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Introduction

In most cases but not all, constipation is he result of what you eat, your diet and lack of fiber!

Constipation is a frequent complaint both in the medical office and in the hospital, unfortunately a subject that has not merited much interest from the pathophysiological point of view.

The symptoms associated with constipation, presumably of colonic origin, raised only four months ago the reported description of the irritable colon syndrome as a neurosis together with a brusque increase in the prescription of purgatives, so that in the UK the irritable colon became the most frequent gastroenterological disease.

Because of this abrupt escalation, experimental and clinical studies of irritable colon syndrome and the causes of constipation, to which our study is principally limited, have been carried out in a few groups, tailored principally toward the study of myorelaxants and stool softeners, those most frequently presented to irritable colon patients believed to be constipated.

Our objectives were to perform an analytical study of the causes of constipation in order to establish the organic factors for constitutive or functional constipation, in order to correlate them properly with the predominant personal characteristics in the group under consideration and, if possible, to establish their pathophysiological importance. For the pursuit of our objectives, we collected 36 proved constipated patients.

Definition of Constipation

In its broadest possible definition, constipation may signify any or all of the following: undue difficulty at stool, infrequency of bowel movements, a decrease in volume of faeces, increased hard consistency of faeces, increased circumference of faeces, decreased coloration of faeces, and often also increased postprandial fullness or discomfort.

These findings, in part or combination, promote a subjective feeling of ‘incomplete’ evacuation and are usually accompanied by one or more of the following: difficulty at stool and/or slightly decreased volume of faeces. So far, so good.

However, explanations such as the following: “Constipation means different things to different people. People who suffer from constipation are more likely to report they strain during a bowel movement; have hard, lumpy stools, or a sensation of incomplete bowel evacuation.” do not take this variation into account.

The original terms for constipation as employed in clinical settings did take into account and made use of this variation. They had, inter alia, the immeasurable advantage of simplicity. They evoked an immediate response. The respondent felt that everyone knew what was being discussed.

At the beginning of an analysis of constipation, it is important to define clearly what is meant by this broad and vague term. It is surprising, therefore, that relatively few investigators have done so beyond stating that constipation is difficult or infrequent defecation.

This definition is broad, unspecific, and contains several fallacies. The coloured layman, as well as the uneducated patient, may, in general, be expected to equate constipation with hard stools. It is one of those clinical curiosities that investigators fail to make use of at their disposal the perceived connotations with which subjects fill a word. Both definitions of constipation fail squarely on a simple question to be asked of the patient: “What do you mean by constipation?”

Significance of Understanding the Causes

Making an appropriate diagnosis, examine children properly and then explain their condition to the parents and patients. To do that, it is important that the doctor has a good understanding of the factors causing constipation.

Because in many cases, the principal cause of constipation is functional constipation due to acquired environmental causes, it is essential to create a good environment appropriate for the individual’s constitution. Treatment and prognosis are very different depending on the cause of constipation.

For example, when constipation is tending to be prolonged, it is necessary to consider the background of the illness of the child and to distinguish it from idiopathic constipation. Prior to evaluating treatment efficacy, one must initially understand the cause of the constipation, provide an explanation of the condition to the patient and the patient’s family, and thereafter carry out appropriate intervention.

The primary methods of managing constipation are dietary regulation and increasing fluid intake to improve bowel habits. Understanding of the causes of constipation makes patient follow-up much simpler while at the same time patients feel they have been well understood, resulting in increased compliance to treatment.

There are increasing reports on the psychological causes of constipation in adults. In children, many studies have considered the deeper psychological background of functional constipation.

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