Chronic Constipation
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Constipation is not a disease. Rather, it is a symptom reported by patients who believe that there is a disturbance of the events they perceive to comprise normal defaecation. As such, patients may associate a wide variety of symptoms with the term constipation, including those apparently more related to defaecation e.g. infrequency of bowel action, loss of urge to defaecate, straining, incomplete, painful or unsuccessful evacuation, or more diverse symptoms such as abdominal and back pain, bloating or nausea. Without agreement over what constitutes normality or abnormality in terms of the type or frequency of symptoms reported by patients, clearly the definition of constipation is highly subjective. In practice, patients present when their personal situation is unsatisfactory.
Management of Conditions and Symptoms
Amy J. Litterini, Christopher M. Wilson in Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Unresolved or untreated chronic constipation can lead to fecal impaction and bowel obstruction. For the appropriate patient, and with communication with the medical provider, light abdominal massage may be a beneficial modality to consider for individuals with chronic constipation. Instruction in abdominal massage, particularly for individuals with Parkinson’s disease, has shown to be beneficial.84 Rectal suppositories and oil retention enemas may be successful in mild cases, and in severe cases, manual digital disimpaction (under the order of a physician and within the scope of nursing practice) can potentially address fecal impaction while the source is being evaluated to prevent recurrence. In patients with a suspected bowel obstruction, urgent medical intervention should be recommended and/or provided. For patients still wishing for intensive medical intervention in the presence of a life-threatening illness, strategies such as corticosteroids to relieve the obstruction can often be effective prior to the consideration for surgical intervention.85
The digestive system
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella in Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Constipation is a condition that is characterized by difficult or infrequent defecation. A number of factors such as low-fiber diet, low fluid intake, and inactivity can cause acute episodes of constipation. Chronic forms of constipation may occur in patients with neurologic disease or spinal cord injury. Hirschsprung disease is a condition in which the ganglion cells in the large intestine do not develop properly during gestation. Patients with this condition suffer from very poor colonic motility and severe constipation. Drugs such as opioids and anticholinergic agents can also cause significant constipation. Treatment of constipation focuses mainly on increasing fluid and fiber intake as well as increasing activity. Laxative drugs may also be used with care to treat acute constipation.
Quercetin promotes gastrointestinal motility and mucin secretion in loperamide-induced constipation of SD rats through regulation of the mAChRs downstream signal
Published in Pharmaceutical Biology, 2018
Ji Eun Kim, Mi Rim Lee, Jin Ju Park, Jun Young Choi, Bo Ram Song, Hong Joo Son, Young Whan Choi, Kyung Mi Kim, Jin Tae Hong, Dae Youn Hwang
Constipation is well known as an acute or chronic gastrointestinal disease characterized by infrequent bowel movements, hard and dry faeces, incomplete bowel evacuation and difficulty during defecation (Walia et al. 2009). Until now, several drugs were developed to treat this disease. In most cases, chemical drugs (laxatives) including Senna™, Correctol®, Exlax®, Senokot™ and Gaviscon® act as stimulants to increase bulkiness and soften stool or as osmotic agents, trigger bowel movements and enhance water flow into the colon to promote elimination (Voderholzer et al. 1997). But, most of above drugs showed some undesirable side effects, such as myocardial infarction, artery contraction and coronary spasms (Lembo and Camilleri 2003; Busti et al. 2004; Kim et al. 2013). Therefore, many studies have focused on identifying novel laxatives with no side effects to treat constipation patients. As part of above studies, we investigated the laxative effect and action mechanism of QCT in Lop-induced constipation model. The results of the present study first demonstrated that QCT can improve the symptoms of constipation through the elevation of stool excretion, and the recovery of histological changes of the transverse colon in Lop-induced constipation model. Especially, our data show the laxative effects of QCT are tightly correlated with the interaction between QCT and mAChR M2/3 signalling pathway.
Therapeutic effects of Bombax ceiba flower aqueous extracts against loperamide-induced constipation in mice
Published in Pharmaceutical Biology, 2023
Liuping Wang, Shiyuan Xie, Xuan Jiang, Caini Xu, Youqiong Wang, Jianfang Feng, Bin Yang
Constipation is a common digestive tract disease (Liu et al. 2020) mainly caused by intestinal disorders, which is associated with infrequent bowel movements (Yin et al. 2018), altered bowel habits, difficulty during defecation and disappearance of defecation intention that causes discomfort and seriously affect the quality of life of patients (Wang et al. 2017). Some studies suggest that multiple plant extracts are attracting attention nowadays because of their laxative and there is hardly any side effect on constipation (Gilani et al. 2000; Han 2015; Lu et al. 2021). Moreover, according to the traditional Chinese medicine theory, the B. ceiba flower is cool-natured (Zhang et al. 2015), and is regarded as having laxative property (Shahat et al. 2003). BCE is an aqueous extract from B. ceiba flower, and our study suggests that BCE has a positive effect on relieving the symptoms of loperamide-induced constipation mice.
An introduction to the Food-Based Dietary Guidelines for the Elderly in South Africa
Published in South African Journal of Clinical Nutrition, 2021
Carin Napier, Heleen Grobbelaar, Wilna Oldewage-Theron
Ageing affects the motor and sensory functions of the gastrointestinal (GI) tract resulting in the elderly having a higher susceptibility to GI complications of co-morbid illnesses.47 Specific age-related GI changes affect the oesophagus and colon specifically. These include reduced peristaltic pressure in the oesophagus leading to dysphagia, gastroesophageal reflux and reduction in colon motility causing constipation.47 GI problems, such as diarrhoea and constipation, are common among the elderly. Rates of almost 50% for the elderly older than 55 years and 70% for those in nursing homes have been reported. Constipation is mainly caused by medication use, certain diseases such as diabetes and irritable bowel syndrome, blunted thirst mechanisms that may result in too low fluid intakes, less responsive intestinal muscle movement, declining cognitive function that may result in the elderly not recognising the urge to defecate, and low-fibre diets due to chewing problems.48 The GI tract has an important role in maintaining homeostasis of many physiological processes such as ensuring adequate digestion and absorption of nutrients.49 A healthy and well-functioning GI tract is associated with life satisfaction whereas diseases of the digestive system have been associated with a higher symptom burden that negatively affects the general health of elderly people. Furthermore, research has found a higher prevalence of anxiety and depression among those elderly who have GI symptoms.50