CONSTIPATION

Overview

Constipation is defined as: Difficulty passing stool Incomplete passing of stool Infrequent passing of stool

Causes of constipation may include:

• Chronic use of medications

• Chronic use of enemas

• Diagnostic procedures

• Emotional stature Neuromuscular impairment

• Gastrointestinal lesions

• Immobility

• Inactivity

• Lack of privacy for personal habits

• Less than adequate intake of bulk

• Medication side effects

• Musculoskeletal impairment

• Obstructive lesions

• Pain on defecation

• Pregnancy

• Weak abdominal musculature fibers

Constipation in pain management is common as many patients receive opioids to manage their chronic pain. Opioids decrease the motility of the gastrointestinal tract, thereby delaying the passage of the stool. Tolerance does not develop to constipation as it does to the other side effects of opiates.

Diagnosis

Patients with constipation complain of:

• Abdominal pain

• Appetite impairment

• Abdominal pressure

• Back pain

• Feelings of fullness

• Hard formed stool

• Headache

• Inability to defecate

• Nausea

• Pain with defecation

Along with attaining the patient’s history, the health care provider can further determine constipation by noting the lack of bowel sounds, palpating the rectal mass, and palpating the abdomen for a mass. If the problem has been noted and addressed for a couple of days without resolve, the physician may order an abdominal x-ray to view the blockage and the cause of the blockage if visible.

Treatment

Constipation can be treated with a liberal diet of fruits, vegetables, and plenty of water. These tend to increase the hydration in the stool allowing it to move more readily through the system. Exercise helps the colon to initiate movement to move the stool through the system. Stool softening medications may be recommended and/or prescribed by the physician.