Constipation Definition and causes

Faculty of Pharmacy - Alexandria University
(Egypt)
Constipation
inbrief

Question №. 1
1. I am 30 years old and my stool Frequency
decreased from three times per day to once
every two days:
 Am I constipated?
 What are the major
symptoms of constipation?
(Egypt)

What is Constipation?
 Decrease in the frequency in of fecal elimination.
 Passage of hard, dry, sometimes painful stool.
 From 3 times daily
to 3 times per week.
Normal Range
* So the patient is not constipated
(Egypt)

Patient Counseling
 Life Style causes of constipation:
1. Diet:
a) Inadequate fluid intake
 Should drink at least 8 glasses of
non-caffeinated fluids daily.
Etiology
(Egypt)

Patient Counseling
b) Inadequate dietary fibers
 Diets include a good quantity of fibers are less likely
to suffer from constipation.
 Fiber retains water, softening stool & ease
evacuation.
 Foods low in fiber  high fat food.
 Foods rich in fiber  fruits, veg. and whole grain.
 Normal daily fiber intake 10 ̴ 25 g.■
Etiology
(Egypt)

Patient Counseling
c) Inadequate exercises
 Walking help prevent constipation by promoting
bowel motility.
d) Loss of defecatory reflex
 If you ignore the urge to have
a bowel movement.
 The urge can gradually go away.
 The longer can you delay it,
the drier and harder stool will become.
Etiology
(Egypt)

Symptoms of
constipation
Headache
Abdominal
bloating
Low back
pain
Sense of
rectal
fullness
(Egypt)

Question №. 2
1. My grandmother usually feels discomfort
from chronic constipation:
 What are reasons for
this problem?
 What are your advice?
(Egypt)

Risk factors of
constipation
Age Gender
Epidemiology
• Constipation is common in
elderly people ( > 65 y.)
• Laxative abuse
•  gut motility
• Medication use
• Poor nutrition
• Females are three times more
likely to suffer from constipation
than males
(Egypt)

Your advice
1. Laxative abuse:
 Lead to cathartic colon (loss of tone of
intestinal muscles) cause poor bowel function.
2. Increase intake fluids & fibers.
3. Increase exercise (  bowel tone).
(Egypt)

Question №. 3
3. My wife is pregnant she is worried about
constipation, I would like to know:
 What is the factors that
predispose pregnant to
constipation?
(Egypt)

Factors which constipate pregnant
• Bowel hypo-motility
 Progesterone
level
• Slowing down the passage
of food
Uterus compress
the intestine
• Reduce bowel activityLess exercise
• Can be constipatedVitamins intake
(Fe2+ , Ca2+ )
(Egypt)

Question №. 4
4. Is there a relationship between
anal disorders as abscesses
and constipation?
(Egypt)

Abscess
 It is a collection of pus (dead neutrophils)
that has accumulated in a cavity formed by
the tissue.
 Usually caused by bacteria or parasites
infection.
(Egypt)

Perianal abscesses
 Found in patients with inflammatory bowel
disease (Crohn's disease) or diabetes.
1
• Passage of hard stool
• Cause an internal wound
2
• The wound infected because of presence of feces in the rectal
area.
3
• Abscess is developed
4
• It presents as a lump of tissue near the anus
5
• By the time, it becomes larger and more painful
(Egypt)

Question №. 5
5. I heard that there is a medical condition
called “Colonic inertia”:
 What is it?
 How diet can affect colonic
motility?
(Egypt)

Colonic Inertia
Prolonged colon transit time
 Colonic dysfunction
 Prolong colon transit of the
fecal polus
 More water absorption
 Increase in its hardness
• The average time of passage through the GIT is 4 days.
(Egypt)

Diet & Colonic motility
 Motility may be stimulated by boosting
carbohydrates intake while limiting
protein.
(Egypt)

Question №. 6
Is it true that some health
problems may lead to
constipation?
(Egypt)

Pain
 During defecation  avoidance  constipation.
Causes
1. Passage of hard stool.
2. Anal fissures and abscess.
3. Hemorrhoids.
(Egypt)

Health problems may lead to
constipation
1. Carcinoma
2. Irritable bowel syndrome (IBS)
common cause in younger people
3. Diabetes
60% of diabetics patient
4. Renal failure
due to electrolyte & fluid disturbance
(Egypt)

5. Parkinsonism
up normal gut motility & rigid muscles
6. Colonic inertia
7. Pregnancy
Health problems may lead to
constipation
(Egypt)

Iron vs. Constipation
 Iron slow down the digestive system &
slowing of normal bowel movement.
 This may be because iron is a metal in its
basic form.
 Metals carry a charge that can affecting
muscles and nerves in the bowel
(Egypt)

Drugs cause constipation
1. Narcotic analgesics
2. Diuretics
3. Anticonvulsants
4. Sympathomimetic or anticholinergic
5. Antihistaminic
6. Antacids (containing Ca2+,Al3+)
(Egypt)

Purgaton®
tablet
Contain senna glycosides (anthraquinone)
 With extended use cause lazy bowel
syndrome (atonic colon)
 So bowel unable to move without chemical
stimulation.■
(Egypt)

(Egypt)
By Hossam Ashour

Constipation Definition and causes

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