Constipation
Constipation may be defined as either the infrequent passage of motions (say less than three times per week) or as difficulty with defaecation and the production of small hard stools. There are many different causes, the most common being insufficient stimulation of the reflex to defaecate because of lack of fibre in the diet, together with suppression of the reflex as a result of psychological problems arising from embarrassment or lack of confidence. (Being required to use a bedpan in an open hospital ward is a potent cause of constipation). Other causes include side effects of drugs such as opiate painkillers, Iron or anti-depressants; painful anal conditions such as anal fissure; obstruction as occurs with, for example, Crohn’s disease or cancer or as a complication of pregnancy when the uterus presses on the bowel; failure of contraction as a result of abnormalities of nerve function - an example being Hirschprung’s disease, where there is absence of one of the nerve plexuses in the bowel wall, as well as being a manifestation of other disorders such as an under active thyroid.
If the constipation is of recent onset, persistent and progressively severe it will require investigation and treatment of the underlying cause. Most cases are, however, mild and will respond to appropriate therapy designed to stimulate bowel action.
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