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Difficult or delayed bowel movements. Constipation may occur as a delay in the frequency of bowel movements, an attempt to pass stools that are hard and compact, or a combination. Constipation tends to be chronic (longterm), though can occur as acute (sudden) episodes. Abdominal cramping and bloating may accompany constipation.
Any rectal bleeding that accompanies constipation or bowel movements requires medical evaluation.
Though constipation can signal serious health conditions such as intestinal obstruction or hypothyroidism, most often constipation relates to lifestyle factors such as diet, physical exercise, and hydration (fluid intake). Numerous medications, notably antihistamine medications, narcotic analgesic medications (pain relievers) and antidepressant medications, can cause constipation. Constipation becomes more common with increasing age, partly due to lifestyle factors and partly due to age-related changes in intestinal motility.
Stools become hardened when the colon extracts too much water from the fecal matter that passes through it. This can occur because the body needs more fluid (inadequate fluid intake) or because the fecal matter spends too much time in the colon (a consequence of inactivity or decreased intestinal motility). Hardened stools are difficult to pass and may cause irritation and even abrasions to the anal canal and anus.
Straining with the effort of a difficult bowel movement aggravates common conditions such as hemorrhoids and can have cardiovascular consequences such as arrhythmia (irregular heartbeat). Longterm use of laxatives causes the colon to become reliant on them to stimulate bowel movements; overuse of laxatives is a frequent cause of chronic constipation.
For occasional constipation, many doctors recommend home treatment for two to three weeks, consisting of:
- Increased water consumption
- Increased fiber in the diet (eating more vegetables, fruits, whole grains, and whole grain products)
- 45 minutes to an hour of daily physical exercise such as walking, which encourages peristalsis (the rhythmic, wavelike contractions of the intestinal wall) and improves blood flow
- No laxatives
- Sitz baths and hemorrhoidal preparations to soothe irritated hemorrhoids
These measures facilitate a return to gastrointestinal regularity for most people. Constipation that extends beyond two or three weeks, occurs with rectal bleeding, or causes abdominal pain or abdominal distention requires prompt medical evaluation.
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