Selasa, 24 Juni 2008

Constipation I

Constipation is a symptom that represents a subjective interpretation of bowel function disturbance. In clinical practice, constipation is generally defined as fewer than three bowel movements per week. It is more prevalent in children and the elderly. Constipation can have many causes, but most often is functional or idiopathic. Chronic constipation may diminish quality of life and it may also signal more serious underlying problems such as large bowel dismotility or mass lesions.

The process of defecation involves the propulsion of stool through the large bowel, the recognition for stool within the terminal end of large bowel (rectum), and the conscious act of defecation. Constipation can be caused by obstruction of the large bowel flow (due to anatomic or functional disorder) or poor propulsive activity (due to inhibition of motility caused by drugs, metabolic disease, or diffuse nerve/ muscle disease).

A patient’s perception of constipation may vary. It may include not only the objective observation of infrequent bowel movements, but also the subjective complaints of straining at stooling, incomplete evacuation, abdominal bloating or pain, hard or small stools, or a need for digital manipulation to enable defecation. Thus, an international committee has recommended operational definitions of chronic functional constipation in adults, infants and young children to guide the evaluation and treatment of constipation.

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