{"id":5352,"date":"2025-12-08T17:12:09","date_gmt":"2025-12-08T22:12:09","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&#038;p=5352"},"modified":"2026-01-12T18:38:38","modified_gmt":"2026-01-12T23:38:38","slug":"constipation","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/constipation\/","title":{"raw":"10p5 Constipation","rendered":"10p5 Constipation"},"content":{"raw":"<strong>Constipation and Its Complications<\/strong>\r\n<h1><strong>Overview<\/strong><\/h1>\r\n<ul>\r\n \t<li>The\u00a0<strong>opposite of diarrhea<\/strong>; characterized by infrequent, hard, dry stools.<\/li>\r\n \t<li>Can be\u00a0<strong>acute<\/strong>\u00a0or\u00a0<strong>chronic<\/strong>.<\/li>\r\n \t<li>Causes\u00a0<strong>abdominal distension and pain<\/strong>.<\/li>\r\n \t<li>Important to address to prevent complications like\u00a0<strong>obstructions<\/strong>\u00a0or\u00a0<strong>ruptures<\/strong>.<\/li>\r\n<\/ul>\r\n<h1><strong>Causes of Constipation<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Decreased peristalsis<\/strong>:\r\n<ul>\r\n \t<li>Slowed movement of food through the GI tract.<\/li>\r\n \t<li>Leads to\u00a0<strong>more water reabsorption<\/strong>.<\/li>\r\n \t<li>Results in\u00a0<strong>hard, dry stools<\/strong>\u00a0that are difficult to pass.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Alternating diarrhea and constipation<\/strong>:\r\n<ul>\r\n \t<li>Periods of rapid transit followed by slow peristalsis.<\/li>\r\n \t<li>Can lead to\u00a0<strong>hard stools<\/strong>\u00a0after diarrhea.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Factors contributing to Acute or Chronic Constipation:<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Aging<\/strong>:\r\n<ul>\r\n \t<li><strong>Weaker smooth muscle<\/strong>\u00a0in the intestines.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Diet<\/strong>:\r\n<ul>\r\n \t<li>Inadequate\u00a0<strong>fiber<\/strong>\u00a0intake.<\/li>\r\n \t<li>Insufficient\u00a0<strong>fluid intake<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Reduced physical activity<\/strong>:\r\n<ul>\r\n \t<li>Muscle atrophy and decreased neural signaling.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Immobility<\/strong>:\r\n<ul>\r\n \t<li>Prolonged bedrest reduces muscle activity.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Delayed defecation<\/strong>:\r\n<ul>\r\n \t<li>Ignoring the urge to go.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Neurological issues<\/strong>:\r\n<ul>\r\n \t<li>Failure to respond to the\u00a0<strong>defecation reflex<\/strong>.<\/li>\r\n \t<li>Damage to\u00a0<strong>neural pathways<\/strong> controlling muscles involved in peristalsis.<\/li>\r\n \t<li>Conditions like\u00a0<strong>multiple sclerosis<\/strong>\u00a0or\u00a0<strong>spinal cord injury<\/strong>\u00a0impair neuronal signaling.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Medications<\/strong>:\r\n<ul>\r\n \t<li><strong>Opiates<\/strong> depress neural activity and peristalsis.<\/li>\r\n \t<li><strong>Anticholinergics<\/strong> reduce peristalsis<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<strong>Anticholinergics<\/strong>\r\n<ul>\r\n \t<li>Block\u00a0<strong>acetylcholine<\/strong>, a key neurotransmitter of\u00a0<strong>parasympathetic (rest and digest)<\/strong>.<\/li>\r\n \t<li><strong>Effect:<\/strong>\u00a0Suppress\u00a0<strong>parasympathetic activity<\/strong>, leading to\u00a0<strong>decreased peristalsis<\/strong>.<\/li>\r\n \t<li>Result:\u00a0<strong>Stagnant<\/strong>\u00a0contents in the intestines with increased resorption time, contributing to\u00a0<strong>constipation<\/strong>.<\/li>\r\n<\/ul>\r\n<strong>Other Factors Contributing to Constipation<\/strong>\r\n<ul>\r\n \t<li><strong>Antacids<\/strong>\u00a0and\u00a0<strong>iron medications<\/strong>:\r\n<ul>\r\n \t<li>Commonly cause constipation if fluid intake isn't increased.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Laxatives<\/strong>:\r\n<ul>\r\n \t<li>Overuse without adequate hydration can worsen constipation or cause dependency.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Obstructions<\/strong>:\r\n<ul>\r\n \t<li>Tumors or strictures (narrowing of the GI tract) impede material passage.<\/li>\r\n \t<li><strong>Scarring<\/strong>\u00a0from previous surgeries or inflammation can cause\u00a0<strong>strictures<\/strong>.\r\n<ul>\r\n \t<li>These blockages cause material to\u00a0<strong>hang out<\/strong>\u00a0longer in the intestines, increasing absorption of water and leading to harder stools.