Infrequent passing of stools, difficulties in voiding, sense of incomplete voiding are all suggestive of constipation.
Medically, constipation is defined as fewer than three bowel movements in a week. Constipation may be considered severe, when there is less than one bowel movement in a week.
Many factors contribute to development of constipation. Different people will have different set of causative factors.
• Insufficient fiber intake in diet.
• Not chewing the food properly / eating hurriedly.
• Reduced water intake.
• Various medications
• Iron supplements
• Antidepressants, tri-cyclic anti-depressants.
• Stopping cigarette smoking.
• Abuse of laxatives.
• Medications containing calcium and aluminium.
• Endocrine disorders like - under active thyroid.
• Any severe illness like stroke, paralysis.
• Major changes in life like pregnancy, old-age or traveling.
• Psychosomatic causes like depression and anxiety neurosis.
• Biochemical imbalance ' low potassium levels in blood.
• Lead poisoning.
• Conditions that obstruct the normal passage of the stools within the intestines ' foreign bodies in intestines, strictures, adhesions, tumors, etc.
• Abdominal surgeries.
• Weakened pelvic floor muscles.
• Constipation can occur sometimes as part of a condition called 'irritable bowel syndrome' where it alternates with diarrhea.
• Hard, difficult to pass stools which require straining or manual removal with fingers - felt more than 25% of times.
• Stools infrequent, less than three times a week.
• Sensation of incomplete voidance.
Other symptoms that a person with constipation may feel are:
• The abdomen may seem bloated, distended or crampy.
• The bowel sounds may seem enhanced.
- A proper clinical history and
- physical examination usually suffices to diagnose constipation.
Other tests that your doctor may advice are:
• Anorectal function tests.
• Sigmoidoscopy or colonoscopy.
• Colorectal transit study.
• Barium enema X-rays of the abdomen.
• Tests to rule out an under active thyroid.