Two very common symptoms, constipation and diarrhea, are seen with many of the digestive system diseases. Often they are symptoms of a particular disease. However, both constipation and diarrhea can be problematic. Therefore, they are presented here.
Constipation is considered a symptom, not a disease. Constipation is different for every individual but is generally described by professionals when any two of the following symptoms exist for at least 12 weeks:
- Straining at the toilet
- Lumpy or hard stool
- Bloating or feeling of a full bowel
- Fewer than three bowel movements per week
When too much water is absorbed by the colon and/or an individual’s muscle contractions are sluggish, the stool hardens, becomes dry, and constipation likely results. Lack of exercise, some medications, insufficient fiber in the diet, laxative abuse, food allergies, cerebrovascular accident or stroke, IBS, pregnancy, and aging all are potential causes of constipation.
Signs and Symptoms
Clients often complain of bloating, abdominal discomfort, and fewer than three bowel movements per week.
A history and physical examination provide pertinent information for health professionals. A rectal examination to detect tenderness or obstruction is often sufficient for a diagnosis. Severe cases may require a colorectal transit study or anorectal function test. Internal obstruction can be viewed by barium enema x-ray, sigmoidoscopy, and colonoscopy.
Dietary and lifestyle changes usually relieve symptoms. A diet high in fiber is recommended, as is consumption of plenty of water and fruit juice or vegetable juice. For more serious or long-term cases, temporary use of laxatives, stool softeners, lubricants, and stimulants may be necessary.
Practitioners will advise clients to drink more water and fruit juice (not caffeine or alcohol, which tends to dry out the colon), eat a handful of prunes a day, eat an apple a day, and increase fiber in the diet. The dietary supplement acidophilus may help rebuild intestinal flora and aid in digestion.
Clients, especially older adults, can be embarrassed and sensitive about discussing their bowel habits. Help clients understand the importance of reporting any over-the-counter or home remedies to their primary care provider. Refer clients to a dietitian if diet modification is recommended.
Prognosis is generally good, but constipation can cause hemorrhoids.
The best prevention for constipation is to follow the dietary suggestions indicated. Advise clients to allow specific time after meals for undisturbed toilet visits and not to ignore the urge to have a bowel movement.
Diarrhea is the frequent passage of feces, with an accompanying increase in fluidity and volume. Diarrhea is not a disease; it is, rather, a symptom of another underlying condition. “Normal” bowel habits vary widely; consequently, what is considered diarrhea in some individuals may be normal in others. This disorder is stressful and embarrassing, especially if the individual is unable to get to a bathroom quickly enough.
Diarrhea is the result of an abrupt increase in intestinal motility. The highly liquid content of the small intestine is rushed through the colon without sufficient time for fluid reabsorption, resulting in the watery stools characteristic of diarrhea. Numerous diseases and conditions can cause such an increase in intestinal motility. Childhood diarrhea may be an inflammatory process of infectious origin or a toxic reaction to dietary indiscretions. Adult diarrhea may result from malabsorption syndrome, gastritis, lactose intolerance, IBS, Crohn disease, ulcerative colitis, GI tumors, diverticular disease, viral and bacterial infections of the intestine, parasitic infections, psychogenic disorders, food allergies, and a variety of medications.
Signs and Symptoms
The diarrhea may vary in fluidity and volume. It may be accompanied by flatulence, abdominal distension, fever, headache, anorexia, vomiting, malaise, and cramping.
The clinical history of the diarrhea involves determining whether its onset was abrupt or gradual and whether it is acute or chronic. To help determine underlying causes, bacterial cultures and microscopic examination of the stool may be performed. Additional tests include proctoscopy, radiological studies, and tests for occult blood.
Treatment goals in clients with diarrhea include relief of symptoms and correction of underlying disorders. Clear liquids may be prescribed for children.
Identify any food allergies and replace fluids, mineral, and vitamin losses in clients with diarrhea.
Caution clients that while the disorder may be selflimiting, medical attention should be sought if diarrhea does not resolve in a few days.
The prognosis of diarrhea depends on the cause. Possible complications include dehydration and electrolyte imbalance. Severe childhood diarrhea may require hospitalization.
Cases of diarrhea due to infectious agents can often be prevented by following proper hygiene and sanitation procedures. Cases due to allergic reactions can be prevented by avoiding known allergens.