Constipation Clinic

Our doctors at the Integral Medical Centre are highly qualified consultants who are specialized in the diseases of the colon and rectum. They can give you proper advice and provide you with a high quality health care service.

 
What is constipation?

Constipation is a condition of the digestive system where a person experiences hard feces that are difficult to pass. It may be extremely painful, and in severe cases (fecal impaction) lead to symptoms of bowel obstruction.

Common symptoms include fewer bowel motions, having to strain to pass a motion and pain. Passing motions that are dry and hard and are like rabbit pellets. A feeling of complete bowel emptying.

People with constipation may feel a 'fullness' with bloating, nausea, even vomiting.  Straining can cause piles and rectal bleeding.

Constipatated patients generally have problems with defecation and pass infrequent stools and/or hard faeces. There are different types of constipation; each type requires a different therapeutic approach.
An increasing number of patients who have not benefited from the usual dietary measures and laxatives treatment need to be seen by a surgeon.

Constipation is not a trivial symptom because patients' life at home or work may be severely affected by abdominal pain, distension, poor sense of well being   and decreased bowel motion.

Patients with minor constipation usually do not require sophisticated investigation. However if the patient age is over 40 years suffering from change in bowel habits; associated with symptoms like decrease in weight, tenesmus (straining while defecating) then the patient will have to seek doctor's advice to find out the underlying causes for these symptoms which could be one of the followings:

Colorectal carcinioma

This is the second most common cause of cancer in the UK (19,000 deaths per yr). The disease alerting symptoms depends on the site of cancer in the colon (left, right).  Patients can present with bleeding and mucous from the rectum, altered bowel habit, tenesmus, decrease in weight, abdominal pain and abdominal mass.

Treatment:

Surgery:  Aims to cure.  The exact technique may increase survival times by up to 50% so expert training is vital. Other treatment options include radiotherapy, which may be used in pre-op rectal cancer to decrease local recurrence and increase 5 years survival.  And chemotherapy, which can be used for certain types of colorectal carcinoma in the palliation of metastatic disease.
 
Research shows that 60% are amenable to radical surgery, 75% of these will be alive at 7 years.

Other causes of constipation can be due to:

Anorectal diseases:  Such as, anal fissure, stricture and rectal prolapse.
 
Intestinal obstruction:  Colorectal carcinoma (mentioned above), strictures (Crohn's disease, Diverticulosis and pseudo-obstruction.

Metabolic/endocrine causes: Drugs, neuromuscular and other rare causes, like idiopathic lslow transient, idiopathic megarectum/colon.

As stated earlier, constipation is not a simple symptom to be ignored.  If the constipation is restricting one's social or work life, he/she will need to seek a doctor's advice, not to only treat the symptoms, but find out the underlying cause and treat accordingly - because constipation causes can be very serious and even fatal if left untreated.