Constipation

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Old Age

20.     Though there are many causes of constipation, old age is generally seen as an epoch when due to the reduced commotion of other body humors, there is a gradual decline in body functions, including that due to digestion. Older people sometimes drink less water due to the fear for passing urine frequently and at night and this may be one of the causes of constipation in addition to dietary reasons and lack of fibre intake. Ageing may also affect bowel regularity because a slower metabolism results in reduced intestinal activity and diminished muscle tone.

Pregnancy

21.     About one in five pregnant women become constipated due to the hormone changes that slow down the gut movements.

Psychological and Emotional Problems

22.     There is some evidence to suggest that psychological and emotional factors like irritability, a negative mindset, anger and grief can weaken the digestive process and many a times, can result in constipation.

Medications

23.     Certain medications have adverse side effects, which can cause constipation. These include anti-depressants, anti-spasmodic drugs, cholesterol lowering drugs, laxatives, pain killers, morphine, iron tablets, calcium pills, antacids, diuretics, sleeping pills, anti-hypertensive agents, and many health supplements. All these can interfere with the normal functioning of the bowels. 

Other Diseases

24.     Certain physical conditions like fad dieting and diseases can slow down the evacuation process. Diseases such as tumours or growths, a sluggish liver, colitis, spastic condition of the intestine, hyperacidity, diseases of the rectum and colon, bad teeth, uterine diseases, diabetes, abnormal condition of the lower spine and enlargement of the prostate glands can also cause chronic constipation. Certain conditions like piles, fissures and pelvic floor dysfunction (known as outlet obstruction or outlet delay), where muscles of the pelvis that surround the rectum and anus do not work properly and also result in improper and ineffective opening of the bowels. Other medical conditions which can cause poor mobility of the bowels include irritable bowel syndrome, Parkinson’s disease, under-active thyroid (hypothyroidism), liver dysfunction, spinal problems, food allergy, insomnia, paralysis, anaemia, gallbladder, large intestine and rectum problems.

Unknown Cause (Ideopathic)

25.     Some people have a good diet, drink a lot of fluid, do not have a disease which can cause constipation, yet they become constipated. Their bowels are said to be “under active”. This is quite common. Most cases occur in women. This condition tends to start in childhood or in early adulthood, and persists throughout life. 

COMPLICATIONS OF CONSTIPATION

26.     Occasional constipation should not be a cause for concern, but its chronic form may lead to certain complications. Straining, while passing stool, can make the existing piles to bleed or may lead to rectal prolapse. It also poses risk for cardiac patients and the raised intra-abdominal pressure could lead to hernia. Sometimes hard stool may cause fissures in anal-tissues resulting in pain and bleeding. A distended rectum often aggravates problems faced by the patients who have an enlarged prostate.