Patho-Physiology:
Colonic mutility studies by radiologic and manometeric methods indicate two major motor disturbances leading to constipation: spasticity on the one hand and atonicity on the other. Spastic constipation, seen for exampler in irritable bowel syndrome, is often associated with hard, pellet like stools (Beeson, McDermott, Wyngaarden, 1480).
Causes of Constipation:
The most common form of constipation, imaginary constipation, is based on public misconception, often enhanced by media advertisements extolling the virtues of “regularity”, implying that a specified number of movements (usually one a day) represents the rigid limits of normal. This can lead to a secondary form of constipation resulting from abuse of laxative to achieve this imaginary goal. Constipation may also result from neurotic fastidiousness with avoidance of public toilet facilities. Constipation also may result from mechanical obstruction of the intestine (Beeson, McDermott, Wyngaarden, 1480).
Diagnosis:
Primary local symptoms of constipation are those of the infrequent painful passage of hard stools. With excessive retention and abdominal distention, cramping pain may ensue. Complaints of headaches, lethargy, and anorexia may be elicited. Fever is sometimes reported after extremely long periods of retention, especially in children (Beeson, McDermott, Wyngaarden, 1481).
Treatment:
Treatment is directed toward eradicating the underlying cause whenever this is known. Symptomatic therapy is used as an adjunct to specific therapy or as primary therapy when the cause is not apparent or is not amenable to specific therapy (Beeson, McDermott, Wyngaarden, 1481).
Medication:
Laxatives or cathartic medication should be avoided whenever possible and, when needed, used in the smallest doses possible as infrequently as possible. Periodic attempts are made to withdraw all laxatives gradually. Laxative medication may be considered under several categories (Beeson, McDermott, Wyngaarden, 1481).
Diverticulosis:
Diverticulosis is a condition in which the weakening of the muscle walls of the colon results in the formation of sacs that fill with feces. Diverticulosis may be associated with obesity, constipation, or the aging process. When the sacs become inflamed, the condition is known as diverticulitis (Fishbein, 487, Vol. 2).
Cause of Diverticulosis:
The cause of diverticulosis is not known with certainty, but many physicians believe that it is related to too little roughage in the diet. Roughage is coarse, bulky food that is rich in plant fiber. It has been observed that people in developing countries whose diets include large amounts of plant materials (fruits and vegetables) almost never have diverticulosis. Diverticulosis is common in the United States and in other developed countries, where refined foods often lack significant amounts of fiber. Young people rarely have diveticulosis, but are more likely to occur as people age (Izenberg, 294 vol.1).
Symptoms:
People with diverticulosis may never know they have it because it does not always cause symptoms. Sometimes, however, the diverticula may become inflamed, causing diverticulitis. This may happen when the diverticula become plugged with waste. The symptoms of diverticulitis include, abdominal pain, fever, gas, diarrhea, or constipation, and bleeding from the rectum (Izenberg, 295 vol.1).
Diagnosis:
A doctor can find out if a person has diverticula by x-ray examination or by looking inside the colon through a viewing instrument like a sigmoidoscope or a colonscope. Diverticula that have not caused symptoms are sometimes discovered during routine medical checkups (Izenberg, 295 vol.1).
Treatment:
Diveticulosis does not usually require special treatment, although doctors may recommend increasing roughage in the diet. In mild cases of diverticulitis, treatment may include drinking more fluids, bed rest, and antibiotics to control infection. Sometimes doctors recommend intravenous or IV fluids (Izenberg, 295 vol.1).
Prevention:
Including adequate amounts of vegetable fiber in the diet is often recommended as a way to avoid diverticulosis and diverticulitis. Bran, cabbage, beans, and whole-grain breads are examples of foods high in dietary fiber. Particularly older adults, to maintain regular bowel habits and to reduce the risk of diverticulitis, often use fiber supplements (Izenberg, 296 vol.1).
Inflammatory Bowel Disease:
Inflammatory bowel disease (IBD) involves inflammation of the intestines and is a chronic (long-lasting) illness. The two major types of IBD are Ulcerative Colitis and Crohn’s Disease. Ulcerative colitis affects the lining of the large intestine (colon) and or the rectum. Crohn’s disease affects deeper layers of tissue and can occur in any part of the digestive system, although it occurs most commonly in the lower part of the small intestine (ileum) (Izenberg, 481vol.2).
Definition:
Inflammatory Bowel Disease (IBD) encompasses several diseases caused by inflammation of the intestinal tract. The different types of IBD have many symptoms in common, including abdominal pain, frequent diarrhea (sometimes with blood and mucus), constipation, weight loss, fatigue, and fever. Why some people get IBD is not clear. What is known is that IBD is not passed from person to person. However, up to 25% of people with IBD have a relative with the disease, suggesting that genetic factors play a role in its development. Some researchers believe that IBD occurs because a virus or bacterium triggers an inappropriate response from the immune system in people who have a genetic tendency for the disease. This response causes the digestive tract to become inflamed (Izenberg, 481vol.2).
Diagnosis:
A medical history, physical examination, and diagnostic tests are problems required to diagnose IBD. Blood samples may be taken to look for evidence of anemia and infection. Examination of stool samples for the presence of blood also may help the doctor make a diagnosis. Often the colon is examined through a procedure called a colonscopy. An endoscope is inserted through the anus. This allows the doctor to see the inside lining of the colon and rectum. Sometimes during the colonscopy a tissue sample (called a biopsy) is taken from the intestine lining for further examinations under a microscope (Izenberg, 483vol.2).
Treatment:
Medication and diet are two primary approaches to controlling IBD. They do not cure the disease, but are effective in reducing symptoms in the majority of people. In case of IBD, surgery may be necessary. Anti-inflammatory drugs often are used to help control the inflammation caused by the disease. In some cases, immunosuppressant drugs may be helpful in controlling symptoms that do not respond to inflammatory drugs. Antibiotics often are used to treat crohn’s disease in addition; several experiment drug therapies are under investigation. Many of the drugs used to treat IBD are powerful and may have undesirable side effects. The physician must balance the undesirable side effects against the positive benefits of the drugs, sometimes trying several different drug combinations before a successful balance is reached (Izenberg, 484vol.2).
Intestinal Gas: Could Not Find