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Structural Complications<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Hemorrhoids<\/strong>:\r\n<ul>\r\n \t<li>Swollen veins caused by\u00a0<strong>chronic irritation and straining<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Fissures<\/strong>:\r\n<ul>\r\n \t<li>Small\u00a0<strong>wounds<\/strong>\u00a0or tears in the anal canal caused by hard stools.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Diverticulitis<\/strong>:\r\n<ul>\r\n \t<li><strong>Inflammation of diverticula<\/strong>\u00a0(small outpouchings of the colon wall).<\/li>\r\n \t<li><strong>Diverticulosis<\/strong>: presence of diverticula without inflammation.<\/li>\r\n \t<li><strong>Diverticulitis<\/strong>\u00a0develops if diverticula become infected or irritated.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h1><strong>Prevention and Management<\/strong><\/h1>\r\n<ul>\r\n \t<li><strong>Prompt bathroom habits<\/strong>:\r\n<ul>\r\n \t<li>Respond to the urge to prevent stool hardening.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Maintain a high-fiber diet<\/strong>.<\/li>\r\n \t<li><strong>Stay hydrated<\/strong>.<\/li>\r\n \t<li><strong>Stay active<\/strong>:\r\n<ul>\r\n \t<li>Exercise promotes normal bowel movements.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><strong>Address underlying neurological or muscular causes<\/strong>.<\/li>\r\n \t<li><strong>Seek medical attention<\/strong>\u00a0if persistent or complicated.<\/li>\r\n<\/ul>\r\n<h1><strong>Summary<\/strong><\/h1>\r\n<ul>\r\n \t<li>Constipation is caused by slowed or ineffective peristalsis.<\/li>\r\n \t<li>It can lead to\u00a0<strong>hemorrhoids, fissures, diverticulitis<\/strong>, and\u00a0<strong>bowel obstruction<\/strong>.<\/li>\r\n \t<li>Lifestyle modifications and medical interventions are key to prevention and treatment.<\/li>\r\n<\/ul>\r\n&nbsp;\r\n<ul>\r\n \t<li>Medications that block parasympathetic activity, like anticholinergics, can lead to or worsen constipation.<\/li>\r\n \t<li>Non-drug factors like medication side effects, obstructions, and strictures also contribute to difficulty passing stool.<\/li>\r\n \t<li>Proper hydration and addressing underlying causes are essential for managing constipation.<\/li>\r\n<\/ul>","rendered":"<p><strong>Constipation and Its Complications<\/strong><\/p>\n<h1><strong>Overview<\/strong><\/h1>\n<ul>\n<li>The\u00a0<strong>opposite of diarrhea<\/strong>; characterized by infrequent, hard, dry stools.<\/li>\n<li>Can be\u00a0<strong>acute<\/strong>\u00a0or\u00a0<strong>chronic<\/strong>.<\/li>\n<li>Causes\u00a0<strong>abdominal distension and pain<\/strong>.<\/li>\n<li>Important to address to prevent complications like\u00a0<strong>obstructions<\/strong>\u00a0or\u00a0<strong>ruptures<\/strong>.<\/li>\n<\/ul>\n<h1><strong>Causes of Constipation<\/strong><\/h1>\n<ul>\n<li><strong>Decreased peristalsis<\/strong>:\n<ul>\n<li>Slowed movement of food through the GI tract.<\/li>\n<li>Leads to\u00a0<strong>more water reabsorption<\/strong>.<\/li>\n<li>Results in\u00a0<strong>hard, dry stools<\/strong>\u00a0that are difficult to pass.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Alternating diarrhea and constipation<\/strong>:\n<ul>\n<li>Periods of rapid transit followed by slow peristalsis.<\/li>\n<li>Can lead to\u00a0<strong>hard stools<\/strong>\u00a0after diarrhea.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Factors contributing to Acute or Chronic Constipation:<\/strong><\/h1>\n<ul>\n<li><strong>Aging<\/strong>:\n<ul>\n<li><strong>Weaker smooth muscle<\/strong>\u00a0in the intestines.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Diet<\/strong>:\n<ul>\n<li>Inadequate\u00a0<strong>fiber<\/strong>\u00a0intake.<\/li>\n<li>Insufficient\u00a0<strong>fluid intake<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Reduced physical activity<\/strong>:\n<ul>\n<li>Muscle atrophy and decreased neural signaling.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Immobility<\/strong>:\n<ul>\n<li>Prolonged bedrest reduces muscle activity.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Delayed defecation<\/strong>:\n<ul>\n<li>Ignoring the urge to go.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Neurological issues<\/strong>:\n<ul>\n<li>Failure to respond to the\u00a0<strong>defecation reflex<\/strong>.<\/li>\n<li>Damage to\u00a0<strong>neural pathways<\/strong> controlling muscles involved in peristalsis.<\/li>\n<li>Conditions like\u00a0<strong>multiple sclerosis<\/strong>\u00a0or\u00a0<strong>spinal cord injury<\/strong>\u00a0impair neuronal signaling.