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Constipation

Constipation

Description

Bowel habits vary widely among individuals. Constipation, therefore, is only diagnosed if the normal pattern of bowel movements changes and if these movements are irregular, unusually infrequent, and/or difficult.

Atonic constipation, or inactive colon, is the condition of chronic constipation, which often leads to fecal impaction. This state is common in elderly persons, invalids, and person confined to bed because of forced inactivity.

Constipation is usually a symptom of another disease and should be treated as such. Increased dietary bulk, increased fluid intake, increased exercise, modification of bowel habits, and prescription bulk-forming laxatives may help the condition.
 

Causes

Primary Factors
Constipation is primarily caused by delayed evacuation of feces from the colon, increasing absorption of fluids.

Predisposing Factors
There are many predisposing factors, some of which are:
 

Certain medications Parasympathetic drugs
Resisting the urge to defecate Spinal cord injury
Emotional conflicts Scleroderma
Overuse of laxatives Hirschsprung's disease
Lack of dietary fiber Diverticulosis
Pregnancy Interception
Inactivity Hernia
Prolonged travel Hypothyroidism
Anal fissure Hypercalcemia
Hemorrhoids Hypokalemia
Severe depression Porphyria
Prolonged dependence on enemas Lead poisoning
Stricture Multiple sclerosis
Neoplastic obstruction Cerebral palsy
Barium ingestion Senility
Ingested rock-like material Vascular disorders of the intestine


 

Signs & Symptoms

 

Hard, dry, infrequent stools Unexplained tiredness
Painful bowel movement Lower abdominal pain
Straining to defecate Cramps
Feeling of rectal fullness Bad breath
Feeling of excessive coldness Watery fecal material
Dry skin or hair Irritable colon
Hemorrhoids  


 

Nutritional Supplements

Structure & Function: Intestinal Health

---------------------------------
General Supplements
---------------------------------

  Adult Child/Adolescent
 
Bran fiber 3 - 5 tbsp 1 - 3 tbsp
Chlorophyll*    
Fiber*    
Flax seed oil*    
Fluids 3 - 5 pints 1 - 3 pints
Magnesium 200 - 1,000 mg 200 - 1,000 mg
Vitamin C 1,000 - 10,000 mg 50 - 5,000 mcg




Notes:

Magnesium is recommended as a (sulfate).

Oat bran is probably the leading form of bran, or fiber

Corn and wheat are also good sources of fiber and provide a little variety.


Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.
 

Dietary Considerations

The time needed for the emptying of intestinal contents is dependent on the density of the feces and the tone of the intestinal musculature. Feces should be well-formed, soft and moist. Areas of the fecal mass should be bulky, so intestinal muscles have a resistant surface on which to push. Bulk and natural lubrication are provided by the inclusion of fruits and vegetables in a High Fiber Diet. The individual should be instructed to drink plenty of fluids (at least 8 to 10 glasses per day) in order to soften the stools further.

If there is no bulk in the diet, the intestinal muscles become weak and atonic from lack of exercise. Muscle weakness can result from immobility due to prolonged periods of sitting or traveling, or occur in association with debilitating diseases such as arthritis, muscular dystrophy, or multiple sclerosis. Progressive muscle weakness decreases the efficiency of peristalsis and is manifested as chronic atonic constipation.

People will often resort to using laxatives as a remedy for chronic constipation. This practice is dangerous if continued over an extended period of time. The intestine will become increasingly dependent on laxatives for elimination because its inactive muscles will have weakened and become inefficient at passing mass through the digestive tract.

Laxatives increase gastric mobility and may decrease the absorption of many nutrients, especially the fat-soluble vitamins. This malabsorption may produce fat-soluble vitamin deficiencies as well as other vitamin deficiencies and their symptoms with prolonged laxative usage.

Mineral oil should not be used as a laxative for prolonged periods. Dietary carotene and fat-soluble vitamins mix with the oil and are excreted in the feces rather than being absorbed in the intestine.

An individual should consume foods, such as prunes, rhubarb, figs and dates, which have natural laxative properties, as a preventative measure against constipation. Prune juice contains the natural chemical laxative diphenylisatin.
 

Homeopathic Remedy

 

1.Hydrastis canadensis 15C for obstinate cases
2.Nux vomica 30C
3.Magnesia phosphorica 30C



Advanced, by symptom:
 

1.Sluggish bowels, low fiber diet Alumina.
   
2.Urgent need but inability to pass stools Nux vomica



Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.


References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Tissue Salts

 

Calc. Fluor. Relaxed muscles are incapable of expelling feces, anal fissures;
   
Ferr. Phos. hot rectum, hardened feces, piles (hemorrhoids), rectal prolapse;
   
Kali Mur. light-colored stools, white or greyish coated tongue;
   
Kali Phos. dark brown stools, streaked with yellowish-green mucus;
   
Nat. Mur. dry bowels but watery secretions of the eyes, saliva etc.;
   
Nat. Phos. infants;
   
Nat. Sulf. biliousness, hard, knotty stools, or soft stools which are difficult to expel;


 

Herbal Approaches

----------
Herbs
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Cascara Sagrada Bark (Rhamnus purshiana)
Licorice Root (Glycyrrhiza glabra)
Linseed (Flax seed)
Olive oil
Pokeroot
Rhubarb Root (Rheum palmatum)
Scotch broom
Senna

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Discussion:

There are several approaches to constipation: bulk, lubricating, osmotic etc.

Purgatives are also available in different strengths.

Most work to evacuate the bowels by discharging bile from the liver and gall ducts i.e. cholagogues e.g. rhubarb, cascara sagrada.

For dry, hard stools, lubricating laxatives may be used e.g. flax seed or olive oil.

