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constipation

Definition of Constipation

Constipation, costiveness, or irregularity is a condition of the digestive system in which a person (or animal) experiences hard feces (faeces) that are difficult to expel. This usually happens because the colon absorbs too much water from the food. If the food moves through the gastro-intestinal tract too slowly, the colon may absorb too much water, resulting in feces that are dry and hard. Defecation may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction. The term obstipation is used for severe constipation that prevents passage of both stools and gas. Causes of constipation may be dietary, hormonal, anatomical, a side effect of medications (e.g. some opiates), or an illness or disorder. Treatments consist of changes in dietary and exercise habits, the use of laxatives, and other medical interventions depending on the underlying cause.

Signs and Symptoms

In common constipation, the stool is hard, difficult, and painful to pass. Usually, there is an infrequent urge to void. Straining to pass stool may cause hemorrhoids. In later stages of constipation, the abdomen may become distended and diffusely tender and cramp, occasionally with enhanced bowel sounds.

The definition of constipation includes the following:

infrequent bowel movements (typically three times or fewer per week)

difficulty during defecation (straining during more than 25% of bowel movements or a subjective sensation of hard stools), or

the sensation of incomplete bowel evacuation.

Severe cases ("fecal impaction") may feature symptoms of bowel obstruction (vomiting, very tender abdomen) and "paradoxical diarrhea", where soft stool from the small intestine bypasses the impacted matter in the colon.

What Causes Constipation??

The main causes of constipation include:

Hardening of the feces

Insufficient intake of dietary fiber

Dehydration from any cause or inadequate fluid intake

Medication, e.g. diuretics and those containing iron, calcium, aluminum

Paralysis or slowed transit, where peristaltic action is diminished or absent, so that feces are not moved along

Hypothyroidism (underactive thyroid gland)

Hypokalemia

Injured anal sphincter (patulous anus)

Medications, such as loperamide, opioids (e.g. codeine & morphine) and certain tricyclic antidepressants

Severe illness due to other causes

Acute porphyria (a rare inherited condition)

Lead poisoning

Lactose Intolerance

Dyschezia (usually the result of suppressing defecation)

Diverticula

Tumors, either of the bowel or surrounding tissues

Obstructed defecation, due to:

Mechanical causes from morphological abnormalities of the anorectum including megarectum, rectal prolapse, rectocele, and enterocele

Functional causes from neurological disorders and dysfunction of the pelvic floor muscles or anorectal muscles, including anismus, descending perineum syndrome, and Hirschsprung's disease

Retained foreign body or a bezoar

Psychosomatic constipation, based on anxiety or unfamiliarity with surroundings.

Functional constipation

Constipation-predominant irritable bowel syndrome, characterized by a combination of constipation and abdominal discomfort and/or pain

Smoking cessation (nicotine has a laxative effect)

Abdominal surgery, other types of surgery, childbirth

Severe dehydration

Some causes are with particular respect to infants:

Switching from breast milk to bottle feeds, or to solid meals

Potty training anxiety

Hirschsprung’s disease - a condition from birth where the child has a nerve cell defect that affects communication between the brain and bowels

Treatment For Constipation

In people without medical problems, the main intervention is to increase the intake of fluids (preferably water) and dietary fiber. The latter may be achieved by consuming more vegetables and fruit and whole meal bread, and pulses such as baked beans and chick peas and by adding linseeds to one's diet. The routine non-medical use of laxatives is to be discouraged as this may result in bowel action becoming dependent upon their use. Enemas can be used to provide a form of mechanical stimulation. However, enemas are generally useful only for stool in the rectum, not in the intestinal tract.

Lactulose, a nonabsorbable synthetic sugar that keeps sodium and water inside the intestinal lumen, relieves constipation. It can be used for months together. Among the other safe remedies, fiber supplements, lactitiol, sorbitol, milk of magnesia, lubricants etc. may be of value. Electrolyte imbalance e.g. Hyponatremia may occur in some cases especially in diabetics.

In alternative and traditional medicine, colonic irrigation, enemas, exercise, diet, and herbs are used to treat constipation. The mechanism of the herbal, enema, and colonic irrigation treatments often includes the breakdown of impacted and hardened fecal matter.

Laxatives

Laxatives may be necessary in people in whom dietary or other interventions are not effective or are inappropriate. Laxatives should be used with caution and only as necessary. The following sequence of laxative use is recommended: bulk forming, then stool softeners, then osmotic, then stimulants, then suppositories, and finally enemas (only as a last resort). The reason for this cautious use is because laxatives can lead to dependence, and like all medications they have side effects. Laxatives should not be used if there are signs and/or symptoms of a bowel obstruction.

Physical intervention

Constipation that resists all the above measures requires physical intervention. Manual dissimpaction (the physical removal of impacted stool) is done for those patients who have lost control of their bowels secondary to spinal injuries. Manual dissimpaction is also used by physicians and nurses to relieve rectal impactions. Finally, manual dissimpaction can occasionally be done under sedation or a general anesthetic—this avoids pain and loosens the anal sphincter.

