Constipation is a symptom characterized by a delay or difficulty in bowel movements. We talk about constipation when there are fewer than three bowel movements per week and / or when the stools are difficult to pass (to exempt, for doctors).
It is chronic when it lasts for more than 6 months. Loose stools do not refute constipation, which stood on a scientifically daily stool weight less than the average verification impractical.
Constipation by slowing intestinal transit is the most common form. Constipation "terminal" called dyschezia recto-anal is a disorder of one bowel movement, the rectum and anus. It is frequently combine the two disorders.
Constipation may be the only disease (idiopathic constipation) or be secondary to another disease.
The consipation: risks
In Western countries, the prevalence of constipation is between 15 and 20% of the population. A survey of the general population on subjective complaints found constipation in 35% of respondents, and a sensation of incomplete evacuation in 19% (Abstract hepato-gastroenterology 2009 - ECN Elsevier) . Women are more likely than men to this complaint.
Constipation accompanies the drug morphine, cocaine and their derivatives are strongly constipating. Consumption of many drugs affecting the autonomic balance also exposes this side effect.
It can eventually lead to complications such as anal fissures, hemorrhoids, weakness perineum promoting urinary and / or anal intercourse, and sexual disorders.
The major risk is occlusion or sub-ileus, not exceptional in the elderly by forming an obstructive fecalith (rectal accumulation of hard stools that can not be removed naturally).
Psychiatric patients who ingested strange impulses can be seen on digestive blockages bezoars (balls of indigestible materials: eg hair or plastic materials). In these patients, the prescription drug also causes occlusion neurotropic sneaky when medical care is inadequate.
Finally, the occlusion may occur on an obstacle not ingested, usually a colon tumor (cancer) or local extension of an abdominal tumor.
Dining set in motion all digestive functions simultaneously. Some functions take precedence over others, a hierarchy which varies during the digestion. Normal transit time of the bolus from the mouth to the anus is around 65 hours on average, with large individual variations.
In constipation called "slow transit" stagnating feces in the colon. In constipation called "terminal", they accumulate in the rectum.
While the "terminal constipation" is often associated with sequelae of surgery of the anus or obstetric trauma or accidental, the "transit constipation" is related to a disorder of intestinal motility: too many contractions / relaxations, anarchic and ineffective.
Sex hormones are involved, as well as socio-educational reflexes inculcated. Personality (anxiety background) is involved, or sexual abuse and maltreatment.
Neurohormonal disturbance in question may be transient (occasional stress) or sustainable familial predisposition or chronic illness: diabetes, hypothyroidism, Parkinson's disease, multiple sclerosis ...
Very often it is the side effect of drugs: opiates against pain, analgesics containing codeine, anti-epileptics, anti-depressants, anticholinergics, neuroleptics, gastric bandages ...
Poor dietary habits (low fiber meal, abuse of chocolate), and / or physical inactivity are equally guilty. Finally, remember to go to the bathroom when the need is urgent and is a common cause of constipation "instilled".
Transit constipation with stool appears rare, usually but not always hard. There is no real difficulty of evacuation. But digestive discomfort is common: flatulence, colic, bloating ...
In case of constipation "terminal", defecation is felt incomplete and difficult. Thrust forces are important and required repeated. Yet they lead to the feeling that it is still to be exempted.
Warning: The efforts to push the saddle efforts are important cardiovascular which can cause a heart attack (myocardial infarction) or cerebrovascular accident (CVA), especially when advancing age when patient concerns are focusing on their bellies at the expense of other organs.
Must be able to identify the warning signs of cancer: presence of blood in the stool, increase or unusual symptoms, constipation alternating with diarrhea, abdominal pain.
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