Most people think of constipation as just not being able to "go" enough. We don't focus on specifics such as hard pellet stools or straining. Only after the process becomes too uncomfortable or too inconvenient, do we start seeking a solution. We then become aware we have a long standing problem, chronic constipation.
It's not uncommon to have bouts of constipation. Eating the wrong foods for a period of time, easing off exercise, not just getting the amount of fluids right, can give us constipation. Life changes such as pregnancy can wreak havoc with this system. Being so busy we ignore the urge to go. Traveling may change our bowel habits for the worse.
CHRONIC CONSTIPATION IS NOT A DISEASE
Constipation is a symptom and not a disease. The chronic constipation of the vast majority of adults is a functional disorder. Functional disorders have no structural pathology, hormonal or biochemical problems. Functional chronic constipation may be caused by an underlying neurological, psychosomatic or psychological issue.
Chronic constipation has a precise set of criteria. These criteria define a length of time to properly evaluate frequency and difficulty in defecating.
THE ROME CRITERIA AND CHRONIC CONSTIPATION
Following are the Rome criteria for evaluating the presence of chronic constipation.
According to these criteria, the time-frame for evaluating chronic constipation is 12 months. If two or more of the following problems occur over at least 12 weeks. you have chronic constipation. These 12 weeks do not have to be consecutive.
(1) Straining over 25% of the time.
(2) Hard, lumpy or pellet like stools for more than 25% of the time.
(3) A feeling of incomplete evacuation for greater than 25% of the time.
(4) Sensation of anorectal obstruction/blockade again for greater than 25% of the time.
(5) Needing to use manual maneuvers to remove stool - again for greater than 25% of the time.
(6) And finally, the issue of frequency: less than 3 times a week.
The following conditions also apply:
1) Insufficient criteria to establish irritable bowel syndrome (ibs). Irritable bowel syndrome is distinguished by abdominal pain, bloating and discomfort relieved by defecation. At the onset of the disorder there is a change in appearance and frequency of stool.
2) Loose stools occur only when taking a laxative.
Remember, whenever you notice changes in bowel habits, you must discuss these changes with a physician.
HARD PELLET STOOLS ALONE NOT A SURE SIGN OF CHRONIC CONSTIPATION
From this, we learn that occasional occurrences of hard pellet stools alone does not mean chronic constipation. Similarly, you don't have to worry about having just three bowel movements a week. Though it seems everyone is saying you should have 7-21, three might be just right for you.
Monday, August 3, 2009
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