Posted on 26 Oct 2016
MOTION SE HI EMOTION”-CONSTIPATION:NEED FOR TREATMENT
All of us have seen Movie PIKU and had a great laugh watching movie. In PIKU, they narrated story of a person with long time constipation, his treatment methods, and emotions attached with his problem.
Story of the movie was true in sense that our emotions are connected with our motions. If we have a good motion in the morning, feel good factor remains for whole day.
When such a movie impresses the audience, there is an element of reality which makes us love the movie. Many of us like PIKU, because atleast once in a while, we have a person in our family who is chronically constipated ( and sometimes we ourself are that person).
Let us understand Constipation and its treatment in this article.
–SO, IS THIS CONSTIPATION A DISEASE?
NO, Constipation is a symptom, which signifies that something is not right there in our intestines. And this problem is very common in population.as per data ,2% population is suffering from constipation. Out of them ,1:2 female, and 1:3 male, above age of 65 have constipation.
-IS NOT PASSING STOOL FOR ONE DAY IS CONSTIPATION?
NO , as per definition, one, or all of the following symptoms is an indication of constipation-
STRAINING ON MORE THAN 25% OF BOWEL MOVEMENT
FEELING OF INCOMPLETE EVAUATION IN >25% BOWEL MOVEMENTS.
HARD STOOL IN >25%.
INFREQUENT DEFECATION WITH THREE OR LESS BOWEL MOVEMENTS IN A WEEK.
–WHAT ARE THE CAUSES OF CONSTIPATION?
There are multiple causes of constipation and sometimes more than one cause is present in one person. most important cause are as listed:
1.Faulty Diet and Habits LIKE
-Inadequate bulk (ﬁber) Excessive ingestion of foods that harden stools (e.g., cheese)
-Lack of exercise
-Ignoring call to stool
-Environmental changes (e.g., hospitalization, vacation)
2.Structural or Functional Disorder
3.NEUROGENIC:DISEASE BEYOND INTESTINES
5.SOME DRUGS and IMMOBILIZATION
6.ENDOCRINE AND METABOLIC :SOME DISEASE PROCESS.
-WHY CONSTIPATION SHOULD BE EVALUATED AND TREATED:
As pointed above, constipation is mostly due to lifestyle causes, but significantly , and specially in elderly, some diseases process also present as warning signs of diseases. Like, feeling of incomplete passage of stool in a patient , with no previous complaint, MAYBE a sign of colon cancer.
Constipation is leading reason for development of many painful complaints of bowel and anus like,
-PROLAPSE OF RECTUM.
-IRRITABLLE BOWEL SYNDROME
All this condition can be prevented by treatment of constipation at initial stage.
-WHEN SHOULD PATIENT SEE A SURGEON FOR CONSTIPATION?
NOT ALL CASES OF CONSTIPATION NEEDS SURGICAL TREATMENT. But if you have long term symptoms for constipation, like more than 10-15 days , without any cause, you must consult your doctor for finding out actual cause of your problem.
But , there are some warning signs for which you must see your doctor as early as possible.
–WHAT ARE THOSE WARNING SIGNS?
Severe constipation – where you are unable to pass stool and flatus , and your belly size increasing, with or without abdominal pain and vomiting.
Something flash like comes out when you pass stool, which reduced by pushing up.
Bleeding and pain after passing stools. Bleeding may be like a jet or drops after stool or mixed with stool.
Black colour stools.
When you feel incomplete passage of stool and again have urge to pass stool after some time and you pass some sticky material.
You have early morning diarrhea with passage of sticky material.
You have family history of colonic cancer in your family.
-HOW DOCTORS DETECT CAUSE?:
Surgeons use various examination methods for treatment of constipation. Not all methods and investigations necessary for all patients but only if symptoms are suggestive of diseases and some abnormality is detected by surgeon during examination.
Various procedures are-
PHYSICAL EXAMINATION BY A SURGEON.
COLONIC TRANSIT TIME STUDY.
VARIOUS OTHER TESTS RARELY NEEDED.
AGAIN, all precedures are not needed in all patients. mostly, a thorough clinical examination in clinic will suffice for diagnosis.
