Constipation can be divided into three categories, by the time it takes to treat the problem. The short-term ones are caused by travel, diet, medication, surgery and other known causes. They mostly correct themselves. The medium-term ones are caused by low-fiber diet, low liquid consumption, lack of exercise, old age, pregnancy, abuse of laxatives and consumption of dehydrating things like caffeine and alcohol. These can be treated with changed in diet, life-style changes and laxatives. The long-term Constipation, or Chronic Constipation, is caused by serious disorders of the GI tract or other chronic diseases. The GI tract problems include irritable bowel syndrome, intestinal obstruction, colonic inertia, anorectal dysfunction and structural problems like tumors, fissures, hemorrhoids, fistulae and other problems. To diagnose the above problems many tests are used, including barium x-rays, sigmoidoscopy or colonoscopy, colorectal transit study, anorectal function test and defecography. If no structural obstruction is found in the GI tract, the Chronic Constipation is treated like other less serious ones. Educating the patients about bowel movements, maintaining a high-fiber diet and a lot of liquid intake, avoiding dehydrating substances, exercising and bowel training are the starting treatments, along with bulk-forming laxatives like psyllium and methylcellulose. If the problem persists, more harsh laxatives, such as hyperosmatics or saline, can be tried. Stronger laxatives like anthraquinones, emollients or stimulants are tried next. Biofeedback is a good treatment if the Constipation is caused by outlet inertia. Surgery should be considered a last resort if no improvements is seen in three to four months of treatment. Abdominal colectomy, ileorectomy and ileoanal pouch are the surgical procedures with a very good chance of relief. Other underlying causes are neurological disorders, metabolic and endocrine problems, diabetes, stroke, Parkinson's disease, multiple sclerosis, spinal cord injuries, uremia, hypercalemia, amyloidosis and scleroderma. |
