Cancer Vijay

Stop suffering in silence as cure is easy for most.

Time and again   we suffer in silence because what concerns us seems to be too sensitive to talk.    We want to   treat symptoms on our own or simply ignore them until it’s too late. I agree that it is a sensitive topic, but it may lead to severe pain, bleeding and other complications.

Visiting the restroom is part of daily life. Don't feel embarrassed about discussing.

Constipation is one of the most common bowel problems. A condition that causes significant pain and discomfort and affects the quality of life

It affects people of all ages

Passing stools becomes more difficult and less frequent

  A condition, that causes a backup in our digestive system. In some, it may be uncomfortable.  The food that we eat can take several days to exit our body. 

  -not passing stools regularly or 

  -unable to completely empty bowel. 

 -can also cause your stools to be hard and lumpy, 

-as well as unusually large or small.

The severity of constipation 

- varies from person to person. 

 - for a short time, 

-but for others, constipation can be a long-term (chronic) 

.

 

 

What's behind this unsettling phenomenon? 

Factors

Can occur to anyone at any age -  babies, children, and adults anyone.

Affects twice as many women as men 

More common in older adults and also during pregnancy.

 

Difficult to identify the exact cause 

Things that contribute to the condition are as follow

·        type of diet, 

not eating enough fiber, such as fruit, vegetables, and cereals

·        genetic predisposition, 

·        colonic motility, 

·        absorption, 

·        Social-economic status, 

·        daily behaviors 

not drinking enough fluids 

a change in your routine, lifestyle, eating habits

ignoring the urge to pass stools

anxiety or depression

·        pharmaceutical factors

side effects of certain medications

·        biological 

Diagnostic and therapeutic options have a key role.

  Debates still continue about the timing of diagnostic and therapeutic algorithms.

In children, poor diet, fear about using the toilet, and problems toilet training can all lead to constipation.

 

You may be able to treat constipation yourself by making simple changes to your diet and lifestyle  If these changes don't help and the problem continues, you should see your Doctor

Also, speak to your doctor if you think your child might be constipated.

 

Treatment

First treatment 

1 Diet and lifestyle changes.

           2 Increasing your daily intake of fiber, 

          3 Drink plenty of fluids, 

         4 More exercise.

Most of the time this will work.

If these don't work, you need to visit your doctor.

Treatment  is generally effective, 

But in some cases, it can take several months.

 .

Prevention

Easy and very effective

 1 diet and lifestyle changes 

2 Giving yourself enough time and privacy to pass stools comfortably 

  3 not to ignore the urge to go to the toilet.

 

Complications

·        hemorrhoids (piles)

·        Prolapsed Hemorrhoids

·        Perianal Hematoma

·        fecal impaction ( dry, hard stools in the rectum)

·        bowel incontinence ( leakage of liquid stools)

 .

 

 

Normal bowel habits 

-vary from person to person. 

Some  go to the toilet more than once a day, 

 others may only go every 3 or 4 days

.  some infants pass stools several times a day, others pass a few times a week.

 Symptoms

- more difficult to pass stools

 - unable to empty your bowel completely. 

-stools may appear dry, hard and lumpy, 

- abnormally large or small.

Other symptoms of constipation can include:

·        loss of appetite

·        Pain in the abdomen

·        feeling bloated

·        feeling sick

  children

- infrequent or irregular bowel movements, 

·        feeling unwell 

·         irritable, angry or unhappy

·        loss of appetite

·        a lack of energy

·        foul-smelling wind and stools

·        stomach pain and discomfort

·        soiling their clothes

·         

When to Visit your Doctor

If you are unable to treat constipation yourself by making simple changes to your diet and lifestyle. 

  if you notice any rectal bleeding, unexplained weight loss or persistent tiredness or other symptoms.

Causes 

it may be difficult to identify the exact cause. 

 several factors can increase chances 

the common reason for Constipation is when stools remain in the colon (large intestine) for too long, become hard and dry due to colon get more time to absorb too much water from the stools.

Most cases of constipation aren't caused by a specific condition and, including:

·        Low fiber diets, such as fruit, vegetables, and cereals

·        a change in - routine or lifestyle 

·         limited privacy when using the toilet

·        ignoring the urge to pass stools

·        lack of exercise

·        immobility 

·        not drinking enough fluids

·         fever other diseases

·        being underweight or overweight

·        anxiety or depression

·        psychiatric problems, 

Medication

  medication that can cause constipation include:

·        aluminum antacids )

·        antidepressants 

·        antiepileptics 

·        antipsychotics 

·        calcium supplements

·        opiate painkillers, such as codeine and morphine

·        diuretics  

·         Hematinic

 

Pregnancy

  constipation during pregnancy is very common, may cost a lot later on during pregnancy or after delivery.

 By a process known as peristalsis, the bowel moves stools and waste products to the anus.  In pregnancy, the body produces more of the female hormone progesterone, which is a muscle relaxant and weight and position of gravid uterus pressure on the large intestine.

  Pregnant women need to treat constipation safely without harming either baby or women. baby. 

Common causes

·        anal fissure  

·        underactive thyroid gland (hypothyroidism )

·        bowel cancer

·        irritable bowel syndrome (IBS)

·        diabetes

 

Rare causes

·        hypercalcemia 

·        muscular dystrophy 

·        multiple sclerosis – 

·        Parkinson's disease – 

·        spinal cord injury

·        inflammatory bowel disease 

·        Hirschsprung's disease

·        Cystic fibrosis

·        anorectal malformation

Babies and children

Constipation in babies and children is quite common.  Poor diet, fear about using the toilet, and poor toilet training can all be responsible.

Poor diet

  over-fed 

who don't get enough fluids

  too much milk 

Not enough fiber in their diet.

