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Posted by Master, Doctor Mai Vien Phuong - Department of Examination & Internal Medicine - Vinmec Central Park International General Hospital
Constipation means different things to each person. For some people, constipation means infrequent bowel movements. For others, that means having hard-to-pass stools or straining hard stools. However, others may define constipation as the feeling of not having a bowel movement after having a bowel movement.
1. Chronic versus acute constipation
The main difference between chronic and acute constipation is how long the constipation lasts.
In general, acute or short-term constipation is:
Infrequent, lasting only a few days; Due to a change in diet or habits; Traveling, being inactive, sick or taking medicine; Relieve with over-the-counter (OTC) laxatives; Exercise or a high-fiber diet. On the other hand, chronic constipation is:
Long-lasting, lasting more than three months and even continuing for years; Disrupting a person's personal or work life; Not relieved by changes in diet or exercise; Request medical attention or prescription drugs.
2. Who is at risk for chronic constipation?
Constipation is one of the common chronic digestive disorders in adults. In the United States, more than 2.5 million people visit a doctor each year for constipation. Every year, Americans spend nearly $800 million on laxatives to treat constipation.
The following people have a higher risk of chronic constipation:
Women People over 65 People who do not participate in physical activity or Are confined to bed due to a physical disability such as a spinal cord injury Women pregnant female
Táo bón là một trong những rối loạn tiêu hóa mãn tính thường gặp ở người lớn
3. Causes of Chronic Constipation
While an inadequate diet and lack of exercise can lead to short-term abdominal troubles, chronic constipation can be caused by other medical conditions and medications, including:
Pelvic floor dysfunction, which can be difficult to coordinate muscle contractions in the rectum Endocrine or metabolic problems, such as diabetes Hypothyroidism Multiple sclerosis, Parkinson's disease, spinal cord injury and stroke stroke Anal and rectal tearing Colon narrowing (intestinal stricture) Mental health problems, such as depression, eating disorders and anxiety Intestinal diseases, such as Crohn's disease, colon Cancer, diverticulitis and irritable bowel syndrome Physical disability resulting in immobility Chronic constipation can also be caused by taking prescription or over-the-counter medications for another health condition. Some medications that can cause chronic constipation include:
Opiates Calcium blockers Anticholinergics Tricyclic antidepressants Parkinson's medications Sympathomimetic Antipsychotics Diuretics Antacids, especially especially calcium-rich antacids Calcium supplements Iron supplements Antidiarrheals Antihistamines It is not always known what causes chronic constipation. Chronic constipation that occurs for no apparent reason is called chronic idiopathic constipation (CIC).
Chế độ ăn không đủ dinh dưỡng và thiếu tập thể dục là nguyên nhân hàng đầu dẫn đến táo bón
4. Diagnosis of Chronic Constipation
What is considered “normal” bowel movements can vary from person to person. For some, it might mean going three times a week or twice a day. For others, it might mean going every day. There really isn't a standard or perfect number for bowel movements.
Therefore, doctors have tried to come up with a list of criteria to help them diagnose chronic constipation. The Rome IV diagnostic criteria for functional constipation require that symptoms include two or more of the following:
Less than three spontaneous bowel movements per week Straining for at least 25% of the time Hard stools lumpy or hard at least 25% of the time (Bristol Stool Chart can help you describe your stool pattern.) Feeling of incomplete bowel movements, at least 25% of the time Feeling of obstruction at least 25% of the time having a bowel movement Manual action (such as using your finger) helps to have a bowel movement at least 25% of the time However, the main endpoint of chronic constipation is that the symptoms are more than present three months.
Diagnostic tests
Your doctor will ask you questions about your symptoms, medical history and medications (prescription, over-the-counter and supplements) you are taking. If you have been experiencing symptoms of constipation for more than three months and meet other diagnostic criteria for chronic constipation, your doctor may conduct a physical exam.
Physical examination may include blood tests and rectal examination. A rectal exam means that the doctor inserts a gloved finger into the rectum to check for blockage, pain, or blood.
Your doctor may want to do additional tests to determine the cause of your symptoms. These tests may include the following:
Marker test (colorectal movement study): You take a pill that contains a tracer that will show up on an X-ray. Your doctor can see how food moves through your intestines and how well the muscles of the intestines are working. Anorectal manometry (anorectal pressure measurement): Your doctor inserts a tube with a balloon on the tip into the anus. The doctor inflates the balloon and slowly pulls it out. This allows your doctor to measure the tension of the muscles around your anus and your rectal function level. Rectal X-ray with Baryt Contrast: Your doctor inserts barium dye into your rectum with a tube. Baryt highlights the rectum and large intestine, allowing doctors to see them better when viewing them on an X-ray. Colonoscopy: Your doctor examines your colon using a camera and camera light attached to a flexible tube, called a colonoscope. This usually involves sedatives and pain relievers. The main difference between chronic and short-term constipation is how long the symptoms last. Unlike short-term constipation, chronic constipation can dominate a person's work or social life.
Constipation that persists for more than three months without relief after high fiber intake, water intake and exercise is considered chronic.
It is important to see a doctor for a more accurate diagnosis. Your doctor will ask you questions about your bowel movements and use diagnostic tests to find the cause of your constipation. They may prescribe medication to help or may advise you to stop taking certain medications. Two medications have been approved by the U.S. Food and Drug Administration, lubiprostone (Amitiza) and linaclotide (Linzess), both of which have been shown to safely improve symptoms of chronic constipation.
If you have blood in your stools, unexplained weight loss or severe pain during bowel movements, see your doctor immediately.
Currently, Vinmec Times City International General Hospital is applying a method of treating cases of constipation due to a decrease or loss of defecation reflex by electric stimulation of the anus combined with interference waves, biofeedback training. (Biofeedback). The above method has helped >80% of patients to recover the defecation reflex, improve bowel motility and bowel movement, and improve constipation.
Depending on the patient's constipation, the doctor will appoint necessary investigations such as: Colonoscopy with contrast, anorectal pressure measurement, assessment of bowel function and pathologies. related to the pelvic region,... To find out the cause, thereby giving the optimal treatment regimen. Hundreds of patients of different ages have achieved the desired treatment results. The most important criterion to evaluate the success of treatment is that the patient has a regular daily bowel movement, easier to pass.
Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
Reference article source: Constipation and impaction: What is it? (2014); Diagnosis of constipation. (2014, November); Gray, J. R. (2011). What is chronic constipation? Definition and diagnosis
