Constipation is defined as having less than three bowel movements per week or hard stools that are difficult to pass. Common causes include low-fiber diets, lack of physical activity, certain medications, and ignoring the urge to have a bowel movement. Diagnosis involves physical exams, blood tests, and imaging tests of the colon and rectum. Treatment begins with lifestyle changes like increasing fiber intake and exercise. If those don't help, doctors may prescribe laxatives, stool softeners, or suppositories to relieve constipation symptoms.

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UNIVERSIDAD TECNICA DE MACHALA
ACADEMIC UNIT OF CHEMICAL
SCIENCES AND HEALTH
MEDICINE SCHOOL
ENGLISH
CONSTIPATION
STUDENTS
William Cruz
Kevin Herrera
TEACHER:
Mgs. Barreto Huilcapi Lina Maribel
CLASS:
EIGHTH SEMESTER ‘’A’’
Machala, El Oro
2018

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Constipation
Definition
Constipation is a condition that can present one or both situations:
 less than three stools per week
 hard, dry, and small stools that are painful or difficult to pass
You may feel pain or swelling (feeling of fullness) in the abdomen, the area between
the chest and hips.
Intestinal habits are not the same for everyone. Some people think they are
constipated if they do not have bowel movements every day. Some people may have
three stools per day. Other people may have three stools per week.
Most people sometimes suffer constipation. Constipation generally lasts only a short
period and is not dangerous. When the cause of constipation is known, measures can
be taken to alleviate it.

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Etiology
Constipation is one of the most common gastrointestinal problems in the United
States. Constipation occurs more frequently in:
 pregnant
 Adults 65 years and older
 people who are not white
 low income people
Many women suffer constipation during pregnancy or after giving birth. Constipation
after surgery is also common. People who take medications for depression or
analgesics for reasons such as bone fracture, tooth extraction or back pain, may have
constipation.
Constipation occurs because bowel movements spend too much time in the colon.
Common factors that can cause constipation include the following:
Diets low in fibers. The most common cause of constipation is a diet with a low fiber
content. Fiber is found in foods that come from plants. The fiber helps keep stools
soft so that they move easily through the colon. Liquids, such as water and juices,
help the fiber work better.
Lack of physical activity If you must remain at rest and can not exercise, you may
suffer from constipation. Scientists do not know the reason for this.
Medicines. Some medications to treat other health problems can cause constipation. It
can also cause constipation to take over-the-counter laxatives too often. A laxative is
a medication that dissolves bowel movements and increases bowel movements. If you
take laxatives in excess, your colon can not contract well. The nerves, muscles and
tissues of your large intestine can be damaged.
Changes in lifestyle or changes in daily routine. Your bowel movements may change
when you travel, with pregnancy or as you get older.

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Ignore the urgency of going to the bathroom. If you ignore the urge to make a bowel
movement, over time, you may stop feeling the need to do so. This habit can cause
constipation.
Certain health problems. Some health problems can cause stools to move more
slowly through the colon, rectum, or anus. These problems can cause constipation.
Examples are disorders that affect the brain and spine, such as spinal cord injuries,
Parkinson's disease, and disorders that affect the way your body receives energy from
food, such as diabetes or hypothyroidism. Parkinson's disease is a disorder that affects
nerve cells in a part of your brain that controls muscle movement. Hypothyroidism is
a disorder that causes your body to produce a shortage of thyroid hormone, which can
cause many of the body's functions to be slower.
Problems in the gastrointestinal tract. The problems of the gastrointestinal tract that
compress or narrow the colon and rectum can cause constipation.
Functional gastrointestinal disorders. Functional gastrointestinal disorders are
problems caused by changes in the functioning of your gastrointestinal tract. If you
have a functional disorder you may have frequent symptoms, but your gastrointestinal
tract is not damaged. Functional constipation is often caused by problems with the
muscles of the colon or anus, which cause bowel movements to move more slowly.
Irritable bowel syndrome is a functional gastrointestinal disorder that has constipation
as a symptom.
Signs and symptoms
The signs and symptoms of chronic constipation include the following:
 Have less than three bowel movements per week
 Having lumpy or hard stools
 Make a great effort to have bowel movements
 Feeling as if there is a blockage in the rectum that prevents bowel movements
 Feel like you can not completely empty the rectum

