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Constipation

DEFINITION

It is defined as incomplete emptying of rectal contents, difficult passage of hard stool irrespective of frequency. Stools can be described as incomplete, infrequent or unduly hard where unusual straining is required to achieve complete emptying of bowels.

CAUSES-

-Inadequate fibrous supplements in the diet.

-Drinking less quantity of water.

-Insufficient time for complete emptying of the bowels. This is normally seen in places where latrine is one and the people in the house are 5-6 in numbers.

-Lack of privacy for defecation

-Good tone of abdominal muscles is very essential. People with protruding tummies lose abdominal tone; ladies undergoing repeated pregnancies lose pelvic and abdominal muscle tone.

-Indian seats are better compared to English seats as one can apply force to evacuate.

-Drugs used for relieving abdominal pain, hyperacidity, high blood pressure, headache can lead to constipation.

-Gastro-colic reflex
In this reflex- anything reaching the stomach either liquid or solid, in turn stimulates the colon, which results in a call to evacuate. Many people drink a glass of water, a cup of tea or coffee,. This reflex is very advantageous and should be encouraged.

-Some people do not concider it necessary to go to the toilet in the morning after getting up. This is because they do not feel important to form a habit of going to the toilet irrespective whether the urge of emptying is there or not.

-Use of strong purgatives, frequent use of enema can lead to Constipation.

The misconception in the mind of layman and even Doctors is that daily one bowel movement is essential for health. This is really not true. A normal person may pass stool once in 2-3 days or 2-3 times a day. It all depends upon the habit formed by the individual.


TREATMENT-

-The main treatment consists of giving assurance and advice to the patient regarding diet and other things to follow, thereby naturally preventing constipation.

-High fiber diet consisting of fresh green vegetables, salads and fruits.

-Drinking large quantity of water at least 10-15 glasses of water in a day.

-Advice regarding specific exercises for abdominal muscles.

-Use of Gastro-colic reflex in treating Chronic constipation. The ideal time to go to the toilet is 20-30 minutes after heavy breakfast.

-Drugs- Making use of Bulk laxatives, Bran, Ispagula, fiber supplement.

- Do not make use of stimulant laxatives as frequent use of them causes cramps and lose tone of the colon.

-Liquid Paraffin (Cremaffin) also can be used.

-Use of suppositories and Enema.

-Patients can try a glass of hot milk with 1-2 teaspoonful of honey
(to be taken at bedtime.)


HOMOEOPATHIC REMEDIES

Causes in general-

-Irregular or less bowel peristaltic movements.
-Insufficient fecal matter because of less food intake
-severe dehydration or less water intake.
-Mechanical obstruction.
-In sedentary lifestyle and less fiber diet;
-It is a common symptom during PREGNANCY.
-In children it may be because of faulty bladder, bowel training like postponing the call while playing or occupation.
-Weakness of abdominal or pelvic floor muscle particularly in old age -Tightness of the muscles of external or internal sphincter.

Since causes for Constipation differ in Adults & Children medicines are given in two different sections

Remedies in general: -
Bryo, Nux v, Opium, Alumina, Hydrastis, Mag Mur

1) Bryonia-

Suitable for patients who are irritable with dark hair, dark complexion, firm muscles.
There is dryness of mucus membrane.
No urge to pass stools.
Stools which are dry and hard large as if burnt and passed with a lot of difficulty.
Abdomen is sensitive to touch.
Pressure in the stomach like that of a stone comes out
Great thirst for a large quantity of water at long intervals.
Stools are brown, bloody
<< morning, slightest motion, hot weather sets in.
<< eating cold drinks or ice in hot weather.

2) Nux Vomica-

Very useful for those who have constipation due to the overuse of purgatives & laxatives.
Suited to persons who are quick active nervous irritable and doing a lot of mental work, leading a sedentary life.
Constipation is with frequent and ineffectual urge but after passing stool there is unsatisfactory feeling as if part of it has remained unexpelled.
There is small quantity of stool at each attempt.
There is constriction of rectum.
Urging of stool is felt throughout the abdomen.
CONTRAINDICATED WHEN THERE IS AN ABSENCE OF DESIRE FOR DEFECATION.

3) Opium-

Complete or partial paralysis of gastrointestinal tract
If that results from fright, from charcoal vapors, lead poisoning,
Bad effects of fear still remaining, leading to constipation.
No desire for stool at all.
Stool is hard, round, black balls.
Stools protrude from rectum & recede back.
Violent pain in the rectum.
Hard bloated abdomen.

4) Hydrastis-

For debilitated person with marked derangement of gastric & liver functions.
Symptoms for those who have had excessive use of alcohol.
Stool dry with smarting pain in rectum and pain remaining for long after passing stool.
Constipation with sinking feeling in stomach and associated dull headache.
Constipation causing fissures in anus.

5) Magnesium Muriaticum-

Especially suited to women having constipation with menstrual complaints and also infants during dentition.
Stool hard large knotty like sheep's dung
Crumbling at verge of anus.
Difficulty in passing stool.

Causes of constipation in children

Constipation in Children (Infants, bottle fed, babies & kids)
Since the causative factors in children and adults are different
these remedies are useful in children.

Remedies In Children: -
Aesculus hip, Bry, Collinsonia, Alumina, Psorinum, Puratin

1) Aesculus Hip -

Pain in abdomen.
Rectum feels full of small sticks.
Child complaints of pricking pains.
Dry hard white stools.
Purple coloured pile. Burning in anus.
Child afraid of passing stools
Rectal pain << after stool.
>> cold water application.

2) Collinsonia-

Burning pain in anus.
Diarrhoea alternates with constipation.
Itching in anus with sensation of sticks in rectum.
Beeding piles,
great flatulence
stool sluggish & hard.

3) Paraffine-

Obstinate constipation with frequent desire for stools.
Continuous urging for stool without result.
Knife like pains. Pain in lower abdomen.
Child complains or points out at lower abdomen.
(Another useful remedies Psorinum)

4) Natrum Phos-

Habitual constipation in young children.
Constipation due to liver dysfunction.
This remedy is a good laxative when administered with the food of infants.
Dose 1\4 tea spoon 3 times daily for children below 1 yrs of age.

5) Silicea-

Loss of power of rectum for expulsion of stool.
It recedes after having been partly expelled.
Constipation of poorly nourished children with pale earthy face. Profuse sweat around head and neck
Cold palms & soles with cold sweat.

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