Chronic or occasional constipation
Constipation, what is it?
Constipation is a delay or difficulty in the passage of stool. It can be occasional (travel, pregnancy, etc.) or chronic. Chronic constipation occurs when the problem has lasted at least 6 to 12 months, with more or less marked symptoms.
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The frequency of stool evacuation varies from person to person, ranging from 3 times a day to 3 times a week.
Constipation occurs when stools are hard, dry and difficult to pass. This usually happens if there are fewer than 3 bowel movements a week.
Constipation, what is it? understanding everything in 2 min.
Constipation can be transient (or progressive), meaning that stool stays too long in the colon, or terminal (or evacuating), meaning that it builds up in the rectum. Both problems can coexist in the same person.
In North America, it is estimated that between 12% and 19% of the population, both children and adults, suffer from chronic constipation9 .
The contracting intestines
During digestion, the intestines contract to move food through the digestive tract. This contraction is called peristalsis. If constipation occurs, peristalsis slows down and the stool remains in the colon for too long.
In the vast majority of cases, no organic cause is found and constipation is said to be "functional".
Bad eating habits
Most of the time, functional constipation is caused by poor eating habits, physical inactivity, stress, anxiety, or the presence of hemorrhoids or anal fissures that cause the person to abstain from having a bowel movement.
Constipation can result from food allergies or intolerances, particularly to lactose in cow's milk, which is less rare than is believed in young children with chronic constipation.
Withholding from going to the bathroom...
Delayed bowel movements when the need is felt is another common cause of constipation. The longer it stays in the colon, the harder the stool will be and the harder it will be to pass.
This is because the body reabsorbs a lot of water from the stool through the colon. Retained stool can also cause pain and anal fissures.
In some people, at the time of defecation, the anal muscle (the anal sphincter) contracts rather than relaxes, blocking the passage of stool.
Hypotheses often point to psychological factors to explain this lack of synchronization of reflexes.
In many cases, however, no cause or trigger can be found.
Constipation can also be the result or accompaniment of a more complex disease (irritable bowel syndrome, for example).
It can also be a diverticulitis, an organic lesion of the colon (e.g. colorectal cancer), a metabolic abnormality (hypercalcemia, hypokalemia) or an endocrine (hypothyroidism) or neurological problem (diabetic neuropathy, Parkinson's disease, bone marrow disease).
In rare cases, constipation is caused by a bowel obstruction, which is a total blockage of the bowel movement. Constipation then occurs suddenly and is accompanied by vomiting. It requires an emergency consultation.
Many drugs can also cause constipation, including, paradoxically, some laxatives when taken for long periods of time, anxiolytics, antidepressants, morphine, codeine and other opiates, some antispasmodics (anticholinergics).
Also, anti-inflammatories, muscle relaxants, some antihypertensives (especially calcium channel blockers like diltiazem), diuretics, aluminum-containing antacids, and so on.
Some iron supplements may also cause constipation, but not all iron supplements have this effect.
Finally, in rare cases, in children, constipation may be a sign of Hirschsprung's disease, a disease present from birth linked to the absence of certain nerve cells in the intestine.
When to consult?
Constipation, especially when it occurs suddenly, can be a sign of a serious illness, such as colon cancer.
Therefore, this symptom should not be overlooked. It is advisable to consult a doctor in the following cases.
- Recent constipation or constipation with blood in the stool.
- Swelling, pain or constipation alternating with diarrhea.
- Weight loss.
- Stools that continually decrease in size, which may be a sign of a more serious problem in the bowel.
- Constipation that has lasted more than 3 weeks
- Constipation that persists in newborns or very young children (since Hirschsprung's disease has to be ruled out)
Generally, constipation is mild and disappears on its own in a few days, thanks to an adapted diet. However, if it persists, sometimes complications may arise:
- hemorrhoids or anal fissures;
- intestinal obstruction;
- Fecal incontinence;
- Fecal impaction, i.e. the accumulation and compaction of dry stool in the rectum, which occurs mostly in elderly or bedridden people;
- laxative abuse.