The 7 Causes of Constipation
The term constipation, also known as costiveness, is used by patients to describe infrequent bowel movements, incomplete evacuation, excessively hard stool, or a defecation disorder resulting from perianal diseases. Since bowel movement frequency in healthy people can range from three times a day to three times a week, it is more meaningful to evaluate constipation not in terms of bowel movement frequency, but as a deviation from an individual's previous bowel habits.
Chronic constipation is common in Western societies, with approximately 10% of the population regularly using laxatives. Most patients with chronic constipation have accumulation of a large, dry stool mass in the rectum, initial defecation insufficiency, or a habit of ignoring or postponing the urge to defecate. This voluntary suppression of the need to defecate occurs in childhood or later in life. This is often due to an uncomfortable toilet environment, a hectic work schedule, or conditions requiring bed rest.
MORE COMMON IN WOMEN
Constipation is more common in women, which results from women being especially more meticulous about using the toilet outside their homes. If continuous distension of the rectum by feces becomes chronic, the person's sensitivity to noticing rectal fullness begins to decrease. Progressive bowel movements become more difficult, resulting hemorrhoids and fistulas make defecation considerably more difficult, and defecation begins to be suppressed. To escape this difficult situation, the patient begins to use laxatives and enemas, spontaneous bowel movements become impossible, and the patient becomes dependent on these medications.
Causes of constipation:
1. Functional causes: A diet low in fiber, insufficient water consumption, irregular bowel habits
2. Colon diseases: Obstructive lesions (such as tumors, strictures), Hirschsprung's disease, and collagen-vascular diseases (for example scleroderma)
3. Rectal diseases: Stricture (ulcerative colitis, post-surgical), painful lesions (fissure, abscess), rectal mucosal prolapse, rectocele, rectal intussusception
4. Neurological diseases: Spinal cord injury, Parkinson's disease, Hirschsprung's disease, Chagas disease, cerebral tumors, cerebrovascular events
5. Metabolic and endocrine diseases: Porphyria, hypothyroidism, hypercalcemia, pheochromocytoma, uremia, diabetic neuropathy.
6. Psychiatric disorders
7. Medications: Analgesics, antacids, anticholinergics, anticonvulsants, antidepressants, bismuth powders, iron preparations, heavy metal poisoning, medications used in Parkinson's disease, etc.
In my next article, I will address the topic of "the causes and treatment of constipation."