notes2 copy.gif (2951 bytes)

Julio Alejandro Murra-Saca MD.
Gastroenterologist, Coloproctologist
Tel : (503) 226-3131, (503) 225-3087, Celular (503) 887-2507
Edificio Centro Scan, Colonia Médica, San Salvador, El Salvador.



murra2.gif (3687 bytes)

Notes on Cyber Gastroenterology


Constipation is passage of small amounts of hard, dry bowel movements, usually fewer than three times a week. People who are constipated may find it difficult and painful to have a bowel movement. Other symptoms of constipation include feeling bloated, uncomfortable, and sluggish.
What are Some Common Misconceptions About Constipation?
Many false beliefs exist concerning proper bowel habits. One of these is that a bowel movement every day is necessary. Another common fallacy is that wastes stored in the body are absorbed and are dangerous to health or shorten the life span. These misconceptions have led to a marked overuse and abuse of laxatives.
Many people think they are constipated when, in fact, their bowel movements are regular. For example, some people believe they are constipated, or irregular, if they do not have a bowel movement every day. However, there is no right number of daily or weekly bowel movements. Normal may be three times a day or three times a week depending on the person. In addition, some people naturally have firmer stools than others. At one time or another almost everyone gets constipated. Poor diet and lack of exercise are usually the causes. In most cases, constipation is temporary and not serious. Understanding causes, prevention, and treatment will help most people find relief.
Who Gets Constipated?
women, children, and adults age 65 and over. Pregnant women also complain of constipation, and it is a common problem following childbirth or surgery.
Constipation is one of the most common gastrointestinal complaint in the United States, resulting in about 2 million annual visits to the doctor. However, most people treat themselves without seeking medical help, as is evident from the $725 million Americans spend on laxatives each year.

Acording the American Society of dietist is necessary 20 to 35 Gr. of fiber
every day to mantain healhty.

Causes: Constipation may originate primarily from within the colon and rectum or externally.

Functional Causes
Constipation due to Functional Causes

Constipation Causes
Inadequate water intake
Low fiber dietary intake
Sedentary lifestyle
Altered motility
Irritable Bowel Syndrome
Slow transit
Failure to respond to urge to defecate

Medical Illnesses
When people are sick their bowels may not work well. Diabetes, scleroderma, neurological diseases like Parkinson's disease, and multiple sclerosis and other medical illnesses can affect the intestines and cause constipation.

Medicines can cause constipation. Pain medications, especially narcotics, many psychotropic drugs, antacids that contain aluminum, antispasm drugs, anticonvulsants (for epilepsy), tranquilizers, antidepressants, and iron supplements can all cause constipation., Calcium-channel blockers, Inadequate thyroid hormone supplementation (hypothyroidism)
Although laxatives are frequently used to treat constipation, chronic laxative use becomes habituating and may lead to the development of a dilated atonic laxative colon, which requires increasing laxative use with little success.

Treatment Approach to Functional Constipation.
The treatment approach for each of these conditions is different. In patients with normal-transit constipation, reassurance and education may be sufficient. Further treatment may be determined by psychosocial assessment. The clinical approach for slow-transit constipation usually consists of dietary changes, including increased fluid and fiber intake, stool softeners, and various laxatives. Some prokinetic agents may also be considered, including prostaglandin analogs (misoprostol) and serotonin-receptor agonists such as cisapride (under restricted use only) and tegaserod (recently approved for irritable bowel syndrome with constipation).




bt37.gif (3388 bytes)
bt34.gif (3394 bytes)
bt35.gif (3380 bytes)
bt36.gif (3395 bytes)
bt43.gif (3337 bytes)
bt69.gif (3404 bytes)
bt50.gif (3391 bytes)
bt65.gif (3331 bytes)
bt40psd.gif (3401 bytes)
bt39.gif (3380 bytes)
bt70.gif (3383 bytes)
bt58.gif (3377 bytes)
bt52.gif (3388 bytes)
bt45.gif (3364 bytes)
66.gif (3443 bytes)
bt68.gif (3354 bytes)
bt47.gif (3415 bytes)
bt20.gif (3406 bytes)
bt53.gif (3419 bytes)
bt54.gif (3374 bytes)
bt55.gif (3436 bytes)
bt56.gif (3407 bytes)
bt59.gif (3357 bytes)
bt57.gif (3367 bytes)
bt62.gif (3368 bytes)
bt71.gif (3636 bytes)
bt60.gif (3379 bytes)
bt64.gif (3452 bytes)
bt61.gif (3807 bytes)
bt63.gif (3371 bytes)
bt73.gif (3371 bytes)
bt51.gif (3392 bytes)