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Constipation is defined as a decrease in the frequency of fecal elimination and is characterized by the passage of hard dry and sometimes painful stools normal stool frequency ranges from three times daily to three times per week patients may experience abdominal bloating headaches low back pain and or a sense of rectal fullness from incomplete evacuation of
Feces epidemiology of constipation so constipation is common in all age groups however there is a higher prevalence in people 65 years of age women suffer from constipation more often than men constipation can be caused by many factors including a diet insufficient in fiber causes constipation second cause is inadequate fluid intake similarly lack of exercise is
Also the main cause poor bowel habits such as failure to respond to the defecatory urge or hurried bowels for example incomplete evacuation can contribute to constipation medications may also cause constipation such as narcotic analgesics diuretics anticholinergics antidepressants antihypertensives antihistamines phenothiazines anti-spasmodics iron supplements
Calcium or aluminum containing antacids non-prescription non-steroidal anti-inflammatory drugs histamine 2 receptor antagonists like ranitidine pregnancy is a common contributor to constipation the increased size of the uterus hormonal changes intake of calcium and iron containing prenatal vitamins and a reduction in physical activity are all considered contributing
Factors systemic disorders such as intestinal obstruction tumor inflammatory bowel disease diverticulitis hypothyroidism hyperglycemia irritable bowel syndrome cerebrovascular disease or parkinson disease are also risk factors now coming towards treatment of constipation non-pharmacologic treatment includes increased intake of fluids at least eight eight servings of
Non-caffeinated fluids daily and fiber eg whole grain breads and cereals beans prunes peas carrots corn the recommended adult intake of fiber is 20 to 35 grams per day but individuals who are consuming inadequate amounts of fiber should increase the amount of fiber intake slowly to prevent gastrointestinal distress increase exercise to increase and maintain bowel
Tone pharmacologic treatment of constipation so recommendations for simple constipation should begin as a stepwise approach with bulk-forming laxatives as first line hyperosmotic laxatives as second line and then stimulant laxatives if the previous recommendations were ineffective or intolerable self-care for the treatment of constipation should be limited to seven
Days bulk-forming laxatives are natural or synthetic polysaccharide or cellulose derivatives that absorb water to soften the stool and increase bulk which stimulates peristalsis bulk-forming agents include psyllium eg metamucil console fiberol methylcellulose e g citrocell calcium polycarbophyll eg console fiber caplets fibercon and wheat dextran eg benefiber all
Bulk-forming agents must be given with at least eight ounces of water to prevent choking another class is hyperosmotic laxatives which work by creating an osmotic gradient to pull water into the small and large intestines resulting in increased peristalsis and bowel motility for example glycerin polyethylene glycol lactulose stimulant laxatives work by altering
Water in electrolyte transport by the intestines and by stimulating bowel motility they are recommended for relief of constipation when an individual has failed or is intolerant to bulk forming or hypersmodic agents however stimulant laxatives are being used more frequently as first-line therapy for opiate induced chronic constipation eg senna bissacodal castor
Oil cascara sagrada aloe vera emollient laxatives also known as surfactants work by allowing water to move more easily into the stool this creates a softer stool which is easier to pass thus these agents are particularly useful in those who must avoid straining to pass hard stools e.g recent myocardial infarction rectal surgery emollient laxatives have very few
Side effects but they are not as effective as other laxatives eg docusate sodium docusate calcium saline laxatives which include sodium and magnesium salts work to draw water into the colon this class of laxatives includes magnesium citrate magnesium hydroxide eg milk of magnesia phillips caplets and sodium phosphate eg fleet enema lubricant laxative mineral oil
Is the only available agent in this class it works at the colon to increase water retention in the stool foreign
Transcribed from video
Constipation | How to get rid of Constipation| What causes Constipation? |Treatment of Constipation By Dr. Asif Khan Official