How To Evaluate Constipation
How to treat constipation basically depends on what appears to be the main causes and contributors to a persons symptoms.
An evaluation should start with the health provider asking for more information regarding the symptoms, including how long theyve been going on, as well as the frequency and consistency of stools.
Its also important for the clinician to ask about red flags that might indicate something more serious, such as colon cancer. These include:
- Blood in the stool
- Weight loss
- New or rapidly worsening symptoms
The next steps of the evaluation will depend on a persons medical history and symptoms. Its generally reasonable for a healthcare provider to check for these common causes of constipation:
- Medication side-effects
- Low intake of dietary fiber
- Low fluid intake
- Common causes of painful defecation, such as hemorrhoids or anal fissures
Evaluation for possible mechanical obstruction will depend on what the clinician sees on physical examination, the presence of potential red flags, and other factors. Generally, a rectal exam is a good idea.
In a 2013 review, the American Society for Gastroenterology recommends that clinicians evaluate for possible pelvic floor dysfunction mainly in those people whose constipation doesnt improve with lifestyle changes and over-the-counter laxatives.
They also recommend diagnostic colonoscopy only for people with alarm symptoms, or who are overdue for colorectal cancer screening.
Constipationdefining Normal Is Not So Easy
When it comes to treating patients with constipation , Dr. Deutsch first asks a lot of questions.
I tell people that their normal may not be my normal or the next persons normal. We are all very different when it comes to bowel habits, she says. I need to know what the stool looks like, from the color to the length, and how long it takes you to go. If someone is only going once or twice a week and the stools are looking like little rabbit pellets, I need to tease that out.
To help explain, Dr. Deutsch often shows patients a bell-shaped curve from a study published in Gastroenterology. On the national average, people poop anywhere from three times a week to three times a day, she says. That is a huge range. I stress that if you dont feel good, we need to make you feel good. If you are worried that you are sitting on the toilet for an hour and passing small, hard pellets, we should see if you are getting enough fiber or physical movement every day. Or maybe we need an over-the-counter or even prescription-strength laxative.
Dr. Deutsch also doesnt shy away from sharing her own experiences. It can be TMI, but I let people know that we all deal with these problems once in a while, she says. If I dont go to the gym and I dont eat any fruits and vegetables for a week, my poop looks like something my cat would produce.
Can Hemorrhoids Block Bowel Movements
Although hemorrhoids are common, they arent easy to deal with for most patients. When it comes to having a bowel movement, hemorrhoids can make it difficult.
Whether hemorrhoids occur internally or exist around the opening of the anus, they can make it hard to pass your stool.
The swelling that occurs from hemorrhoids can keep you from being able to pass a bowel movement. If you have constipation and hemorrhoids simultaneously, it only worsens your condition.
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Medical Procedures For Hemorrhoids That Wont Go Away
If hemorrhoids don’t go away with home treatments, medical procedures may be necessary.
If you visit your doctor with painful external hemorrhoids those located around the outside of the anus that are visible from the outside your doctor may offer to excise them during the office visit. You will be given a shot with a local anesthetic to numb the area before the procedure.
Doctor’s office procedures for internal hemorrhoids those located inside the rectum may include:
Rubber Band Ligation This is the most commonly performed hemorrhoid procedure in the United States. In this procedure, which can be used for grades 1, 2, and 3 internal hemorrhoids , the doctor places a small rubber band around the base of the hemorrhoid, which can be done when your doctor performs an anoscopy examination to better visualize the hemorrhoids. The rubber band cuts off the hemorrhoid’s blood supply.
The procedure typically causes the hemorrhoid to shrink and fall off within about a week, though several short visits to your doctor may be necessary to completely get rid of the hemorrhoid. Minor bleeding and a feeling of pressure may occur, but this can usually be alleviated with OTC pain relievers. This procedure is not associated with significant recovery time.
When Do I Need To See A Doctor About Rectal Bleeding
Its usually a good idea to reach out to your healthcare provider whenever you have rectal bleeding. It can be a sign of another health condition that might need treatment. If you have heavy bleeding or are seeing blood in multiple bowel movements, its urgent that you see your provider. Rectal bleeding can have serious causes that need to be treated.
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Are There Any Tests For Rectal Bleeding
There are several ways your healthcare provider can evaluate rectal bleeding to help figure out the cause. Your provider might start by asking you about the situation around your rectal bleeding. Some questions may include:
- When did the rectal bleeding start?
- What did you eat the day before seeing the rectal bleeding?
- How frequently do you have a bowel movement?
- Have you been constipated?
Causes And Risk Factors
The underlying cause of hemorrhoids that form in the anus or rectum is still a matter of debate. One theory is that it is due to the breakdown of the supporting tissues in the anal canal.
When hemorrhoids are untreated, last for a long time, or are under more physical pressure, they can become prolapsed and protrude out of the anus or rectum.
There are several risk factors for prolapsed hemorrhoids, including:
- Advanced age
- Overuse of anti-diarrhea medications
Sometimes, placing something in the anus, such as during sexual activity, or for medical treatment, can also cause pressure, resulting in a prolapsed hemorrhoid.
