Monday 12 May 2014

Constipation!!!

Constipation refers to infrequent or hard stools, or difficulty passing stools. Constipation may involve pain during the passage of a bowel movement, inability to pass a bowel movement after straining or pushing for more than 10 minutes, or no bowel after more than 3 days.
Constipation is a relative term. Normal patterns of bowel and you may not have bowel movements every day. While some healthy people have consistently soft or near runny stools, other have consistently firm stools, but no difficulty passing them.
Causes and risk factors of constipation
ü  Sedentary life style or inactivity
ü  Low fiber diet
ü  Abuse of laxatives
ü  Hormonal disorders
ü  Certain medications such as antidepressants, narcotic medicines, anticonvulsants
ü  Certain disease related to colon
ü  Improper functioning of pelvic muscles
ü  Stress
ü  Diseases of rectum
ü  Endocrine or metabolic disease such as diabetes, hyperthyroidism
ü  Low fluid intake
Sign and symptoms of constipation
  • Hard, dry, or lumpy stools
  • Fewer than three bowel movements a week
  • Having a strain to have bowel movements
  • Pain or bleeding with bowel movements
  • Feeling bloated or sluggish
  • Feeling like you still need to go after having bowel movements
Diagnosis in case of constipation
  • Barium enema- to exclude obstruction if constipation of recent origin
  • Water soluble contrast media – if megarectum or megacolon is suspected
  • Anorectal physiological studies – to elicit Anorectal inhibitory reflux and to assess pelvic floor coordination
  • Upper gut barium studies – to exclude pseudo obstruction if lower bowel is dialated
  • Upper gut transient studies – if patient has upper gut symptoms or surgery for constipation is contemplated.
  • Proctography- if a large retrocele is suspected.

Prevention of constipation
  • Increased fluid intake – drink at least 8 to 10 glasses of water per day
  • Fiber rich diet – adding fiber rich diet with foods such as brown rice, whole wheat bread, shredded wheat, rolled oats etc.
  • Exercise – the patient should incorporate moderate exercise, such as walking, and other exercises to his daily exercise.
  • Avoid fat – moderate the consumption of fat-containing foods, such as bacon, butter, cream, and oil. Although these foods will help to soften intestinal contents, they sometimes causes diarrhea.
  • Laxatives – take laxative but avoid over use.
  • Enema – enema should be taken in case of obstinate constipation but avoid excessive use of enema.
Homeopathic treatment of constipation
 Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat constipation but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat constipation that can be selected on the basis of cause, sensations and modalities of the complaints.  For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of constipation:
 Agaricus – obstinate constipation following diarrhea in old spirit drinkers; anorexia; painful straining in the rectum before stool.
Aethusa - most obstinate constipation, with feeling as if all action of the bowels had been lost; intolerance of milk; pain with soreness in hypochondria
Alumen – stool knotty and hard; evacuation with great difficulty; cramps frequent in pit of stomach; long lasting pain in rectum after stool
Alumina – inability to pass stool with absence of desire; nausea and faintness; rectum inactive; even a soft stool, like putty, and sticking to anus, requires great straining.
Bryonia alba – constipation due to difficult secretion of mucus membrane there is no moisture about the parts and no mucus soften the hard stools; stool hard, dry as if burnt; stool are expelled with difficulty; obstinate headache with constipation. Complaints are associated with excessive thirst and white coated tongue.
Aloe socotrina – constipation precedes diarrhea; hard lumps mingled with jelly like mucus; constant desire to pass stool but only a little wind passes; great fullness sensation; marble like nodules may escape unconsciously.
Antim crude – diarrhea alternate with constipation; specially in old people; stool is too hard; constipation associated with much flatus and abdominal pain; constipation during child bed; nausea and vomiting; loss of appetite; tongue white coated.
Asafoitida – obstinate constipation; associated with abdominal pain and haemorrhoidal cramps; constant desire to pass stool; with pressing sensation towards the rectum and offensive discharge.
Belladonna – no urging; pain in abdomen along with spasm; suppression of stools with distension of abdomen; coated tongue; eructations; taste sour.
Baptesia – constipation with torper of the liver; great difficulty to pass; resembles sheep’s dung.
Calcaria carb – no urge to pass stool; looking like lumps of chalk in children during the period of dentition; feeling of faintness after stool
China – constipation with vertigo; no urging; larger accumulation of faeces, especially after continued purging, with difficulty to pass them; inactivity of rectum
Collinsonia- constipation during pregnancy; great pelvic congestion; associated with uterine disorder; congestive inertia of bowels; pressure and weight in the rectum; stool hard and sluggish; accompanied with pain; sensation as if sand in the rectum
Graphites – atonic dyspepsia and constipation;  dryness of mucus membrane of rectum; stool knotty, the flattened lumps covered with mucus and united with mucus threads; sensation in the rectum as if much remained after stool; rectal prolapse; soreness and tearing in the rectum after stool.
Ignatia – constipation in consequences of cold, or from carriage, from riding in a carriage; great desire to pass stool; constriction in the anus after stool
Kali carb – stool insufficient; bowels inactive; large sized feces; feels distressed an hour or two before stool.
Lycopodium – digestion impaired; hard stools; passed with difficulty; much loud flatus; pain in abdomen from left to right; tension with itching in anus in the evening; aggravation 4 to 8 pm.; abdominal plethora with constipation in old people of the higher classes; who are suffering from retarded defecation.
Natrum Mur – constipation from inactivity of rectum; obstinate constipation; with much perspiration
Nux Vomica – stool hard and difficult; frequent urging to pass stool with no evacuation; sensation as if much feces remained after passing stool; constipation alternate with diarrhea.
Opium – opium is one of the best medicines of constipation; long standing cases of constipation; no desire for stool; inactive rectum; dryness of mucus membrane; spasmodic retention of feces; heaviness sensation of abdomen; constipation from fright and fear; from chronic lead poisoning.
Platina – excellent remedy for constipation while travelling.
Plumbum met – stools like sheep’s dung; black balls; small and hard stool; evacuation obstructed; stools consisting of small; great tenesmus in rectum.
Podophyllum – remedy for constipation of children after a spell of diarrhea.
Sepia – constipation of females; inability to expel feces or to strain stool; constipation during pregnancy; prolapse rectum; constant fullness, as if weight in rectum; difficult, a little of mucous-covered feces is discharged off and on but gives no satisfaction.


Silicea – stool of large, hard lumps, which remain long in rectum; stool hard has to remove mechanically; even a soft stool expelled with much difficulty; constipation of women before and during menses.

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