Constipation is common in children and may be related to any of the causes noted in the previous section. In a small number of children, constipation may be the result of physical problems. Children with such defects as the absence of normal nerve endings in portions of the bowel, abnormalities of the spinal cord, thyroid deficiency, mental retardation, and certain other inherited metabolic disorders often suffer symptoms of constipation. Constipation in children, however, usually is due to poor bowel habits.

Studies show that many children who suffer from constipation when they are older have a history of passing stools that are firmer than average in their early weeks of life. Because this occurs before there are significant variations in diet, habits, or attitudes, it suggests children who develop constipation have a normal tendency to have firmer stools. Such children suffer little from the tendency unless it is aggravated by poor bowel habits or poor diet.

Constipation may result in pain when the child has bowel movements. Cracks in the skin, called fissures, may develop in the anus. These fissures can bleed or increase pain, causing a child to withhold his or her stool. Children may withhold their stools for other reasons as well. Some find it inconvenient to use toilets outside of the home. Also, severe emotional stress caused by family crises or difficulties at school may cause children to withhold their stools. In these instances, the periods between bowel movements may become quite long, in some cases lasting longer than one or two weeks. These children may develop fecal impaction’s, a situation where the stool is packed so tightly in the bowel that the normal pushing action of the bowel is not enough to expel the stool spontaneously.

written by Joy Seeman

© 2009 HIC

If you have ever stood in a drug store and looked at all the available laxatives, you know how confusing it can be to make a good choice. There seem to be so many different types, and you do not have any idea which one is safer or better than the next. Before you purchase a laxative, hopefully, you have tried lifestyle changes to relieve the constipation. Often adding more fiber-rich food, liquid, and exercise to your daily routine will clear up the problem. If those measures have failed, it is time to look at over-the-counter remedies.

To begin with, laxatives come in two forms–those that can be taken orally and others that are inserted rectally. Oral laxatives can be bought as liquids, wafers, gums, powders or tablets, while rectal laxatives come in the form of suppositories or enemas. All laxatives can become habit forming and create a dependency which may increase constipation instead of curing it. When people consult a doctor about constipation, a prescription for laxatives is written 85 percent of the time. So it is important to understand the types of laxatives available, how they work and how to use them safely.

Great, now what ?

Laxatives work in various ways, and people can respond to the same laxative differently. Here are some laxatives, and how they are classified.

• Bulk-forming laxatives (often referred to as fiber supplements) are the gentlest on your body, and they are safe for long-term use. Metamucil and Citrucel are two examples of this type. This laxative absorbs water into the stool, forming bulk to aid movement through the intestines. Side effects can be bloating, gas and cramping, so it is important to drink plenty of fluids. If you take certain medicines, fiber can interfere with their absorption; these medicines are best taken an hour before or two hours after consuming fiber supplements. Introduce fiber gradually into your diet to avoid excessive gas and bloating.
• Osmotic and hyperosmolar laxatives draw fluids into the intestine from the surrounding tissue, softening the stool and making it easier to pass. Milk of Magnesia, Miralax®, and Kristalose® are examples of these types of a liquid laxative. It is important to drink a lot of water to help make the laxative effective and to prevent gas and cramps.
• Emollient laxatives (stool softeners) contain compounds that soften the stool. They can take up to a week to be effective, and are often used by women after giving birth, hemorrhoid sufferers, and patients recovering from surgery. Colace® and Kaopectate® are well-recognized brand names. Side effects can be stomach or intestinal cramping.
• Oral stimulants work by stimulating rhythmic contraction of the digestive tract, accelerating transit time of the stool. This type works quickly, but is harsher on the digestive system. Ex-Lax® and Senokot® are two popular brands. The drawbacks are that it can create dependency and weaken the bowel’s ability to move naturally. The side effects are possible cramping, diarrhea, nausea, belching, faintness, and urine discoloration.They should only be used for a short time.
• Rectal stimulants are inserted into the rectum (suppositories), causing the lining of the colon to produce rhythmic contractions, as it should do naturally, to move the stool along. If you need immediate relief, rectal stimulants work almost immediately. These laxatives are sold under brand names such as Fleet Bisacodyl® and Dulcolax.®  Rectal irritation, stomach discomfort, and cramping can be the side effects.If you have health conditions, you need to be careful of using laxatives. Consult your doctor for advice with the following medical problems: heart disease, high blood pressure, kidney disease, stomach pain, nausea, rectal bleeding or vomiting. Laxatives can effect medications that you are taking, causing some of them not to be absorbed into your system. Be sure not to exceed the recommended dosage unless advised by your doctor. An electrolyte imbalance can develop with oral and rectal laxatives after prolong use which can lead to weakness, confusion, abnormal heart rhythms, and seizures. If you are pregnant, consult your doctor about laxatives  because they can harm you and your baby.

