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What is constipation? Am I constipated?

Constipation, constipated

What is constipation?

Have you ever tried straining so hard you even went to the extent of imagining yourself bursting in pieces inside the comfort room? Of course you must have. It would be hard to believe if you have not experienced this even for just once in your entire life!

Constipation as a condition is certainly not new in clinical practice. Although it is only reported to occur in about 10-15% of adults in the total population, frequently occurring in the elderly, in women, and in children, it is in fact a relatively common complaint encountered by medical health providers. Constipation itself is a term that is ambiguous and hard to delineate. Although it usually refers to persistently difficult, occasional, or seemingly “incomplete” defecation, a very extensive range of bowel habits makes constipation essentially difficult to define accurately.

The basis for constipation is what makes it more confusing and hard to characterize. While some base constipation on a decrease in the frequencies of defecation per week, others base it on their difficulties encountered during straining, awkwardly hard stools, an unexplainable feeling of abdominal fullness or satiety that makes them less likely to defecate easily, and even a number of individuals define it as a sense of partial and incomplete evacuation of fecal matter. All of these unfortunately constitute the variety of considerations needed prior to coming up with an essentially concrete clinical impression of constipation. So the next time you try to label something as “constipation”, make sure you have made a split-second thinking and a thorough analysis involving the considerations mentioned above. You should be certain as to what you are trying to mean by “constipation”, in contrast to that of the simple “difficulty with defecation”.

Do not be mistaken by separating constipation from the hardness or softness of the fecal matter along with it, and the difficulty encountered during the defecation process. It is not advisable to associate the definition of constipation based on the nature of the fecal matter alone or on the defecation process alone. The nature of the stools is likely to reflect time elapsed with regards to defecation. One can derive from examination of hard, pellety stools that the gastrointestinal tract it came from had slow transit, while that of loose and watery stools imply a rather rapid transit. Aside from being either solid or liquid, size can also be an indicator, such that bigger stools are more difficult to expel than that of normal stools, thus it is associated with slow transit. Take note therefore that constipation can also be a function of the period of transit in your gastrointestinal tract, and any abnormalities in stools are rather clues on the actual abnormalities in the gastrointestinal tract!

Among the obstacles and hindrances encountered in assessment for constipation is the apparent difficulty to assess it objectively. If defecation occurs once a day in one individual, encountering someone who defecates only thrice a week would make him consider and think that the other is suffering from constipation. It is just the same with the other factors. One cannot just label abdominal fullness as abdominal fullness per se because there are no specific standardized and quantitative measures to be able to assess it in history taking and physical examination. This is why in a lot of cases involving patients with constipation as well as with other serious complaints, modalities such as enemas or digital disimpaction is utilized in order to substantiate an individual patient's claims pertaining to difficulty in defecation.

Constipation should be understood from the point of view of its specific etiologies, among of which will be discussed in the succeeding pages. Every one should bear in mind that constipation as a complaint should not be taken lightly – it can be a simple call for an uncomplicated and straightforward dietary change, or it can also be a giant knock on the head telling you about a progressing colon cancer!

In to swimbi.com