Senna is regarded as a strong purgative laxative.

Cathartic laxatives are strong and irritating, even toxic and should only be used occasionally. Contraindications of cathartic laxatives include: lactation; menstruation; pregnancy and general debility. E.g. Pokeroot and Scotch broom.

References:

Godding, EW: Laxatives and the special role of Senna. Pharmacology, 1988(1):230-236.

Hoffmann, D: The New Holistic Herbal. Element, 1983. Third edition 1990.

Aromatherapy - Essential Oils

 

Marjoram Essence, Orange Essence,
Peppermint Essence, Tangerine Essence,
Ylang-Ylang Essence.  

 

Related Health Conditions

 

Anal fissure Hernia
Cerebral palsy Hirschsprung's disease
Cramp Hypothyroidism
Depression Lead poisoning
Diverticulosis Multiple sclerosis
Fecal impaction Pregnancy
Bad breath Scleroderma
Hemorrhoids Senility


 

Abstracts

References

Alpers, D.H., R.E. Clouse, & W.F. Stenson. 1983. Manual of Nutritional Therapeutics. Little, Brown, and Company, Boston. 457 pp.

Andrews, P. J. et al: Chronic Constipation Reversed by Restoration of Bowel Flora. A Case and a Hypothesis. European Journal of Gastroenterology and Hepatology, 1992;4:245-247.

Arthur, C., et al: Prostaglandin Metabolism in Relation To the Bowel Habits of Women. Prostaglandins, Leukotrienes and Essential Fatty Acids, 1992;46:257-259.

Baum, H.M., R.G. Sanders & G.J. Straub. 1951. The occurence of diphenyl isatin in California prunes. J of Am Pharmaceutical Association vol.40

Berkow, R. 1977. The Merck Manual. Merck Sharp and Dohme Research Laboratories Pub., Rahway, New Jersey. 2165 pp.

Bland, Jeffrey. Nutraerobics. San Francisco: Harper & Row, 1983.

Bland, Jeffrey. Medical Applications of Clinical Nutrition. New Canaan, Conn.: Keats, 1983.

Chicago Dietetic Assoc & the South Suburban Dietetic Assoc of Cook & Will Counties. 1981. Manual of Clinical Dietetics. W. B. Saunders Co., Phila.

Chasroff, I.J. & J.W. Ellis. 1983. Family Medical Guide, William Morrow & Company Inc., Pub. 594 pp.

Disch G et al., Therapeutic availability of iron administered orally as the ferrous gluconate together with magnesium-L-aspartate hydrochloride. Arzneimittelforschung, 1996 Mar, 46:3, 302-6.

Eagles, J.A. & M.N. Randall. 1980. Handbook of Normal and Therapeutic Nutrition. Raven Press, New York. 323 pp.

Galender, C. N, & D. Gallender. 1979. Dietary Problems and Diets for the Handicapped. Charles C. Thomas; Springfield, Illinois. 207 pp.

Griffenberg L et al., The effect of dietary fiber on bowel function following radical hysterectomy: a randomized trial. Gynecol Oncol, 1997 Sep, 66:3, 417-24.

Guillemot F et al., Action of in situ nitroglycerin on upper anal canal pressure of patients with terminal constipation. A pilot study. Dis Colon Rectum, 1993 Apr, 36:4, 372-6.

Hamilton, H. K. ed. 1982. Professional Guide To Diseases Intermed Communications Inc. Pub, Springfield, Massachusetts. 1323 pp.

Heinerman, John. 1982. Herbal Dynamics. Root of Life, Inc.: Publ.

Kirschmann, J.D. 1990. Nutrition Almanac: Nutrition Search. McGrew-Hill: New York.

Klauser, A. G. et al: Nutrition, Physical Activity and Chronic Constipation. Gastroenterology and Hepatology, 1992;4:227-233.

Kolasa KM et al., Nutrition during pregnancy. Am Fam Physician, 1997 Jul, 56:1, 205-12, 216-8.

Kunz, J.R.M. 1982. The American Medical Association Family Medical Guide. Random House Pub, New York. 832 pp.

McClung HJ et al., Constipation and dietary fiber intake in children. Pediatrics, 1995 Nov, 96:5 Pt 2, 999-1,000.

Murray, M.T., & J.E. Pizzorno. 1991. Encyclopedia of Natural Medicine. Rocklin, Ca; Prima Publishing.

Pennington, J. 1978. Nutritional Diet Therapy. Bull Publishing Co., Palo Alto, Ca. 106 pp.

Petersdorf, R.G. & R.D. Adams. 1983. Harrison's Principles Of Internal Medicine. 10th ed. McGraw Hill Pub Co., New York. 2212 pp.

Ryding, A. & B. Odegaard. Prophylactic Effect of Dietary Fiber in Duodenal Ulcer and Bowel Disease. Lancet. October 2, 1982.

Stewart E et al., A strategy to reduce laxative use among older people. Nurs Times, 1997 Jan 22-28, 93:4, 35-6.

Subak-Sharpe, G.J. 1984. The Physician's Manual For Patients. Times Books Pub., New York. 607 pp.

Tolia V ett al., A prospective randomized study with mineral oil and oral lavage solution for treatment of faecal impaction in children. Aliment Pharmacol Ther, 1993 Oct, 7:5, 523-9.

Tucker, D.M. & G.E. Ingleff. Dietary Fiber and Personality Factors as Determinants of Stool Output. Gastroenterology, 81. 1981.

van der Plas RN et al., Biofeedback training in treatment of childhood constipation: a randomised controlled study [see comments]. Lancet, 1996 Sep 21, 348:9030, 776-80.