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Can I Take My Routine Medications On The Morning Of My Test
If you are scheduled for a morning procedure, do not take any medication EXCEPT for blood pressure, heart and seizure unless you are otherwise instructed by our physician or your primary care physician. If you are scheduled for an afternoon exam you may take your routine medicaiton EXCEPT the medications that you were instructed to hold. Pain medicaiton should not be taken within six hours of any procedure.
I Am A Diabetic What Precautions Should I Take
If you are a diabetic we will give you special instructions when your procedure is scheduled. You will need to let us know about ALL of your diabetic medications. You should check your blood sugar frequently during the day before and the day of the procedure. Since you will be on clear liquids, your blood sugar will tend to drop faster than normal. To avoid this be sure to include some liquids with regular sugar in your diet. It may also be helpful to have some glucose tablets on hand in case your blood sugar drops and it is past your cut off time for fluids.
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Preventing Constipation Is Key To Reducing Hemorrhoid Pain
Going to the bathroom shouldnt cause anxiety or pain, but hemorrhoids can cause these problems. To counteract this, you should try some preventative steps to stop problem hemorrhoids from hurting you in the first place.
Try tweaking your diet to include more vegetables and high-fiber foods. High fiber diets regulate your colon and reduce the frequency of bleeding hemorrhoids.
Drink more water to keep your colon healthy and your stools naturally softer. This should make going to the bathroom a strain-free process.
If you happen to do exercises like weightlifting that puts excess pressure on your backside, you should regulate your workouts to relieve some of that pressure.
Taking these steps now can help you with painless bathroom breaks in the future. As we say at Doctor Butlers: Leave the Pain Behind!
About Doctor Cutler
Alabama Colon & Rectal Institute Is Centered Around Treating Diseases Of The Colon Rectum And Anus
Alabama Colon& Rectal Institute has been in practice since 1990 as a free standing, private practice located in downtown Birmingham, Alabama. We are known for our efficiency and patient care, in a more relaxed office-based setting. Our doctors are known regionally for their expertise and are active in teaching surgical residents and other physicians. We are also a major sponsor of The Rumpshaker 5K, a race that promotes awareness about colorectal cancer. Check out our website for more information, or give us a call to make an appointment at 458-5000, or email us at .
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Is Miralax Or Metamucil More Effective For Constipation
While both Metamucil and Miralax are designed to relieve constipation, they are both fundamentally different products. Metamucil is a fiber supplement that utilizes psyllium as its dietary fiber source. Miralax is an osmotic laxative, binding water to the stool for easier passage.
Metamucil, because it is a fiber supplement, has other purposes and health benefits than Miralax. For sufferers of chronic constipation, Metamucil is often the starting point. And if extra fiber doesnt work, then a laxative should come into effect.
Metamucil may not immediately relieve constipation, and in fact, its labeling suggests that for those new to taking Metamucil, to begin with, small doses.
Taking too much Metamucil at once can lead to these side effects:
- Excess gas
- Digestive issues
For immediate alleviation of constipation, take Miralax. Miralaxs singular purpose is constipation relief by binding water to stools. Miralax has hundreds of customer reviews to back its effectiveness in ending constipation while taking this product.
Regardless of which product you take for constipation, make sure that you consult with your doctor beforehand and follow the packaging instructions. Metamucil should be taken an hour before or after other medications. Both products should be consumed with plenty of water.
I Think I Have Hemorrhoids But Im Not Sure How Can I Tell And What Are The Treatments
Hemorrhoids are normally sort of vascular cushions. When these vessels enlarge, they become symptomatic. The most common symptom is painless, bright red bleeding. There are many theories for causes of symptomatic hemorrhoids. These include pregnancy, diet, straining due to constipation or weight lifting, and heredity.
Treatment of hemorrhoids is dictated by the severity of symptoms and how chronic they are. Most patients require nothing but reassurance and modification of diet. Ointments and suppositories may have a limited role in treatment, but are still widely used. If conservative treatment does not help with symptoms, other available options include rubberband ligation of hemorrhoids, or even surgery by a rectal surgeon in selected cases. In your case I would suggest using stool softeners like Colace. If you are constipated, I would also advise using Miralax powder mixed with water.
In patients who are over the age of 40 and have a family history of colon cancer, and other symptoms like changes in bowel habits, anemia, diarrhea or abdominal pain, I would recommend they undergo thorough evaluation including a colonoscopy.
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How To Treat Constipation
In most older adults with constipation, there are no red flags or signs of mechanical obstruction.
To treat these cases of garden-variety constipation, geriatricians usually use a step-wise approach:
- Identify and reduce constipating medications if possible.
- This might mean checking to see if iron is really indicated for anemia treatment
The American Society of Gastroenterology recommends more in-depth constipation evaluation for older adults who fail to improve from this type of first-round treatment. Some older adults do have pelvic floor disorders, which can be effectively treated through biofeedback.
