Constipation

Constipation can be expressed as severe or rare stools that can affect people of all ages. When evaluating constipation, the frequency of defecation, whether defecation is difficult, the solidity level of the stool, and whether full relief is felt after defecation are important.

In the normal digestive process, defecation is expected on average every 3 days. Depending on bowel movements and eating habits, this may be delayed for up to 5 days. The severity of constipation can vary from person to person. Constipation, which is uncomfortable for one person, may not be a problem for another.



According to the general opinion for constipation:

• Defecation less than 3 times a week
• Straining, hard stools and the absence of a feeling of complete ejaculation were observed as sufficient symptoms in a quarter of defecations.

Constipation is mostly caused by malnutrition, inactivity and defecation habit disorder. Inadequate fiber intake, insufficient fluid intake, or excessive nutrition above the digestive capacity facilitate constipation. Constipation may be seen in patients who work by sitting constantly, sedentary life or bedridden patients, as inactivity will restrict bowel movements and will not facilitate bowel emptying. Constipation is common, especially after long journeys. In addition, despite the regular functioning of the intestines, these delays that delay the expulsion of stool that pass into the rectum and that are made voluntarily cause the stool to accumulate in the rectum and be added to the ones that follow. These accumulations both make defecation more difficult over time, and cause the waiting stool to harden. Therefore, when the stool alarm is felt, it is necessary to go to the toilet without delay.

Toilet habit is an important issue that should be acquired regularly from childhood. Individuals who were frequently constipated and had painful defecation as children may have a reaction to defecation from childhood. Especially in schools where there is no hygienic toilet environment, the fact that children do not want to go to the toilet and prefer to wait until home ensures that this delaying habit is taught to the child naturally. It is natural that difficult defecation and painful defecation occur with delay. The expected pain sensation causes delay and vicious circle. These people usually have cracks, fissures or hemorrhoids that cause anal pain.

Not drinking enough water can cause the stool contents to solidify, causing constipation. Acquiring the habit of drinking enough water at any age will also prevent constipation. It should not be forgotten that liquids such as tea taken instead of water may cause more fluid loss due to their diuretic effect. What is meant by adequate fluid intake is to drink water directly.

Since caffeinated drinks will slow down bowel movements, the waiting time of the stool in the intestine is prolonged and causes it to solidify. This is why people with diarrhea are often encouraged to drink coffee in public. Reducing caffeinated beverages for people who are constipated may make constipation less frequent.

People who have constipation problems tend to use laxatives at the first opportunity, which may cause their bowels to lose their ability to pass stool on their own and to wait for such drugs all the time. This situation, which is also described as intestinal laziness, can facilitate chronic constipation problems. Failure to resolve constipation despite taking laxatives is expressed as tolerance to laxatives over time. Intestines begin to be unaffected by laxatives over time. Laxatives should be used only rarely in cases of constipation that cannot be resolved by other measures. While laxatives may be effective in constipation lasting less than 5 days, enemas may be more appropriate in constipation for 5-7 days or longer, since stool may be hardened in the rectum. Therefore, using laxatives in all constipations may not solve the problem.

Acute constipation

In people who are healthy in the past, new-onset constipation is called acute constipation. If constipation is progressive in these patients, it may be a sign of a serious illness.

Acute constipation is usually caused by fecal stones in the elderly. They are mostly weak and debilitated patients who are bedridden or frequently use sedative drugs. The stool is petrified in the rectum and occludes the duct. The overflow of stool passing around this fecal stone can be mistakenly considered as diarrhea. These patients experience severe rectal discomfort.



In addition, rectum or large intestine tumors, mesenteric vascular occlusions, painful rectal lesions, drugs, intestinal obstructions, urinary system diseases, neurological disorders and some systemic diseases may also cause acute constipation.

Chronic constipation

Bad eating habits, bad toilet habits, insufficient fluid intake, lack of exercise, medications and laxatives can be expressed as constipation due to chronic habits.

It is more common in irritable bowel syndrome when successive constipation and diarrhea are accompanied by hard stools.

Constipation can sometimes be seen as a symptom of anxiety or depression. In this case, gastrointestinal system symptoms are not observed.

In cases of chronic constipation, it is often seen that the feeling of defecation is constantly suppressed in patients or rectal desensitization develops due to irregular laxative use. In these patients, even if the rectum is full of feces, there may be no desire to defecate.

In some cases, anal fissures or hemorrhoids can also cause chronic constipation as they suppress the desire to defecate.

In some patients, when megacolon develops, constipation that does not respond to treatment and lasts for a long time can be seen.

Causes of constipation

• Rectal filling disorders
  • Conditions related to gastrointestinal diseases
    • Conditions that narrow the intestinal lumen
      • Tumors
      • Inflammatory bowel diseases
        • Crohn’s disease
        • Ulcerative colitis
        • Diverticulitis
      • Conditions that impair bowel functions
        • Irritable bowel syndrome
        • Congenital aganglionic megacolon (Hirschprung’s disease)
      • Systemic diseases
        • Pregnancy
        • Hyperthyroidism
        • Hyperparathyroidism
        • Hypokalemia
        • Diabetes mellitus
        • Porphyria
        • Lead poisoning
      • Drug side effects
        • Opiates
        • Ganglion blocking drugs
        • Anticholinergics
        • Non-absorbable antacids
        • Antidepressants
        • Hemanitics
        • Diuretics
      • Rectal ejaculation disorders
        • Organic disorders of the defecation reflex
          • Anorectal disorders
            • Anal ulcer
            • Anal fissure
            • Anal fistula
            • Proctitis
            • Hemorrhoids
            • Increase in anal sphincter tone
          • Neurological diseases
          • Physical inactivity
          • Abdominal muscle weakness
          • Senile
        • Non-organic conditions that impair the defecation reflex
          • Bad toilet habit
          • Bad gut and eating habits
          • Laxative abuse
          • Psychiatric disorders