When using a laxative to cure occasional constipation, remember these tips:

• If you need to use laxatives to be “regular,” use fiber first.
• Drink fluids and stay well hydrated when using laxatives. Avoid regular use of stimulant laxatives. They can limit your body’s ability to absorb vitamin D and calcium.
• If your problem with constipation continues, see your doctor. Constipation may be a warning sign of a more serious problem such as colon cancer, diabetes mellitus, or hypothyroidism, among others. Your doctor can evaluate your medical history, do a physical exam and laboratory tests, and determine the exact cause and solution for your constipation.

Written by, Joy Seeman

2009 Hemorrhoid Information Center

Constipation, at one time or another everyone gets it. Constipation might be a symptom of a more serious medical disease. It is very important to understand that Constipation is not a disease but a symptom.  Suffering from constipation is not a cause for serious alarm as it is often caused by a poor diet or elimination habits. Constipation is easily relieved by using laxatives and increasing amount of water intake.

Constipation is a common medical condition wherein a person suffers from decreased and irregular bowel movements.  In this condition, bowel movement is described as occurring less than 3 times a week.  Passing out feces maybe accompanied by pain and stool is described as dry and hard.

Why do stools harden?

Pain in constipation is caused by passing out hard stools.  Water is mainly absorbed in the large intestines. The large intestine also plays a major role in stool formation. The main cause of hardened stools is decreased water intake. Liquids are not only taken up by drinking water but are also contained in food. Water acts as a natural laxative making stools softer and making it easier to pass out.

Stools also harden when they stay abnormally long in the rectum. Stool is normally stored in the rectum before they are passed out through defecation. Establishing normal patterns of elimination is needed for regular bowel movements.

Sedentary lifestyles or lack of exercise may also cause constipation. Peristalsis is the movement of food in the body. General body weakness may cause decreased peristalsis, making stool to stay longer in the rectum before being passed out. Patients recovering after a major surgery often find themselves suffering from constipation. Anesthesia causes decreased peristaltic movements and laxatives are introduced to promote easier defecation.

Another cause for hard stools is the lack of fiber in the diet. A daily intake of fruits, vegetables and grains is recommended. These types of food are not only good for promoting normal stool consistency but are also excellent for preventing many types of diseases such as cancer.

Medicines such as diuretics, or those containing calcium and iron can cause constipation. Diuretics increase water elimination through urination making little water available for the formation of stools making them harder. Calcium is a mineral that causes the body to absorb more water; it is needed for maintaining normal levels of fluid in the body. Medicines containing large amounts of calcium may increase fluid retention decreasing water available for stool formation.

Abnormal growths in the lower digestive tract such as the large intestines or rectum can block the passages making stools to stay longer than normal. Polyp formation or cancers can produce abnormal tissue growth decreasing the surface and diameter of the lower passages.

Managing and treating constipation

Laxatives are used as immediate treatment for people suffering from constipation. Laxatives or stool softeners maybe directly introduced through the anus to instantly induce defecation. Increasing water intake can also be done to improve stool content and act as a lubricant for passing out stool.

Constipation can be easily avoided by lifestyle changes, below are simple ways on how you could maintain a normal bowel elimination pattern.

• Drinking plenty of water and liquids
• Developing regular bowel habits
• Avoiding medicines which may cause constipation
• Regular exercise
• Maintaining a diet rich in high fiber (fruits, vegetables, grains)

Assessment and diagnostic methods

Diagnosis is based on history, physical examination and visualization through different laboratory tests and techniques. A medical history is taken to assess how long the patient has been suffering from constipation. A patient is also asked to describe the consistency of the stool and asked if there is any blood or any abnormal content in the stool. A quick interview is also made by asking for any recent medications or changes in diet.

For patients found to be exhibiting severe symptoms associated with constipations a laboratory test is done to visualize the anatomy and determine if the digestive tract is functioning normally.

• Sigmoidoscopy
• Barium Enema X ray
• Colorectal Transit Study
• Anorectal Function Test
• Defecography

Constipation should not be taken lightly. Constipation might be an early symptom of a serious disease such as cancer. Constipation can cause hemorrhoids. Harder stools require a greater effort during defecation. Straining causes tissue trauma to the anus or linings of the anus and rectum which may result to bleeding. Treatment for hemorrhoids includes warm tub baths, applying creams and placing an ice pack over the affected area.

