Why does constipation occur?
Constipation has multiple causes. The most frequent thing is that it appears due to disorders of the functioning of the intestine, what the Digestive System specialists call primary constipation, but it should always be discarded that it is not the manifestation of another disease, which is determined as secondary constipation, since the treatment can be very different.
Diseases that cause constipation
Drug consumption: one of the most frequent causes of secondary constipation is the taking of some type of medication. Medication for pain, high blood pressure, neurological diseases or depression among many others can cause constipation.
• Laxatives : Chronic consumption of irritating laxatives increases and perpetuates constipation, and can lead to lack of mobility of the colon.
• Metabolic problems : metabolic and endocrine diseases can cause constipation. Especially diabetes and hypothyroidism.
• Neurological disorders : the nervous system frequently causes a decrease in bowel movements and constipation occurs. It is common in patients with multiple sclerosis, spinal cord injury or Parkinson's disease.
• Injury to the anus , such as hemorrhoids or fissures, can induce constipation since there is much pain during defecation and the subject unconsciously tends to suppress the act of defecating. Likewise, in most cases, constipation occurs without a clear cause, as a result of inappropriate diet or alterations in the functioning of the colon, rectum or anus. It's what doctors call "primary constipation."
More frequent causes of primary constipation
Most patients with primary constipation, ie chronic constipation without clear cause, have some irregularities in the functioning of the colon, rectum or anus.The abnormalities that generally produce primary constipation are:1. Decreased movement of the colon2. Absence of anal relaxation3. Poor sensitivity of the rectum4. Insufficient abdominal strength
Diagnosis of constipation
In most cases, to diagnose constipation, it is enough to obtain the opinion of a doctor specialized in Digestive System, without added diagnostic tests. The doctor asks the patient for his age, family history, dietary habits, his daily habits, whether he smokes or drinks, if he takes medication, etc.. In the case of constipation of recent onset, it should be ruled out that it is due to a problem in the colon, however, the longer the time of evolution, the more likely it is that it is a primary constipation.
Before a great effort during the defecation suggests a problem in the expulsion of the feces, so a possible alteration in the relaxation of the anus when defecating should be studied.
Pain during defecation arises when there are anus lesions such as fissures or hemorrhoids. Colon or rectal cancer should always be ruled out in a patient who has a recent change in the shape and consistency of bowel movements, a permanent sensation of need to evacuate, and blood in the stool. Although the most frequent cause of blood in the stool is due to hemorrhoids.
Diagnostic tests for constipation
After examining the patient and knowing his / her family history, the Digestive System specialist will perform some diagnostic tests to find the cause, such as blood tests, and anatomy studies to find out if there is any lesion and correct functioning of the colon, rectum no longer.
The anatomy study may be performed by contrast or endoscopic radiography, the latter being more preferable. The colonoscopy is based on the introduction of a catheter through the anus with a minicamber at the tip to examine the colon and look for lesions. It is a test that is now performed with deep sedation, so it does not produce any discomfort.
To know the cause of primary chronic constipation, that is, when something goes wrong in the colon, rectum or anus, several studies can be done:
TO. Anorectal Manometry : This is a very simple scan that is not at all annoying. It consists of measuring the pressures in the rectum and anus. It is performed when it is suspected that constipation is due to a lack of opening of the anus during defecation. It is also useful in cases of constipation due to neurological or muscular diseases.
B. Study of the rectal sensitivity : consists of swelling a balloon inside the rectum to determine the volume necessary for the patient to notice and feel like defecating.
C. Measurement of the movements of the colon (colonic transit time) : this study calculates the rate of movement of feces through the colon, assessing if the transit is too slow or if they are retained in some segment. The procedure consists in the taking of capsules containing a known number of markers that can be located when making x-rays.