When a person does not have a motion of the bowels as frequently as is natural to him, the condition is called constipation. This may occur temporarily from various causes, the bowels returning to their proper condition after a few days, or it may become a habit. In the latter case the condition is termed costiveness. Constipation generally occurs after acute illnesses; also as a reaction after the use of purgatives; from irregularities in diet, or from want of proper attention to the calls of nature. Certain articles of food produce constipation in some individuals, whilst others are not affected by them. Occasionally it is due to disease of malformation of the bowels. When it occurs after acute illness it is generally due to loss of power of the bowel itself, and disappears when the strength is restored.
Many persons imagine themselves constipated when they are not.
It is not necessary for every one to have a motion of the bowels daily. Some people can go two, or even three or more days, without any desire for a motion. If the action takes place without discomfort, and the delay causes no other symptoms, such as headache, there is no occasion for the least anxiety. Indeed, patients who are habitually costive may console themselves with the reflection that the condition is much better than its opposite –chronic looseness of the bowels–and that costive persons are usually long livers.
But when constipation or costiveness is attended with pain, or difficulty in evacuating the bowels, it may be enough to make life a burden, and something must be done. The usual thing is for the patient to resort to purgatives, and this is the worst thing to do. The usual result of this is to give present relief at the expense of aggravating the condition.
Obstruction of the Bowels is the extreme stage of constipation. In this there is a blocking of the bowel by hardened faeces, which cannot be passed by the bowel, which is in the state of paralysis. If purgatives are given in this state the general result is to irritate the bowel, and cause irregular contractions, which may cause one part of the bowel to slip into another part (intussusception), and this, if not speedily relieved, ends in gangrene. Obstruction is not nearly so common as is imagined; many people who suffer from very sluggish bowels consider they have obstruction, when there is really no blocking of the bowels, but only inactivity.
General Treatment.–Much may be done in the way of restoring to the bowels their natural function by exercise and diet. The use of whole meal bread in place of white bread (which often contains alum, a possible cause of constipation), dried fruits, such as figs, prunes, Carlsbad plums, and ripe fruits, fresh and cooked, should be tried.
Stewed rhubarb is often efficient. Meat must be taken moderately, not oftener than once a day, and a liberal supply of vegetables. Alcohol in all forms should be avoided. Strong tea should not be taken. The substitution of coffee for tea at breakfast will often assist the bowels to act.
Among other remedial measures may be mentioned the use of a cold water compress placed on the body at night; drinking a glass of cold (or hot) water on rising and going to bed, and the use of the enema or injection. For this plain water, thin, gruel, barley- water, or milk, should be used, warm or cold; warm, when the enema is given to produce an immediate relief; cold, when it is given to strengthen the lower bowel. In the latter case it should be given at bedtime, and water should be used quite cold, and retained if possible. Another useful domestic remedy may be mentioned, and it is especially useful where constipation is complicated with piles. Put a tablespoonful of coarse black treacle (golden syrup will not do) into a tumbler of cold water over night. In the morning stir it and drink by sips whilst dressing. This will often induce an action of bowels. The following is also useful at times: Take a teaspoonful of linseed (which has been carefully washed) and a tablespoonful of wheaten bran. Mix. Add half a pint of boiling water and boil in a pannikin for a few minutes to thicken. Pour off the clear. Add sugar to taste and take the whole at bedtime, warm.
Medicines.–(Two or three times a day.)
Opium 3.– An inclination to evacuate but feeling as if the orifice were closed; no regular pressure; sensation as if a load on abdomen; heavy drowsy feeling; dry mouth, thirst, want of appetite. Stool hard round black balls like marbles.
Nux vomica 3.– In sedentary persons and those accustomed to drink spirits. Bad taste in the mouth, want of appetite, especially in the morning, slimy tongue, irritability, headache; frequent urging, little or nothing passes.
Puls 3.– After taking rich or fat food; with moroseness and taciturnity.
With indigestion, weight at stomach after food and pain between shoulders;patient irritable, feels chilly, subject to rheumatism. Stool hard, large, light-coloured, and dry.
Constipation with sadness, complete loss of appetite. When there is much flatulence and gravelly urine.
Constipation of hard round balls; colic; abdomen drawn in; also constipation of children with large bellies in mesenteric disease.
Aesculus hip. 3.– Constipation of hard round balls, backache aggravated by walking.
Natrum mur. 6.– Constipation in chilly subjects; earthy complexion; feeling of contraction at the anus; and as if something were lodged in the rectum (lower bowel).
Frequent disposition to go to stool with ineffectual efforts. Sinking sensation at stomach, hot flushes, and fainty spells. See also Piles.