Can Children Use Olive Oil
Babies and children with constipation should not take olive oil.
Instead, the American Academy of Pediatrics recommend a small amount of apple or pear juice, Karo syrup, or pureed prunes for infants.
Toddlers and older children may get relief with high-fiber foods such as prunes, apricots, and whole grain cereals.
If dietary changes do not help, children should see a doctor for additional treatment.
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I Have An Artificial Joint My Orthopedic Surgeon Said I Need
No. The American Society for Gastrointestinal Endoscopy, has concluded that antibiotic use for patients with artificial joints is not recommended.
If your surgeon advises you to take antibiotics anyway before and/or after the procedure, he or she may choose to provide you with a prescription for the medication of their choice.
Six Kinds Of Food Can Effectively Prevent Constipation
So, after we know the reasons why hemorrhoids cause constipation, we need to find the solution for the question of Can hemorrhoids cause constipation? How to solve the constipation so that we can prevent the hemorrhoids from burgeoning? This is a difficult assignment because if we prevent the hemorrhoids from forming successfully, then the chance of suffering constipation is less or rare for patients. So, we need to solve the problem of how to get rid of constipation firstly? Then we can get rid of hemorrhoids adversely. Lets begin with foods.
Constipation is shameful disease for many people, previously high incidence in the elderly, and now young people are also susceptible to such a disease.
After Japanese MSN Website interviewed some nutrition experts, the author pointed out that there are six categories of food that can effectively prevent constipation, patients can eat frequently.
Sesame, almonds and other foods that is rich in magnesium.
A joint study of Japan National Institute of Health Nutrition and Womens Nutrition University shows that people with low magnesium intake is easy to get constipation. Magnesium has a laxative function that can soften the feces. Adequate intake of magnesium will help purge. Magnesium-rich foods conclude peanuts, brown rice, walnuts, bananas and so on.
Pickles, fermented soy sauce and other foods that is rich in plant lactic acid bacteria.
Asparagus, onions and other foods that is rich in oligosaccharides.
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I Have Diagnosed Myself With Irritable Bowel Syndrome I Have Loose Runny Stools Several Times A Week And Sometimes I Have Abdominal Pain Too Is This Really Ibs
Irritable bowel syndrome is a functional gastrointestinal disorder characterized by chronic, recurrent abdominal pain or discomfort associated with disturbed bowel habits. Most patients with IBS continue to have symptoms for many years. Most population studies have shown prevalence of IBS in up to 15 percent of adults in the U.S. The cause of this disease is poorly understood, although it is probably what we like to call “multi-factorial,” because it likely involves visceral hypersensitivity and altered motility, immune activation, and stress response. Because IBS is known to cluster in families, there may be a genetic component as well.
This is one of the most difficult conditions to diagnose, even by specialists and experts. Therefore, it is not a good idea for you to diagnose this condition by yourself. There are several other diseases which may mimic irritable bowel syndrome. Most important of these conditions would be inflammatory bowel disease, celiac disease, endocrine disorders and cancer .Therefore, I would advise a thorough diagnostic work-up before labeling and treating yourself for irritable bowel syndrome.
How Common Are Hemorrhoids
Hemorrhoids are very common in both men and women. About half of the population have hemorrhoids by age 50. Hemorrhoids are also common among pregnant women. The pressure of the fetus in the abdomen, as well as hormonal changes, cause the hemorrhoidal vessels to enlarge. These vessels are also placed under severe pressure during childbirth. For most women, however, hemorrhoids caused by pregnancy are a temporary problem.
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Causes Of Hemorrhoids In Runners
So what causes hemorrhoids in runners?
The science is still divided as to what exactly causes hemorrhoids, but likely several factors are at work.
In the medical literature, hemorrhoids are linked with lingering constipation, straining during bowel movements, or extended sitting on the toilet. These may compromise blood flow to and from the area, causing swelling and inflammation in the veins.
As for runners, the most common cause of the condition might boil down to not having enough water. Chronic dehydration paves the way to constipation, which consists of hard stool that results in straining.
When you strain during a bowel movement, you place extra pressure on your hemorrhoids which, in turn, may irritate and inflame the tissue.
Other causes, according to research, include:
- Frequent diarrhea
Strain Less And Reduce Time On The Toilet
Straining on the toilet puts extra pressure on your hemorrhoids. Because hemorrhoids are protruded blood vessels, more pressure causes them to swell up and become primed for tears or irritation as a stool passes over them. Try a step stool to elevate your feet while sitting on the toilet this change in position of the rectum helps for easier passage of stools.
Likewise, its easy to become distracted by a book or your phone while in the bathroom, but you may actually be causing problems by sitting on the toilet for a long time. As you sit, blood pools into the veins in your anorectal area, causing further stretching of protruded blood vessels, or hemorrhoids. If the blood vessel gets too big, it could break and cause bleeding.
That said, dont delay bowel movements out of fear of straining or extended time on the toilet. Go to the bathroom when you feel the need, because delaying causes further harmful straining.
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