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What is constipation?

Constipation is a common digestive problem characterized by difficulty passing stool or infrequent bowel movements. Generally, having fewer than three bowel movements per week is considered to be a sign of constipation. In addition to this, the stools may be dry, hard, or lumpy, making them difficult or painful to pass. One may also experience a feeling of incomplete evacuation or the sensation that the bowel movement is not entirely over. Constipation can be caused by a variety of factors, including a low-fiber diet, inadequate water intake, lack of physical activity, and certain medications. While it is a typically a minor health issue, untreated constipation can lead to more severe complications such as hemorrhoids, anal fissures, and rectal prolapse. Fortunately, constipation can usually be prevented or treated by making dietary and lifestyle changes, or by taking over-the-counter medications.

Signs and symptoms of constipation

• Infrequent bowel movements (less than three times per week)
• Straining during bowel movements
• Abdominal pain and discomfort
• Bloating and gas
• Nausea
• Loss of appetite
• Feeling tired or sluggish
• Rectal bleeding or small tears in the anus (due to straining during bowel movements)
• Hemorrhoids (swollen and inflamed veins in the anus and lower rectum)

Causes of constipation

• Slow movement of stool through the colon, which can cause excessive absorption of water and hardening of stool
• Lack of dietary fiber or inadequate intake of water, which can make stool hard and difficult to pass
• Inactivity or lack of exercise, which can slow down the digestive system and make bowel movements infrequent
• Ignoring the urge to have a bowel movement, which can lead to stool remaining in the colon and becoming harder and drier over time
• Certain medications such as painkillers, antacids, and antidepressants can cause constipation as a side effect
• Medical conditions such as irritable bowel syndrome, hypothyroidism, and neurological disorders can cause constipation as a symptom.

Complications

• Hemorrhoids : Straining during bowel movements can cause hemorrhoids, which are swollen veins in the rectum or anus.
• Anal fissures : Passing hard, dry stools can cause small tears in the lining of the anus, which can be painful and may cause bleeding.
• Rectal prolapse : Chronic straining during bowel movements can weaken the muscles and lead to the rectum protruding from the anus.
• Fecal impaction : In severe cases, constipation can lead to fecal impaction, which is a large, hard mass of stool that cannot be passed without medical intervention.
• Bowel obstruction : Rarely, constipation can cause a blockage in the intestine that requires emergency medical treatment. Symptoms of a bowel obstruction include severe abdominal pain, vomiting, and inability to pass gas or stool.

How is constipation diagnosed?

Constipation can be diagnosed by healthcare providers through several methods, including :

• Medical and family history : Your healthcare provider may ask about any previous surgeries or medical conditions related to your digestive system. They may also inquire about a family history of chronic constipation.
• Physical exam : This will involve assessing your vital signs such as heart rate, blood pressure, and temperature. Your provider may also listen to your abdomen using a stethoscope and conduct a rectal examination.
• Endoscopic examinations : Your doctor may recommend endoscopic procedures to examine your anus, rectum, and colon to identify any structural abnormalities that may be causing constipation.
• Bowel function tests : Additional tests such as defecography, which measures how well you can hold and release stool, and anorectal manometry, which measures how well your sphincter muscles function, may also be recommended by your healthcare provider.

Who is more prone to constipation?

• Women, particularly during pregnancy or after childbirth, are more prone to constipation due to hormonal changes and pressure on the rectum and intestines from the growing uterus.
• People who consume a low-fiber diet, such as processed and fast foods, are more susceptible to constipation as fiber helps to add bulk to the stool, making it easier to pass.
• Certain medications or dietary supplements, such as painkillers, antacids, iron supplements, and diuretics, can lead to constipation as they can slow down the digestive process.
• People with specific health problems, such as functional gastrointestinal disorders, neurological disorders, or metabolic disorders, are more likely to experience constipation due to nerve or muscle damage, hormonal imbalances, or other underlying medical conditions.

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Healing Hands Clinic boasts the highest number of successful STARR Surgery cases in Asia, performed by Dr. Ashwin Porwal, who was the first surgeon to introduce this surgery in Maharashtra and one of the first few in India. He has also undergone training under the supervision of Dr. Longo himself.

The clinic has presented papers on STARR Surgery at numerous national and international conferences, highlighting their expertise in this procedure. Their abstract on 'Obstructed Deflection Syndrome cured with STARR Procedure: A case series of 100 consecutive patients' was published in Colorectal Disease, the official journal of the Association of Coloproctology of Great Britain and Ireland, European Society of Coloproctology - Volume 15, Supplements 3, Oct 2013. With their extensive experience and expertise, Healing Hands Clinic offers the best STARR Surgery services in the region.