CONSTIPATION AND ITS TREATMENT

It is considered that a person is constipated when the number is less than 3 bowel movements per week. This may be accompanied by other signs or symptoms such as hard stools and small quantity, sensation of incomplete evacuation or obstructive or tamponade feeling, which requires much effort and even digital maneuvers to complete the evacuation. 

When this situation lasts over a more than three months, we talk about chronic constipation. The most common is that constipation is due to a functional disorder colon, anorectal or pelvic floor . It can also be secondary to other metabolic diseases (diabetes, hypothyroidism), neurological (Parkinson's, spinal cord injury) or be caused by organic lesions (colorectal cancer, strictures, fissures, etc.). 

In other instances, the constipation may be induced by certain pharmacological treatments : blocking drugs, calcium channel blockers, opioids, anticholinergics, etc. This should be taken into account when making clinical diagnosis.

Consequences of Constipation

A significant percentage of consultations for anal pathology (hemorrhoids, fissures) have an origin in chronic constipation problems. Other diseases such as diverticular disease of the colon or rectal prolapse may be aggravated by constipation.

Get rid of constipation

Changing lifestyle habits is the first and most essential link in the treatment of constipation: avoid a sedentary lifestyle with exercise or sport practiced routinely,   increase the fiber content of the diet, based on fruits, vegetables and whole grains and increase fluid intake : water, juices, teas and soups.

Treatment

There is a wide variety of pharmacological treatments which include agents which increase the volume of feces (Plantago ovata), stimulant drugs (bisacodyl, senna), osmotic (magnesia, lactulose), lubricants and even probiotic substances.

Treatment differs depending on whether the constipation is due to a motor or functional bowel or if it is a defecation disorder. In the first case, the rise of the fiber can be supplemented and osmotic agents in a second step add stimulants. 

Defecation disorders respond well to treatment with rehabilitation (biofeedback) that teaches relaxation coordinate the effort to defecation. In short, the drug treatment was applied in each case so particularized.

Laxatives

Treatment with laxatives should never be raised initially chronically. should continuously seek the best therapy for each patient scenario. Laxative abuse can lead to undesirable situations that occur with wall involvement and function of the colon and may to do so exacerbate intractable constipation. 

Treatment Options for Constipation

Surgery (colectomy) is exclusively reserved for specific cases refractory to medical treatment and with very specific indications. Currently emerging new techniques such as sacral nerve stimulation, in the absence of larger studies, is emerging as a therapeutic future. There are also new drugs whose use in this pathology is pending approval by the competent bodies.