Constipation




© Springer International Publishing Switzerland 2017
Bobby Desai and Alpa Desai (eds.)Primary Care for Emergency Physicians10.1007/978-3-319-44360-7_17


17. Constipation



Alpa Desai  and Bobby Desai 


(1)
Community Health and Family Medicine, University of Florida, Newberry, FL, USA

(2)
Emergency Medicine, University of Florida, Gainesville, FL, USA

 



 

Alpa Desai (Corresponding author)



 

Bobby Desai



Keywords
Infrequent defectionPrimary constipationSecondary constipation



17.1 Introduction


Constipation is a problem affecting between 12 and 19 % of people within the United States [1] and is described as infrequent defecation and/or difficulty passing stool [2]. This condition is more common in certain groups including women, children, and the elderly [3]. The Rome criteria define functional constipation as including two or more of the following: At least 25 % of defecation involves straining, lumpy or hard stool, sensation of incomplete evacuation, sensation of anorectal obstruction/blockage, or manual maneuvers to facilitate defecation, and there are fewer than three defecations per week [4]. Additionally, loose stool are rarely present without use of laxatives, and there are insufficient criteria for irritable bowel syndrome.


17.2 Primary Constipation






  • Normal transit constipation – functional constipation – most common.



    • Stool passes through the colon at a normal rate.


  • Slow transit constipation – prolonged delay of passage of stool through the colon [5].



    • Patients complain of abdominal bloating and infrequent bowel movements [6].


    • Theorized to be due to abnormalities of myenteric plexus, defective cholinergic innervation, and anomalies of the noradrenergic neuromuscular transmission system [5].


  • Anorectal dysfunction – inefficient coordination of the pelvic musculature in the evacuation mechanism [7].



    • Patients complain of feeling of incomplete emptying, sensing obstruction, or a need for digital manipulation.


    • Usually is an acquired behavioral disorder.


17.3 Secondary Constipation: Wide Array of Sources [810]




Nov 20, 2017 | Posted by in Uncategorized | Comments Off on Constipation

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