Toilet training

  Don’t make your child feel stressed or pressured about using the toilet.

   When appropriate try things by themselves 

Do not constantly intervene when they're using the toilet 

Toilet habits

  may have a phobia about using the toilet, or feel they are unable to use the toilets at school.

This fear may be maybe due to pain when passing stools. 

 children ignore the urge to pass stools 

withhold them for fear of experiencing pain and discomfort which leads to from bad to worst. 

·         

Diagnosing constipation

  usually need to carry out any tests or procedures, - confirm a diagnosis based on your symptoms and medical history.

 

  Defining constipation in a number of ways:

·        opening the bowels less than 3 times a week

·        needing to strain to open your bowels on more than a quarter of occasions

·        passing a hard or pellet-like stool on more than a quarter of occasions

Physical examination

  carries out a rectal examination using a lubricated, gloved finger. .

Test

Sonography abdomen

X-ray abdomen standing view

Sigmoidoscopy / Colonoscopy

MRI Pelvic/ CT Scan

anorectal manometry

.

Treating constipation

Lifestyle advice

 

·        Increase daily intake of fiber.

·          bulking agents, such as wheat bran 

·          drinking plenty of water.

·        Exercise more regularly.

·.

·        Fix a place and time for the toilet. 

·        when you feel the urge, don't delay.

·          resting your feet on a low stool while going to the toilet, 

 

Types of Drugs 

Bulk-forming laxatives

  ispaghula husk, 

methylcellulose and 

sterculia. 

, you must drink plenty of fluids with it.

Osmotic laxatives 

lactulose and macrogols. 

you must drink plenty of fluids with it

Stimulant laxatives

  senna, bisacodyl, and sodium picosulphate. 

on a short-term basis, 

How long will I need to take laxatives?

Generally, stop taking the laxative once your stools are soft and easily passed.

If underlying medical condition may have to take laxatives for much longer, maybe many months or even years.

  have to gradually reduce your dose

prescribed a combination of laxatives- reduce the dosage of each laxative, one at a time, before you can stop taking them. 

This can take several months.

 . 

Fecal impaction

  occurs when stools become hard and dry and collect in the rectum and obstruct it., 

making it more difficult for stools to pass along.

  as a result of impaction, overflow diarrhea  may occur-  loose stools leak - may have difficulty controlling 

 

·         

Pregnancy or breastfeeding

 

If dietary and lifestyle changes don't work, 

 a laxative may be needed to help you pass stools more regularly.

Lots of laxatives are safe for pregnant women.

Laxatives that are safe to use during pregnancy are osmotic laxatives lactulose and macrogols. 

Babies who haven't been weaned

  give them extra water between their normal feeds 

Babies who are eating solids

If the baby is eating solid foods, give them plenty of water or diluted fruit juice and fruits. 

·        apples

·        apricots

·        grapes

·        peaches

·        pears

·        plums

·        prunes

·        raspberries

·        strawberries

Never force to eat food if they don't want to. 

Children

 A diet which also contains fruits, vegetables, and wholegrain foods, 

 Be positive and encouraging when it comes to establishing a toilet routine 

Complications of constipation

 

Rectal bleeding

  can cause pain, discomfort, and rectal bleeding.

  small tear around the anus (anal fissure), 

Hemorrhoids/Piles .

  can also cause pain, itching around the anus, and swelling of the anus.

  often settle down after a few days without treatment. However, creams and ointments are available to reduce any itching or discomfort

Fecal impaction

Long-term constipation can increase the risk of fecal impaction, which is where dried, hard stools collect in your rectum and anus.

Once you have fecal impaction, it's very unlikely that you'll be able to get rid of the stools naturally.

Fecal impaction makes constipation worse because it's harder for stools and waste products to pass out of your anus, as the path is obstructed.

Fecal impaction can sometimes lead to a number of other complications, including:

·        swelling of the rectum

·        a loss of sensation in and around your anus

·     Incontinence

·        bleeding from your anus

·     Rectal Prolapse – were part of your lower intestine falls out of place and protrudes from your anus (this can also, occur as a result of repeated straining in people with chronic constipation)

Fecal impaction is usually treated with laxative medication, although suppositories (medication inserted into the anus) and mini enemas (were medicine in the fluid form is injected through your anus) may sometimes be used.

Preventing constipation

There are a number of things you can do to prevent constipation, including making diet and lifestyle changes.

Fiber

Including enough the fibre in your diet can significantly reduce your chances of developing constipation. Most adults don't eat enough fiber.

You should aim to have about 30g of fiber a day. You can increase your fiber intake by eating more:

·        fruit and vegetables

·        wholegrain rice

·        wholewheat pasta

·        wholemeal bread

·        seeds and oats

Eating more fiber will keep your bowel movements regular because it helps food pass through your digestive system more easily. Foods high in fiber also make you feel fuller for longer.

It's important to increase your fiber intake gradually, because a sudden increase may make you feel bloated. Suddenly increasing your intake of fiber may also cause you to produce more wind  and experience stomach cramps.

Read more about how to increase your intake of fiber  

Fluids

Make sure you drink plenty of fluids   a

 cut back on the amount of caffeine, alcohol, and  drinks  

Never ignore the urge to go to the toile 

When going to the toilet, make sure you have enough time and privacy to pass stools comfortably.

Exercise

Keeping active and mobile will greatly reduce your risk of getting constipation. You should do at least 150 minutes of physical activity every week.

 

   the medical definition of constipation 

Fewer than three bowel movements per week

Straining to start or complete a bowel movement

Stool the consistency that looks like rocks and pebbles

A feeling of incomplete emptying

 

Causes 

Slow transit: 

Nerve signaling problems: 

Pelvic floor dysfunction.