Constipation

Constipation

Constipation is a common issue among the general population. Generally, the excretion of most people ranges from 3 bowel movements per day to 3 per week. If a person has fewer than 3 bowel movements per week, it is assumed that they are suffering from constipation. This can cause stools to become hard, making them difficult to pass, requiring a lot of effort, and taking a long time to evacuate. However, if the person is still able to have a bowel movement every day or more than 3 times per week, it would not be considered constipation.

Constipation

Constipation is a common issue among the general population. Generally, the excretion of most people ranges from 3 bowel movements per day to 3 per week. If a person has fewer than 3 bowel movements per week, it is assumed that they are suffering from constipation. This can cause stools to become hard, making them difficult to pass, requiring a lot of effort, and taking a long time to evacuate. However, if the person is still able to have a bowel movement every day or more than 3 times per week, it would not be considered constipation.

The Association of Gastroenterologists of Thailand's Thai Motility Club found that 2.5% of the population has this condition.

Causes of Constipation

         Known Symptoms

1. Obstruction of the gastrointestinal tract, including

• colon cancer
• The skin around the anus bulges into the nearby organs, causing a rectocele.
• narrowing of the rectum (anal stenosis)
• The nearby organs compress the large intestine.

2. Diseases of the endocrine system or abnormalities of mineral salts in the body, including

• Diabetes
• Hypothyroidism
• Hypokalemia in the blood
• Tumors of the adrenal glands (Pheochromocytoma)
• Underactive pituitary gland (Panhypopituitarism)
• Porphyia
• Poisoning from heavy metals such as lead, mercury, arsenic.

3. Medications include:

• Anti-diarrheal drugs such as loperamide
• Painkillers such as morphine, fentanyl
• Anticholinergic drugs such as intestinal spasms
• Psychiatric drugs
• Some anticonvulsants
• Gastrointestinal pill
• Antihypertensive drugs, calcium channel blockers
• Tonic infused with iron
• Diuretics
• Some cancer drugs

4. Neuromuscular diseases

• Parkinson's disease
• Spinal cord injury
• Autonomic neuropathy

Constipation of unknown cause:

• Slower-than-normal colon function
• Problems with the muscles of the pelvic floor

Finding the Cause of Constipation

If a patient presents with alarm symptoms such as a family history of colorectal cancer or inflammatory bowel disease, pale color, hidden blood in the stool, or unexplained weight loss, a colonoscopy should be performed to rule out the cause of colon cancer. This could be supplemented with additional tests such as a blood test, fecal examination, radiographic examination, endoscopy, or a colonic function test, including a colonic transit study and an assessment for defecatory disorder, particularly in patients over 50 years of age.

Treatment

1. To avoid using drugs, it is recommended to adjust diet, behavior, and practice good excretion habits, such as:

• Eat high-fiber foods such as fruits and vegetables.
• Drinking at least 1.5L of water per day
• Daily exercise
• Going to the toilet when you feel the urge to defecate
• avoiding medications that cause constipation
• avoiding long-term use of laxatives
• allowing enough time for defecation without rushing

2. The treatment of constipation may involve the use of oral medications, suppositories, or enemas, depending on the underlying cause or mechanism.
3. Botulinum toxin injections have been shown to be beneficial in patients with excessive tension in the outer sphincter.
4. In cases where treatment does not provide relief, surgery may be an option for treating slower-than-normal bowel function caused by an overly tight outer sphincter and abnormal anatomy of the rectum and rectum.