Constipation

Published on 31/05/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 31/05/2015

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Chapter 16 Constipation

INTRODUCTION

Description: Constipation is the infrequent passage of hard stools, often associated with mechanical or other means to stimulate bowel movements. It often also is related to changes in the size, consistency, and ease of bowel movement in the subjective definition of constipation.
Prevalence: Very common as a sporadic problem, 8% to 10% of women.
Predominant Age: Any, more common in youth and old age.
Genetics: No genetic pattern.

ETIOLOGY AND PATHOGENESIS

Causes: Inadequate dietary fiber and fluid intake, altered gastrointestinal motility (drugs, illness, injury, laxative abuse), metabolic (hypothyroidism, diabetes), mechanical (obstruction, impaction).
Risk Factors: Poor diet and fluid intake, inactivity, medications (narcotics, iron therapy), and sedentary lifestyle.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Bowel movements fewer than three times per week
• Hard stools
• Straining to have a bowel movement
• Inability to have bowel movements without medical or mechanical interventions (enemas, manual evacuation)

DIAGNOSTIC APPROACH

Differential Diagnosis

• Hypothyroidism
• Rectocele
• Laxative abuse
• Dehydration
• Inappropriate expectation

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