Many of the products are widely available over-the-counter. Enemas (clysters) are a remedy occasionally used for hospitalized patients in whom the constipation has proven to be severe, dangerous in other ways, or resistant to laxatives. Sorbitol, glycerin and arachis oil suppositories can be used. Severe cases may require phosphate solutions introduced as enemas.

Paediatrics/Pediatrics

Lactulose and milk of magnesia has been compared to PEG (polyethylene glycol) in children. They had similar side effects but PEG was more effective at treating constipation. Osmotic laxatives are recommended over stimulant laxatives.

Prevention Efforts Constipation

Constipation is usually easier to prevent than to treat. The relief of constipation with osmotic agents, i.e. lactulose, polyethylene glycol (PEG), or magnesium salts, should immediately be followed with prevention using increased fibre (fruits, vegetables, and grains) and a nightly decreasing dose of osmotic laxative. With continuing narcotic use, for instance, nightly doses of osmotic agents can be given indefinitely (without harm) to cause a daily bowel movement.

Recent controlled studies have questioned the role of physical exercise in the prevention and management of chronic constipation, while exercise is often recommended by published materials on the subject.

In various conditions (such as the use of codeine or morphine), combinations of hydrating (e.g. lactulose or glycols), bulk-forming (e.g. psyllium) and stimulant agents may be necessary to prevent constipation.

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How To Lose Weight

do you want to change your clothes into smaller size?
Despite what you may think, losing weight isn't a mysterious process. In fact, weight loss doesn't even have to involve strange diets, special exercises or even the 'magic' of pills or fitness gadgets. Want the secret to weight loss? Make small changes each and every day and you'll slowly (but surely) lose those extra pounds.
Rules of Weight Loss
To lose one pound, you must burn approximately 3500 calories over and above what you already burn doing daily activities. Whew...that sounds impossible doesn't it? Here's how it works.
1. Calculate your BMR (basal metabolic rate). Your BMR is what your body needs to maintain normal functions like breathing, digestion, etc.
2. Calculate your activity level. Use a calorie calculator to figure out how many calories you burn while sitting, standing, exercising, lifting weights, etc. throughout the day.
3. Keep track of how many calories you eat. Use a food journal to add up what you eat and drink during the day. If you're eating less calories than you're burning, you'll lose weight.
Example:
Mary's BMR is 1400 calories and she burns 900 calories in daily activity. To maintain her weight, she should be eating 2300 calories but, after keeping a food journal, Mary finds that she's eating 2550 calories every day. By eating 250 more calories than her body needs, Mary will gain one pound every 2 weeks.
This example shows how easy it is to gain weight without even knowing it. But it's also easy to lose weight. In fact, you can start losing weight right now by making a few simple changes. If you can burn an extra 500 calories each day, you'll lose a pound a week and you won't even have to change your clothes. Try these ideas:

Instead of....	Do this...
Having an afternoon Coke	Drink a glass of water. (calories saved: 97)
Eating an Egg McMuffin	Eat a small whole wheat bagel +1 tbls of peanut butter (calories saved: 185)
Using your break to catch up on work or eat a snack	Walk up and down a flight of stairs for 10 minutes (calories burned: 100)
Hitting the snooze button	Get up 10 minutes early and go for a brisk walk (calories burned: 100)
Watching television after work	Do 10 minutes of yoga (calories burned: 50)

Total Calories Saved: 532 (based on a 140-lb person)

Focusing on daily changes is the best way to reach your goals. No, you won't lose weight overnight but isn't it better to permanently change your life for the better? Say it with me: My Health Is More Important Than My Appearance. Repeat that 10 times a day and you're on your way to better health.

STEP

1. Eat more! Don't be fooled because the article is referring to more of healthy, low-fat foods rather than junk food. Junk food can range from burgers to those cookies that you always bought! Adding a lot of vegetables and fruits to your diet will help you. Also, drinking bouillon, a Haitian soup, made with filtered water will help you feel full.

2. Exercise every day! This could be the most difficult step to follow. But what you can do is actually start slowly then steady increase the amount of exercise. For example, today you will walk for 10 minutes, repeat this for the whole week. For the next week, double your workload. You may get leaner that way! The important thing is to get your heart rate up and start, now!

3. Feed your temptations once in a while. Go ahead and have that donut or slice of pizza, but before you do, drink a few glasses of water and eat a bowl of raw veggies such as cucumbers, celery, carrots, and tomatoes. They will fill you up and you will have very little room to eat the "junk" food.

4. Consume things that have no calories. There are two things you eat and drink that contain no calories: water and fiber. The more of these you get into your diet, the better off you will be. For example, you can eat a pound of mixed salad greens with assorted raw vegetables (carrots, red cabbage, celery, broccoli, onion, etc.) with a low or no-calorie salad dressing and only have eaten 100-150 calories. This is because of the high water and fiber content of the salad and low calorie dressing. Also, eat lots of celery. It has only 8 calories, but amazingly, it takes more than 8 calories to digest it. So, you actually BURN calories by eating celery! It's not much, about 2 calories per 8 inch stalk, but it sure doesn't hurt.

Source :
http://exercise.about.com/cs/weightloss/a/howtoloseweight.htm
http://www.wikihow.com/Eat-and-Lose-Weight