What is constipation and how is it defined?
Since constipation is a very subjective complaint that varies from person to person, sometimes patients may consider different defecation habits as constipation. They may consider not defecating every day as constipation.
As a physician, we can describe constipation as the presence of one of the changes listed below. The need to strain excessively during defecation, constant hard defecation, the feeling of incomplete evacuation after defecation, the need for manual support during defecation, and defecation every 3-4 days. Of course, occasional occurrence of these situations is not considered as constipation.
Who gets it?
Although constipation occurs at all ages, it is more common in older ages and in women. It is also frequently seen in babies and children.
Are there different types of constipation?
Yes, we can divide constipation into two. Chronic constipation; It is a form of constipation that is usually seen in the elderly and has been around for a long time; Some medications and some diseases that affect the intestines cause this type of constipation. Acute constipation is a newly developing form of constipation. It is necessary to investigate what the cause is.
What are the causes of constipation?
There are many causes of constipation. We can group these reasons into five groups. Diseases that cause obstruction in the intestine (cancer, fecal stones, etc.), internal diseases (diabetes, goiter disease, etc.), nerve and muscle diseases (Multiple Sclerosis, Parkinson's, inactivity, etc.), medications (antidepressants) and those whose cause cannot be found. Among these, constipation of unknown cause constitutes the majority of patients.
Is it necessary to know the cause of constipation?
If we know the cause of constipation, our treatment will change accordingly. Our treatment for constipation in someone with diabetes is different, the treatment of constipation due to food change in a child is different, and the treatment of constipation due to bowel cancer will of course be different.
What should be done to find out the cause of constipation?
First of all, it is necessary to decide whether the patient is really constipated or not. Some patients think they are constipated when they do not defecate every day.
As physicians, we question the duration and time of onset of constipation in people we determine to be constipated. The approach to constipation that has been happening since infancy is different, to those that started at a young age and has been happening for a long time, and to constipation that has only started recently. Complaints accompanying constipation are questioned; such as bleeding, weight loss, weakness, abdominal pain, feeling of bloating.
Then, the anal area is examined and it is checked whether there are diseases such as hemorrhoids, cracks, abscesses. In some patients, it is necessary to perform further examinations such as colonoscopy to see the inside of the intestines and to determine the working speed of the intestines.
Are these examinations performed on every patient?
The question of constipation is always questioned. is done to the patient. After this questioning, the physician usually determines the cause and prescribes treatment. Sometimes constipation does not improve as a result of this treatment. In this case, it may be necessary to examine the patients. Or, in a small number of patients, it is necessary to perform these examinations after the first examination before starting any treatment. As a result of the examinations, the necessary treatment is given according to the cause of constipation.
What should be done as treatment?
If a specific cause is found, it is necessary to provide treatment for that cause. If the reason is not clear, it would be beneficial to first increase the amount of fiber in the food, eat plenty of fruits and vegetables, and increase fluid intake. Older people are advised to move a little and take a walk. If constipation does not improve in this way, treatment with medications is started.
What are the foods that prevent and reduce constipation?
Especially foods with plenty of fiber and fiber are useful to correct constipation. Consuming plenty of fruits and vegetables, apricots, figs, olive oil and legumes are useful in relieving constipation as they have plenty of fiber. Our country and Turkish cuisine are lucky in this regard.
Does continuous drug use cause intestinal laziness?
Yes, using some drugs for a long time, for years, causes the intestines to become susceptible to these drugs. reduces sensitivity. Therefore, the effects of the drugs decrease. In a sense, this means that the intestines need other and stronger stimulants to function. Therefore, changing eating habits and improving correct defecation is the key to correcting constipation.
How should correct defecation be?
Defecation is an activity that has biological, psychological and social aspects. Each of these three factors must be in healthy and appropriate conditions for correct defecation. If there is a deficiency or abnormality in one of these factors, correct defecation will not occur, constipation will develop, and diseases may occur. Changes in location, traveling, eating different foods than you are used to, and being under intense stress can also disrupt the defecation pattern and cause constipation.
For people who do not have any disease, we can recommend correct defecation as follows. When there is a need to defecate, one should go to the toilet without waiting, defecate and finish without waiting for a long time in the toilet and without straining too much. It is not right to wait for complete ejaculation, to spend most of the defecation time straining, or to wait long enough to read the newspaper or smoke a cigarette.
Is it necessary to change behavior for correct defecation?
It is useful to acquire some habits. It is useful to get used to sitting on the toilet and defecating at a certain time every day, especially after a meal, such as after breakfast or dinner. A squatting toilet may be more suitable as the muscles of the anus area will relax more by squatting.
Are there any special conditions for constipation?
In children, pregnant women, bedridden patients and patients undergoing surgery Constipation that develops afterwards is characteristic. Children may experience constipation when they start new foods. This constipation can be improved with food regulation and temporary medications. Sometimes, since the cracks in the anal area make defecation painful, the child does not want to defecate and becomes constipated. Constipation during pregnancy is caused by compression of the intestines. Again, constipation can be relieved with diet regulation and some medications. It is beneficial for bedridden patients to eat foods rich in fiber and use mild stool softeners. If you have constipation after the surgery, you should definitely be examined by a doctor and check if there is anything wrong with the surgery. If there is no problem with the functioning of the intestines, constipation can be corrected with medications.
Constipation can be treated with surgery. r?
Except for very rare cases, there is no surgery just for constipation. However, surgery can be performed in cases such as absence of nerves that drive the intestines (Hirschsprung) disease, which is seen in babies and children, extremely lazy intestines (colonic inertia), presence of obstructed anal, hardened stools (fecaloma), or colon cancer.
If constipation is not treated, will other diseases occur?
Yes, if constipation continues, it will be necessary to strain during defecation. Continuous straining can lead to hemorrhoids, fissures and prolapsed anus in the anal area. In very advanced cases, stool that has hardened into stones can cause intestinal obstruction or even perforation. Constant straining may lead to the formation of diverticula (intestinal wall hernia) in the large intestines. Of course, first of all, it is necessary to make sure that constipation is not due to another disease that requires treatment.
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