resulting in constipation, especially during early pregnancy.
Children are very commonly affected by constipation.
Some of the reasons include:
- Poor diet (toddlers who drink too much milk are likely to develop constipation because they are not getting enough fiber)
- Fear of pain or discomfort, or issues with using the toilet
- Underlying conditions like malformations or cystic fibrosis
Medications that often cause constipation include:
Constipation might be caused by a specific underlying condition, such as:
Alternative treatments for constipation are often used, though none have been studied enough to know their long-term results.
Probiotics might have a good effect on constipation. Some specific sugars found in fruits and vegetables are also rumored to help patients with constipation. Acupuncture has also been suggested as an alternative treatment option.
You can help prevent constipation by adopting some healthy habits:
- Eating enough fiber (whole cereals, fruits, and vegetables) and less processed food, dairy, and meat
- Drinking enough fluids per day (especially water)
- Exercising most days of the week
- Adopting healthy toilet habits (like taking your time and never rushing)