31 Possible Causes of Abdominal

Bloating and Abdominal Pain

3. Constipation

Dr. Yousef Elshrek

•Constipation•What Is Constipation?

•Constipation is most often defined as having a bowelmovement less than 3 times per week.

• It usually is associated with hard stools or difficultypassing stools.

•You may have pain while passing stools or may be unableto have a bowel movement after straining or pushing formore than 10 minutes ,or

• a condition in which there is difficulty in emptying thebowels, usually associated with hardened feces.

• What Causes Constipation?

• Your colon’s job is to absorb water and salt from food as it’s passing through your digestive system.

• It then creates stool (waste).

• The colon’s muscles eventually propel the waste out through the rectum to be eliminated.

• If stools remain in the colon too long, they can become hard and difficult to pass.

• Poor diet frequently causes constipation, since dietary fiber and adequate water intake are necessary to help keep stools soft.

• Fiber-rich foods are plant foods that your body is not able to digest.

• Fiber comes in two forms:

• soluble and insoluble. 1. The soluble fiber can dissolve in water, and it creates a soft, gel-

like material as it passes through the digestive system. 2. Insoluble fiber retains most of its structure as it goes through the

digestive system.

• Fiber is very helpful in easing constipation, as both forms of the fiber join with the dry, hard stools—increasing their weight and size while also softening the stools, making it easier for them to pass through the rectum.

• Changes in routine, stress, and other conditions that slow muscle contractions of the colon or delay your urge to “go” may also lead to constipation

• Common Constipation Causes

• low-fiber diet (particularly diets high in meat, milk, or cheese)

• dehydration

• lack of exercise

• delaying the impulse to have a bowel movement

• travel or other changes in routine

• certain medications, such as antacids and pain medications

• pregnancy

• Underlying Medical Problems That Can Cause Constipation

• certain diseases, such as stroke, Parkinson’s disease, diabetes, and lupusproblems with the colon or rectum, including intestinal obstruction, irritablebowel syndrome, or diverticulosis overuse or misuse of laxatives (medicationsto loosen stools) hormonal problems, including an underactive thyroid glandanal fissures (tears) or hemorrhoids

•What Are the Symptoms of Constipation?• Every person’s definition of “normal” bowel movements may

be different.• Some individuals go three times a day, while others go three

times a week.•However, you may be constipated if you experience the

following symptoms:1. fewer than three bowel movements a week2. passing hard, dry stools3. straining or pain during bowel movements4. a feeling of fullness, even after having a bowel

movement5. experiencing a rectal blockage

•Who is at risk for constipation?• Eating a poor diet and not exercising are major risk factors for

constipation.

• However, you may be at greater risk if you are:

1. 65 or older: Older adults tend to be less physically active, mayhave underlying diseases, and may eat poorer diets that lead toconstipation.

2. confined to bed: Those who have certain medical conditions,such as spinal cord injuries, often have difficulty with bowelmovements.

3. a woman or a child: Women have more frequent episodes ofconstipation than men, and children are more often affectedthan adults.

4. pregnant: Hormonal changes and pressure on your intestinesfrom your growing baby can lead to constipation.

•How Is Constipation Diagnosed?• Many people affected by constipation choose to self-treat by

changing their diets, increasing their exercise, or using over-the-counter laxatives.

• However, laxatives should not be used for more than two weekswithout consulting a physician because your body can becomedependent on them for colon function.

• You should talk to your general or family physician if:

1. you have had constipation for more than three weeks

2. you have blood in your stool

3. you are experiencing pain during bowel movements

4. you are losing weight

5. you have sudden changes in your bowel movements

• Your doctor will ask questions about your symptoms, medical history, and any medications orunderlying medical conditions.

• A physical examination may include a rectal exam and blood tests to check your thyroidfunction.

• In severe cases, additional tests may be required to identify the cause of your symptoms.

• These may include:1. An examination of how food is moving through your colon, called a marker study or

colorectal transit study.• For this test, you will swallow a pill that contains tiny markers that will show up on an

X-ray.• Numerous abdominal X-rays will be taken over the next few days so the doctor can

visualize how the food is moving through your colon and how well the intestinalmuscles are working.

• You may also be asked to eat a diet high in fiber during the test.2. An examination of the anal sphincter muscle function, called an anorectal manometry.

• For this test, your doctor will insert a thin tube with a balloon-tip into your anus.• When the tube is inside, the doctor will then inflate the balloon and slowly pull it out.• This test allows him or her to measure your anal sphincter’s muscle strength and see

if your muscles are contracting properly.

• An examination of the colon with a colonoscopy.

• In this test, your doctor will examine your colonusing a tube that is outfitted with a camera(colonoscope).

• A sedative is often given, so you will feel no pain.

• To prepare for this test, you will be on a liquid-onlydiet for one to three days, and may have to take alaxative or enema the night before the test.

• An examination of the colon with a barium enema X-ray.

• For this test, you will drink a special liquid the night before the test to clean outthe bowel.

• The actual test involves the insertion of a dye called barium into your rectum,using a lubricated tube.

• The barium highlights the rectum and colon area, allowing the doctor to betterview them on an X-ray.

• How to Treat and Prevent Constipation

• Changing your diet and increasing your physical activity level are theeasiest and fastest ways to treat and prevent constipation.

• Try the following techniques as well:

1. Every day, drink 1.5 to 2 quarts of fluids, such as water or juice, tohydrate the body.

2. Limit consumption of alcohol and caffeinated drinks, which causedehydration.

3. Add fiber-rich foods to your diet, such as raw fruits and vegetables,prunes, or bran cereal. Your daily intake of fiber should be between20 and 35 grams.

4. Cut down on low-fiber foods, such as meat, milk, cheese, andprocessed foods.

5. Aim for about 150 minutes of moderate exercise every week (about20 minutes a day), such as walking, swimming, or biking.

6. If you feel the urge to have a bowel movement, don’t delay, Thelonger you wait, the harder your stool will become.

7. Add fiber supplements to your diet if needed, Just remember todrink plenty of fluids because you can aggravate constipation if youadd extra fiber without also adding fluids to your diet.

8. Use laxatives sparingly. Your doctor may prescribe laxatives orenemas for a short period of time to help soften your stools. Neveruse laxatives for more than two weeks without talking to yourdoctor because you can cause your body to become dependent onthem for proper colon function.

9. Your doctor may also advise that you stop taking certainmedications that may cause constipation. More severe colon orrectal problems may require manual procedures to clear the colonof impacted stool, therapy to retrain slow muscles, or surgery toremove the problem part of your colon.

31 Possible Causes of Abdominal

Bloating and Abdominal Pain

4. Intestinal obstruction

Dr. Yousef Elshrek