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 Need help to empty the rectum, such as using your hands to press your
abdomen and use a finger to remove stool from the rectum
Constipation can be considered chronic if you have had two or more of these
symptoms during the last three months.
Diagnosis
In addition to the general physical examination and digital rectal examination, doctors
use the following tests and procedures to diagnose chronic constipation and try to
determine its cause:
Blood test. Your doctor will try to detect if there is a systemic condition, such as low
production of thyroid hormones (hypothyroidism).
Examination of the rectum and the lower (sigmoid) portion of the colon
(sigmoidoscopy). In this procedure, your doctor inserts a flexible tube with a light on
the end to examine the rectum and the lower portion of the colon.
Examination of the rectum and the entire colon (colonoscopy). Through this
diagnostic procedure the doctor examines the entire length of the colon with a flexible
tube that has a camera on the end.
Evaluation of anal sphincter muscle function (anorectal manometry). In this
procedure, the doctor inserts a narrow, flexible tube into the anus and rectum and
inflates a small balloon (balloon) into the tip of the tube. Then, the device is removed
through the sphincter muscle. This procedure allows the doctor to measure the
coordination of the muscles you use to evacuate the bowel.
Evaluation of anal sphincter velocity (balloon ejection test). This test, which is often
used with anorectal manometry, measures the time it takes to remove a balloon filled
with water that enters the rectum.
Evaluation of how well food is mobilized through the colon (study of colonic transit).
It is possible that in this procedure you should swallow a capsule that contains a
radiopaque marker or a wireless recording device. For several days the route of the
capsule will be recorded through the colon, which can be seen on radiographs.

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In some cases, you may have to eat a food containing radioactive carbon and a special
camera will record its route (scintigraphy). Your doctor will try to detect signs of
intestinal transit dysfunction and how the food is mobilized through the colon.
X-ray of the rectum during defecation (defecography). During this procedure, the
doctor inserts a soft paste made with barium into the rectum. Then you eliminate the
barium paste in the same way you would evacuate the stool. The barium is visualized
on the x-ray and can reveal the presence of prolapse or problems of muscle function
or muscle coordination.
Defecography by magnetic resonance. During this procedure, as in barium
defecography, a doctor will introduce a contrast gel into the rectum. Then you
evacuate the gel. The resonator can visualize and assess the function of the defecation
muscles. This study can also be used to diagnose problems that can cause
constipation, such as a rectocele or rectal prolapse.
Treatment
The treatment for chronic constipation usually begins with changes in diet and
lifestyle that aim to speed up the transit of stool through the intestines. If these
changes are not effective, the doctor may recommend medication or surgery.
Changes in diet and lifestyle
The doctor may recommend the following changes to relieve constipation:
Increase fiber consumption. Add fibers to your diet increases the weight of stool and
accelerates the passage through the intestines. Start small to consume more fresh
fruits and vegetables every day. Choose breads and whole grains.
The doctor can recommend a specific amount of fiber grams to consume every day.
In general, try to consume 14 grams of fiber per 1000 calories in your usual diet.
Suddenly increasing the amount of fiber you consume can cause bloating and gas; for
that reason, it begins little by little and increases the amount until reaching the goal in
the course of a few weeks.

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Do exercises most days of the week. Physical activity increases the muscle activity of
the intestines. Try to exercise most days of the week. If you still do not exercise,
check with your doctor to know if you are healthy enough to start an exercise
program.
Do not ignore the need to evacuate the intestines. Take your time in the bathroom to
allow yourself enough time to evacuate the bowels without distractions or distress.
Laxatives
There are several types of laxatives. Each one acts in a different way to facilitate
intestinal evacuation. The following are over-the-counter:
Fiber supplements. Fiber supplements add volume to the stool. These include
psyllium (Metamucil, Konsyl), calcium polycarbophil (FiberCon) and fiber with
methylcellulose (Citrucel).
Stimulants Stimulants, such as Correctol, bisacodyl (Ducodyl), Dulcolax and sen oral
sennosides (Senokot), cause the intestines to contract.
Osmotic Osmotic laxatives that help liquids move through the colon. For example,
oral magnesium hydroxide (Phillips Milk of Magnesia), magnesium citrate, lactulose
(Kristalose), polyethylene glycol (Miralax). In addition, polyethylene glycol
(Golytely, Nulytely) is available with a doctor's prescription.
Lubricants Lubricants like mineral oil allow stools to pass through the colon more
easily.
Stool softeners. Stool softeners such as docusate sodium (Colace) and calcium
docusate (Surfak) moisturize the stool through the water they draw from the
intestines.
Enemas and suppositories. Sodium phosphate (Fleet), soap foam enemas or running
water enemas are useful to soften stools and cause bowel evacuation. Glycerin or
bisacodyl suppositories can also soften the stool.
Prevention
The following tips can help you avoid chronic constipation.

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 Incorporate abundant amounts of fiber-rich foods into your diet, including
beans, vegetables, fruits, whole grains and bran.
 Consume less foods with low fiber content, such as processed foods and dairy
products and meat.
 Drink a lot of liquid.
 Stay as active as possible and try to exercise periodically.
 Try to control stress.
 When you feel the urge to defecate, do not overlook it.
 Try to establish regular schedules to evacuate the bowel, especially after a
meal.
 Make sure that children who start eating solid foods consume enough fiber.
Bibliography
 Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller
RC. Functional Bowel Disorders. Gastroenterology 2006; 130: 1480-91.
 Sonnenberg A, Koch TR. Epidemiology of constipation in the United States.
Dis Colon Rectum 1989; 32: 1-8
 Everhart JE, Go VLW, Hohannes RS, Fitzsimmons SC, Roth HP, White LR.
A longitudinal study of self-reported bowel habits in the United States. Dig
Dis Sci 1989; 34: 1153-62.