Constipation: infrequent or difficult evacuation of
feces.  Millions of dollars are spent each year in an effort to remedy
constipation.  Many people erroneously think of themselves as constipated
if they have days during which there are no bowel movements.  Actually,
this vary greatly, so that one person may be perfectly well although he
has a bowel movement only once in two or there days, while another may
be equally well with more than one elimination daily.  One must not
go without a bowel movement for more than three days.  Disease and
condition’s also determine when one should be concern.

On the basis of its onset, constipation may be classified as acute
chronic.  Acute constipation occurs
suddenly and may be due to appendicitis or to an intestinal obstruction. 
Laxatives and enemas should be avoided and a physician should be consulted
at once.  Chronic constipation, on the other hand, has a more gradual
onset and may be divided into two groups:

1.) Spastic constipation in which the intestinal musculature
is overstimulated, so that the canal becomes narrowed and the space (lumen)
inside the intestine is not large enough to permit the passage of fecal

2.) Flaccid constipation which is characterized by a
lazy or atonic intestinal muscle.

The overactive spastic type of constipation is probably much more common
than the atonic lazy kind.  Nervous tensions, excessive amounts of
bulky foods and the use of laxatives increase the muscle tone of the intestine. 
The patient who has sluggish intestinal muscles may be helped by moderated
exercise, and increase in vegetables and other bulky foods in the diet
and an increase in fluid intake.

The use of enemas and so-called colonic flushings is unnecessary and
should be discouraged for most persons.  The lining of the intestine
may be injured by streams of water that remove the normal protective mucus. 
In addition to this, those who have piles (hemorrhoids) will aggravate
this condition by enemas.  Enemas should be done per doctors order.

Some medications will promote constipation such as most all narcotics
(Codeine, Morphine)  and patients should discuss with your doctor
in regards to using stool softeners or other laxative agents.

Postoperative constipation :  usually results from
colonic ileus caused by diminished Gi mortility and impaired perception
of rectal fullness.  Although primarily a problem of elderly postoperative
patients, those also at risk are patient receiving opiates or anticholinergics.


 Increase fluid intake

stool softeners


Non-narcotic algesics (as ordered by your doctor)

Renal and urologic care:  Related to inadequate intake of
fluid and bulk,
constipation may be caused by prolonged immobility;
fluid and dietary restriction such as high fiber foods-often contain too
much potassium for renal patients.  The use of phosphate binders containing
aluminum, which commonly causes serious constipation in dialysis patients.

Treatment:  to ensure correct fluid replacement therapy

Fluid intake -usually 2,500 ml daily to ensure correct fluid replacement

Laxative or enema as ordered by your doctor

Increase fiber and bulk in the diet as prescribed by your doctor

Mild exercise

Gerontologic care:  Related to diminished GI motility,
low roughage diet, decreased activity, abuse of enemas and laxatives, and
weak abdominal muscles

Increase fluid intake (8 oz of water with each
meal and to drink water or juice frequently between meals –UNLESS contraindicated
by cardiovascular or renal disease )

Increase fiber in diet  Avoid high refined processed foods

Increase exercise (if not contraindicated)

Avoid laxatives, narcotic analgesics, aluminum, or barium products

For severe constipation, your doctor may prescribed glycerine suppository

NOTE:  with all medication and change in diet or activities: CONSULT with your DOCTOR.