Constipation and Diarrhea: Abnormal Bowel Habits

Constipation and diarrhea can be a symptom of an underlying condition. If persists, both the conditions require clinical investigation. Lifestyle changes in constipation and adequate rehydration in diarrhea are the mainstays of treatment.

Constipation:

About 10–20% of individuals suffer from constipation.

People who are at a higher risk are:
  • Elderly or bed-ridden patients
  • Anyone who has  a sedentary lifestyle
  • restricted or poor mobility
  • Decreased food and fluid intake
  • Pregnant women  (reasons: increase in fetal pressure, elevated progesterone levels decrease in peristaltic movements)
Etiology: Why does constipation occur?
  • Inadequate intake of dietary fiber
  • Dehydration or less fluid intake
  • Sedentary lifestyle: Lack of exercise and poor mobility
  • Medical reasons: Metabolic disorders (diabetes), Gastrointestinal disease (e.g. hemorrhoids)
  • Certain Drugs-anticholinergics, antispasmodics, etc
Symptoms of constipation
  • Inability to pass stools at regular intervals
  • Straining while passing the stool
  • Passing of abnormally hard stools
  • Abdominal pain and discomfort
  • A sensation of incomplete evacuation
  • Headache, slight anorexia
Treatment:
  • Lifestyle changes:
    • consumption of High-fibre diet,
    • High fluid intake, and
    • Regular exercise
  • Use of Laxatives: It acts by increasing intestinal motility, thereby decreasing the absorption of salts and water.
    • bulk-forming laxatives: e.g. ispaghula husk (powder)
    • osmotic laxatives: e.g. lactulose (liquid)
    • stimulant laxatives: e.g. senna (tablets), bisacodyl (tablets, suppositories), sodium picosulphate
      (liquid), glycerol (suppositories)
    • saline laxatives: e.g. magnesium salts (powder)
Please note:

The following conditions may show constipation as a symptom. So, it is advisable to consult a Physician for further investigation.

  • Intestinal obstruction or perforation
  • Appendicitis
  • Nausea and vomiting
  • Abdominal pain of unknown origin
Diarrhea

Constipation

Diarrhea may be acute or chronic. There are three main types:

  1. Osmotic diarrhea occurs when solute retains water in the intestine lumen. Examples of water-retaining substances are sorbitol, magnesium-containing antacids.
  2. Secretory diarrhea occurs due to increased secretion of electrolytes, like in case of infectious diarrhea
  3. Motility diarrhea occurs due to decreased contact time of faeces in the intestine. certain drugs or inflammatory bowel disorders cause this condition.
Common causes:
Symptoms
  • Abdominal cramps and pain
  • Sudden onset of diarrhea
  • Flatulence, Nausea, and vomiting
  • General weakness
Treatment:
  • Lifestyle changes: Avoid the consumption of dairy products
  • Rehydration: Oral rehydration salts to replace lost electrolytes
  • Antimotility drugs- Opioid antidiarrhoeal drugs like loperamide

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