Achalasia Cardia 

Achalasia Cardia 

  Swallowing Problem Esophageal Manometry POEM

Constipation: Symptoms, Diagnosis, and Treatment

Today we’ll talk about Constipation.

Firstly we will understand the mechanism of passing the Stool, In this process, we will see the Rectum and Anus, Rectum is the lower part of the Large Intestine. When the stool is passing it creates the pressure in Rectum and relaxes the Anus which helps to pass the stool.

What is Constipation: 

If a person is not able to pass stool 3 times a week then that person is suffering from Constipation.

Constipation Symptoms: 

Some patients’ stool becomes harder and they are not able to pass it.

Some patients pressurize their lower stomach so that rectum pressure can increase and they can pass stool easily.

Some patients also use Finger to out the stool. Some patients pass the stool 2-3 times a day but still, they are not satisfied.

Some patients also have pain in the Lower Part of the Stomach or in the Anus.

Constipation Risk Factor: 

• With an increase in age, the risk of constipation also increases
• Constipation is common in Women as well
• Stress Factor in life
• Less Intake of Water
• Lifestyle
• Less intake of  Fruits and Vegetables 
• Excessive intake of Coffee and Chai (Tea) reduces the Water and increases the risk of Constipation

Cause of Constipation: 

• Slow Transit Constipation: Sometimes Large Intestine does not work properly due to which stool can not move and difficult to pass out from the rectum. 
• Anocteral Dyssynergia: Sometimes during passing stool pressure is not created in the rectum and the anus is also not relaxing due to this patient is not able to pass stool easily.
• Nerve Cause: If the patient is suffering from these diseases Diabetes, Parkinson’s Disease, Spinal Cord Injury, and Stroke they may also suffer from Constipation.
• In some patients, the Large Intestine gets fed up due to any disease in it such as Tumer, Polyip, Tuberculosis then which also causes constipation.
• Sometimes  Constipation can be caused due to medicines such as Blood Pressure Medicine, Diabetes Medicine, Stress Medicine, etc.
• Constipation may also cause due to rich calcium in the Blood or the patient suffering from Thyroid. 

Most of the patients raise query that they are suffering from Colitis. Generally Colitis-suffering patient suffers from Diarrhea instead of Constipation. But if Colitis in the rectum then it may be a chance that the patient can suffer from Constipation.

Complications in Constipation: 

1. Anal Fissure: If the stool is hard then it causes a cut in the Anus, when the patient passes the stool it cuts the anus, and due to this Blood flows and it pains a lot. 
2. Hemorrhoids: In some patients, Anal Vein swelled which is known as Bavasir/Piles/Hemorrhoids and it also causes blood flows
3. Colonic Diverticulum: In some patients, the Large Intestine has pit or outpouching. 

Whenever the constipation-suffering patient visits us, we discuss everything with them very well, we also discuss the alarming symptoms as well. As these alarming symptoms help us to know that the patient is suffering mild, moderate, or severe constipation. If the patient has alarming symptoms then it means the patient is suffering from severe constipation.

Alarming Symptoms of Constipation:

• Blood in Stool 
• Severe Pain in Stomach
• Weight Loss
• Fever
• Onset Old Age: It means the patient had no constipation problem ever but in his/her old age he/she suffers from constipation.

Firstly we start the medication for all the patients. If the patient is not responding to the Medicine and they have alarming symptoms as well then we diagnose them. 

Diagnose for Constipation:

1. Blood Test: Hemoglobin, Calcium, and Thyroid 
2.  Special Test: Colonoscopy,  MR Defecography, Anorectal Manometry, Colonic Transit Study

In the Colonoscopy, we put one endoscope in the patient’s stomach through which we study their Large Intestine. 

In MR Defecography, we provide medicine to a patient and asked them to pass out, and during that time through the MIR we study that there is any issue in Rectum or Anus.

In Anorectal Manometry, we put a thin tube in Anus and check the pressures. If the rectum is not able to create enough pressure and the Anus is not relaxing then this condition is called Anorectal Dyssynergia.

Through this, we determine the movement in the Large Intestine. In this, we give a capsule to the patient to swallow and we do an X-Ray to check the movement of that capsule. If the Movement is less then it means the Large Intestine is working slowly.

Treatment for Constipation:

• Change in Lifestyle
• Increase the Physical Activities such as Brisk Walking and other exercises 
• Increase Dietary Fiber by adding more foods and vegetables. 
• Increase Fluid intake
• Avoid Stress
• Maintain a Diet Dairy which mention the fruit and vegetable which causes Constipation problem 
• Avoid Mobile and Newspaper in Toilet
• BioFeedBack Therapy: In this therapy, we provide a balloon to patient which they have to pass out from anus and we measure the Preusser.