Risk factors

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Constipation can develop as a result of a disease or even without any disease.

Constipation in children : It occurs in babies (or infants) who are completely or partially fed upon artificial diet, and in those whose mothers take improper diet. Mother’s milk has a laxative effect, therefore breast feeding must be encouraged.

 

Constipation during pregnancy : Hormonal changes, poor intake of fluids, vomiting results into a constant worry for many pregnant women.

 

Constipation in older adults : With the age, people tend to reduce their physical activity, develop other complaints, and the normal bowel movement is first to be effected.

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Constipation in general

  • Sedentary lifestyle
  • Faulty dietary habits having low fiber
  • Inadequate fluid intake
  • Excessive intake of coffee, strong tea, alcohol
  • Heavy sleep
  • Lack of exercise
  • Stress, anxiety or depression
  • Generalized muscle weakness
  • Excessive use of laxatives and enema as their use is not only habit forming but in long term can also damage the nerve cells of the large intestine.
  • Medicines prescribed for certain ailment like anticonvulsants (used for treatment of fits) can slow passage of food along the bowel, iron supplements (for treating anemia), antidepressants (to treat depression), or pain medications (especially narcotics).
  • Ignoring the urge to have a bowel movement that allows the stool to stay for a longer period in intestine and there is a greater absorption of water from it, so as to make it harder and more difficult to pass. It is usually seen due to :
    • Shyness, inhibition, concern over cleanliness in public places or while traveling. This is one of the underlying causes for ‘travel constipation’.
    • Many kids refusing to use school bathrooms resulting in suppression of desire.
    • Repressive toilet training / teaching a child to restrain natural desires till suitable circumstances are present, can also lead to constipation.
    • Poor Indian women using public places / toilets are almost forced to postpone their desire to defecate till night, when they can get enough privacy.
  • The tendency to constipate also increases during summer season (summer constipation) and while travelling. This may be related to psychological, bodily, and dietary changes occurring in each of the above circumstances.
  • Children suffers with constipation, when they are prevented from drinking liquids before going to bed, inorder to avoid bedwetting at night.
  • Some people prefer not to drink fluids before traveling so as to avoid going to the bathrooms frequently.

Constipation in particular with underlying disease (pathological)

  • Neurological disorders (multiple sclerosis, spinal cord injuries)
  • Metabolic and endocrine conditions (diabetes, uremia, under active thyroid gland)
  • Systemic disorder (Amyloidosis, scleroderma)
  • Hirschsprung’s disease (A disease where there is an inborn lack of nerves in the affected portion of the intestines.)
  • Cancer and prolapse of rectum can narrow intestine and rectum
  • Intestinal obstruction
  • Diverticulosis (pockets develop in the wall of intestine where food material can get lodged)
  • Intestinal tumors
  • Strictures (Colorectal narrowing due to contraction of intestinal wall.)
  • Anal fissure
  • Anal skin irritation (e.g. diaper rash)
  • Injury around anus
  • Hemorrhoids (piles)
  • Irritable bowel syndrome