What is constipation?

Constipation is a common complaint in clinical practice
and usually refers to persistent, difficult, infrequent, or seemingly incomplete
defecation. Because of the wide range of normal bowel habits,
constipation is difficult to define precisely. Most persons have at
least three bowel movements per week; however, stool frequency
alone is not a sufficient criterion for the diagnosis of constipation because
many constipated patients describe a normal frequency of defecation
but subjective complaints of excessive straining, hard stools,
lower abdominal fullness, and a sense of incomplete evacuation. The
individual patient’s symptoms must be analyzed in detail to ascertain
what is meant by “constipation” or “difficulty” with defecation.
Stool form and consistency are well correlated with the time
elapsed from the preceding defecation. Hard, pellety stools occur with
slow transit, while loose watery stools are associated with rapid transit.
Small, pellety stools are more difficult to expel than large ones.
The perception of hard stools or excessive straining is more difficult
to assess objectively, and the need for enemas or digital disimpaction
is a clinically useful way to corroborate the patient’s perceptions of
difficult defecation.

Psychosocial factors may also be important. A person whose parents
attached great importance to daily defecation will become greatly
concerned when he or she misses a daily bowel movement; some children
withhold stool to gain attention; and some adults are simply too
busy or too embarrassed to interrupt their work when the call to have
a bowel movement is sensed.

Further readings

Common causes of constipations

Investigation of severe constipation

Treatment for constipation

Dietary fibers and constipation

Herbal medicine (complementary/alternative medicine) for constipation