-HOW IS CONSTIPATION TREATED?
It is important to treat constipation at early stages. Adequate treatment of a patient with chronic constipation will lead to-
-Restoration of normal frequency and consistency of stools,
-Freedom from the discomforts ordinarily associated with constipation,
-Maintenance of reasonably regular elimination without artiﬁcial aids, and
-Relief of any generalized illness of which constipation may be a symptom. –
-Prevention of complications due to constipations
If there is no specific cause of constipation, or constipation is of recent onset, constipation is treated by following means:
Because the most common causes of constipation are faulty diet and habits, management often requires no more than careful examination and reassurance, together with simple guidance. like
-Not to ignore the call for bowel movement because it disrupts normal funtioning of bowel.
– Increasing water intake upto 2-3 liters per day if patient has no kidney disease.
-Increasing fiber intake in diet- fruits ,vegetables
A fruit basket and salad is key to avoid constipation
-Increasing activity like walking, jogging , if possible, most of the patients claim an easier and more satisfactory bowel action with nothing more than a regular walk in the morning or evening.
-Other factors, such as meal patterns (e.g., omission of breakfast), shift work, and dependence on fast foods, may contribute to abnormal bowel function
-regular and balanced diet- if the patient consumes excessive ingestion of foods that cause hardened stools, such as processed cheese,or dairy products, such foods needs to be eliminated or at least reduced in quantity.
What to eat and what not to eat to avoid constipation
–WHAT IS MEDICAL MANAGEMENT OF CONSTIPATION:
-Treatment of underlying cause as mentioned above , if found in examination, must be treated first and foremost. like in some form of disease called Irritable bowel syndrome needs multidisciplinary therapy in form of drugs and counselling too.
Other than that,traditionally, the mainstay of treatment includes
there are many preparations available in market, both allopathic and ayurvedic and traditional which contains either fibers(Esabgol,Senna,Castor Oil,etc) which increase fiber content of stool,or drugs which increases water content of stool. But their long term use is not recommended as they may form a habit of taking them, and there will be “habitual constipation”, which will be difficult to treat. As there is saying in sanskrit ‘ ati sarvatr varjayet”(अति सर्वत्र वर्जयेत) , excess of medications without finding the cause will do harm , rather than benefit.
-WHAT ARE RECENT ADVANCES IN SURGERY FOR CONSTIPATION:
With advance in technology, and availability of sophisticated investigations, It is now being recognized that surgery has an increasing role to play in the management of these patients. And new methods have emerged for treatment of problems which could not be detected or treated before 10 to 20 years. So a case of chronic constipation may be treated efficiently by
– MRI AND OTHER INVESTIGATIONS,
– STAPLING PROCEDURES LIKE STARR (IN WHICH REMOVAL OF PART OF YOUR BOWEL IS DONE ENDOSCOPICALLY), for anatomic and structural defects in lower bowel ,which can be corrected endoscopically.
-LAPAROSCOPIC SURGERY, for the defects like rectal prolapse, which can be treated in abdominal surgery.
STARR PROCEDURE FOR ODS(CONSTIPATION)
Therefore, WITH ADVANCING TECHNIQUES, CONSTIPATION MAY NO LONGER REMAIN A CHRONIC DISEASE, BUT IT CAN BE TREATED AT ITS ONSET, AND WE CAN PREVENT ITS COMPLICATIONS. And there are multiple options available to treat either by medicines, physiotherapy or surgery.
Constipation affects everybody’s life some or the other time in life, physically emotionally and financially. There are also problems and complications which occur as a consequence of ill-treated constipation. Not only it affects person, but peoples around them too. If we can find a perfect cause for constipation, we can cure it too, either by just some lifestyle changes, by proper medications, physiotherapy , and surgery.
CONTACT US FOR FURTHER INFORMATION AT:
209, CHANAKYA PLAZA, NEW C G ROAD,
PH NO-079-23972423, 8460 3456 61
GENERAL AND LAPAROSCOPIC SURGEON.
disclaimer: all pictures are taken from public domain of free internet. author thanks the original publishers.