Constipation is a very common problem; development of the condition is usually related to insufficient water intake and an improper diet. Laxatives are only prescribed when the symptoms of constipation are severe. It is always important to maintain and restore normal bowel movements through natural means and medications are only a last resort.  Constipation is usually not a cause of great concern, it is easily treated with a proper diet and a healthy lifestyle.

written by,

Ronald Uy , RN

© 2009  Hemorrhoid Information Center

Ahhh, the savory aroma of freshly-brewed coffee in the morning, and those consumed cups of morning Joe help millions of people come alive to prepare for their day. We are a nation of coffee drinkers, consuming tons of the roasted coffee beans to make it a profitable 18 billion dollar industry in this country alone. Some scientists believe the smell of coffee helps restore appetite and refreshes your ability to detect odors. Perfume boutiques offer coffee beans to refresh olfactory receptors between perfume sniffing. But what are the health effects of coffee drinking on the digestive system? Many medical studies have looked at the connection between coffee consumption and digestive disorders; although findings can be inconclusive, some observations can be made.

Regular or Decaf Coffee?

As everyone knows, coffee can be purchased either caffeinated or decaffeinated (where the caffeine has been removed). Caffeine in coffee has been considered the source of health problems for many people because of its effect on the central nervous system, so they often switch to decaf to avoid jitteriness and insomnia. Also, caffeine is addictive and withdrawal from it can be difficult, so many people switch to decaf in the hope that it is better for them. But it seems to have little effect on digestive problems whether you drink caffeinated or decaffeinated coffee.

All coffee affects the digestive system in these ways:

Pregnant women can develop iron-deficiency anemia from Coffee

• Creates a laxative effect, stimulating the wave-like movements of the gastrointestinal tract to empty of its contents. It can be helpful to constipation sufferers, but it can also contribute to extremely loose stools.
• Increases acidity of gastric juices with more acid, surprisingly, produced by decaffeinated coffee. Also, stomach contents may exit into the small intestine before being adequately digested, causing distress or pain in the abdomen.
• Can damage the lining of the intestines in excessive amounts and in sensitive individuals allowing the formation of ulcers and gastritis (inflammation of the stomach’s lining) or aggravating existing conditions. People who suffer from gastrointestinal problems such as IBS, Crohn’s disease, and colitis are usually advised not to drink coffee.
• Increases heartburn or acid reflux by relaxing the lower esophageal sphincter muscle at the juncture of esophagus and stomach. Caffeine is a known relaxant of this muscle, but it can also occur from drinking decaffeinated coffee too.
• Allows the absorption of two chemicals, cafestol and kahweol, which increase LDL levels in cholesterol. Low-density lipoproteins (LDL) are considered the bad cholesterol which leads to cardiovascular disease. These components can be removed from coffee by using paper coffee filters.
• Interferes with the absorption of iron for people who take iron supplements. Pregnant women can develop iron-deficiency anemia.

Most medical authorities believe coffee is harmless to a healthy individual when used in moderation (usually considered drinking two to three cups a day), but aggravates gastrointestinal problems in others. Moderate coffee drinkers have been shown to enjoy some health benefits, such as less risk of developing Alzheimer’s disease, dementia, type 2 diabetes, gall bladder disease, certain types of cancer, and Parkinson’s disease. On the other hand, caffeine dependency can create anxiety and sleep disorders, and attempts to withdraw from caffeine can be difficult to handle in heavy coffee drinkers. Furthermore, people who suffer from gastrointestinal disorders are more sensitive to the adverse effects of both caffeinated and decaffeinated coffee. In the person who experiences digestive disorders, the aroma of freshly-brewed morning Joe should be all that is enjoyed because of the adverse correlation between coffee and the digestive system.

written by Joy Seeman

© 2009 Hemorrhoid Information Center

Coffee and Gastrointestinal Function. (n.d.). Retrieved September 15, 2009, from The Coffee Science Information Center: http://www.cosic.org/

Coffee and Health. (2009, September 16). Retrieved September 16, 2009, from Wikipedia: http://en.wikipedia.org/wiki/Main_Page

Higdon, P. D. (2005, August). Oregon State University. Retrieved September 16, 2009, from Linus Pauling Institute: http://lpi.oregonstate.edu/