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Medications<\/strong>:\n<ul>\n<li><strong>Opiates<\/strong> depress neural activity and peristalsis.<\/li>\n<li><strong>Anticholinergics<\/strong> reduce peristalsis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Anticholinergics<\/strong><\/p>\n<ul>\n<li>Block\u00a0<strong>acetylcholine<\/strong>, a key neurotransmitter of\u00a0<strong>parasympathetic (rest and digest)<\/strong>.<\/li>\n<li><strong>Effect:<\/strong>\u00a0Suppress\u00a0<strong>parasympathetic activity<\/strong>, leading to\u00a0<strong>decreased peristalsis<\/strong>.<\/li>\n<li>Result:\u00a0<strong>Stagnant<\/strong>\u00a0contents in the intestines with increased resorption time, contributing to\u00a0<strong>constipation<\/strong>.<\/li>\n<\/ul>\n<p><strong>Other Factors Contributing to Constipation<\/strong><\/p>\n<ul>\n<li><strong>Antacids<\/strong>\u00a0and\u00a0<strong>iron medications<\/strong>:\n<ul>\n<li>Commonly cause constipation if fluid intake isn&#8217;t increased.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Laxatives<\/strong>:\n<ul>\n<li>Overuse without adequate hydration can worsen constipation or cause dependency.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Obstructions<\/strong>:\n<ul>\n<li>Tumors or strictures (narrowing of the GI tract) impede material passage.<\/li>\n<li><strong>Scarring<\/strong>\u00a0from previous surgeries or inflammation can cause\u00a0<strong>strictures<\/strong>.\n<ul>\n<li>These blockages cause material to\u00a0<strong>hang out<\/strong>\u00a0longer in the intestines, increasing absorption of water and leading to harder stools.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Structural Complications<\/strong><\/h1>\n<ul>\n<li><strong>Hemorrhoids<\/strong>:\n<ul>\n<li>Swollen veins caused by\u00a0<strong>chronic irritation and straining<\/strong>.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Fissures<\/strong>:\n<ul>\n<li>Small\u00a0<strong>wounds<\/strong>\u00a0or tears in the anal canal caused by hard stools.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Diverticulitis<\/strong>:\n<ul>\n<li><strong>Inflammation of diverticula<\/strong>\u00a0(small outpouchings of the colon wall).<\/li>\n<li><strong>Diverticulosis<\/strong>: presence of diverticula without inflammation.<\/li>\n<li><strong>Diverticulitis<\/strong>\u00a0develops if diverticula become infected or irritated.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h1><strong>Prevention and Management<\/strong><\/h1>\n<ul>\n<li><strong>Prompt bathroom habits<\/strong>:\n<ul>\n<li>Respond to the urge to prevent stool hardening.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Maintain a high-fiber diet<\/strong>.<\/li>\n<li><strong>Stay hydrated<\/strong>.<\/li>\n<li><strong>Stay active<\/strong>:\n<ul>\n<li>Exercise promotes normal bowel movements.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Address underlying neurological or muscular causes<\/strong>.<\/li>\n<li><strong>Seek medical attention<\/strong>\u00a0if persistent or complicated.<\/li>\n<\/ul>\n<h1><strong>Summary<\/strong><\/h1>\n<ul>\n<li>Constipation is caused by slowed or ineffective peristalsis.<\/li>\n<li>It can lead to\u00a0<strong>hemorrhoids, fissures, diverticulitis<\/strong>, and\u00a0<strong>bowel obstruction<\/strong>.<\/li>\n<li>Lifestyle modifications and medical interventions are key to prevention and treatment.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ul>\n<li>Medications that block parasympathetic activity, like anticholinergics, can lead to or worsen constipation.<\/li>\n<li>Non-drug factors like medication side effects, obstructions, and strictures also contribute to difficulty passing stool.<\/li>\n<li>Proper hydration and addressing underlying causes are essential for managing constipation.<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":8,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5352","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":67,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5352","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":4,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5352\/revisions"}],"predecessor-version":[{"id":5357,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5352\/revisions\/5357"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/67"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5352\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5352"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5352"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5352"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5352"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}