Constipation describes situations wherein patients have difficulty moving their bowels. From most of the persons complaining of Constipation, only a only a few have any serious underlying disease that needs specialized tests & treatment by a gastroenterologist.
Educating the patient about worrying much about bowel patterns can treat most of the cases. Bowel training - trying a bowel movement everyday simultaneously, preferably early mornings when colon activity is high - can be practiced. The food habits form the important part of the treatment. Eating high-fiber foods like cereals, vegetables & fruits helps a great deal. Limiting foods like ice cream, cheese, meat & processed foods is also preferable. Drinking one.5 - two liters of water per day is essential, as is avoiding dehydrating drinks containing caffeine & alcohol. Regular exercise, besides having other health benefits, is a must for avoiding Constipation.
If no appreciable improvement takes place with the lifestyle changes, then a bulk-forming laxative is indicated. Psyllium & methylcellulose are bulk-forming laxatives which can be used for a long time without side effects. Next in line are medications like hyprosmotics, lactulose, Polyethylene glycol, Glycerin & Sorbitol, & Salines like magnesium hydroxide, magnesium citrate & sodium phosphate. The third-line medications are Anthraquinones like Cascara sagrada, Emollients such as Docusates, Senna & mineral oil, & stimulants such as Phenolpthalein, castor oil or Bisacodyl.
The diagnosis of Constipation is done using methods like physical examination, colorectal transit study, anorectal function tests, barium enema x ray & sigmoidoscopy or colonoscopy.
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