It has not been shown to have a benefit on constipation, while potentially causing cardiac arrhythmias and deaths. Enemas
Enemas can be used to provide a form of mechanical stimulation. A large volume or high enema can be given to cleanse as much of the colon as possible of feces, and the solution administered commonly contains castile soap which irritates the colons lining resulting in increased urgency to defecate. However, a low enema is generally useful only for stool in the rectum, not in the intestinal tract. Physical intervention
Constipation that resists the above measures may require physical intervention such as manual disimpaction (the physical removal of impacted stool using the hands; see fecal impaction). Regular exercise
Regular exercise can help improve chronic constipation. Surgical intervention
In refractory cases, procedures can be performed to help relieve constipation. Sacral nerve stimulation has been demonstrated to be effective in a minority of cases. Colectomy with ileorectal anastomosis is another intervention performed only in patients known to have a slow colonic transit time and in whom a defecation disorder has either been treated or is not present. Because this is a major operation, side effects can include considerable abdominal pain, small bowel obstruction, and post-surgical infections. Furthermore, it has a very variable rate of success and is very case dependent. Prognosis
Complications that can arise from constipation include hemorrhoids, anal fissures, rectal prolapse, and fecal impaction. Straining to pass stool may lead to hemorrhoids. In later stages of constipation, the abdomen may become distended, hard and diffusely tender.
Constipation is also common in individuals with muscular and myotonic dystrophy.Systemic diseases that may present with constipation include celiac disease and systemic sclerosis.Constipation has a number of structural (mechanical, morphological, anatomical) causes, namely through creating space-occupying lesions within the colon that stop the passage of stool, such as colorectal cancer, strictures, rectocoles, anal sphincter damage or malformation and post-surgical changes. Extra-intestinal masses such as other malignancies can also lead to constipation from external compression.Constipation also has neurological causes, including anismus, descending perineum syndrome, and Hirschsprungs disease. In infants, Hirschsprungs disease is the most common medical disorder associated with constipation. Anismus occurs in a small minority of persons with chronic constipation or obstructed defecation.Spinal cord lesions and neurological disorders such as Parkinsons disease and pelvic floor dysfunction can also lead to constipation. Chagas disease may cause constipation through the destruction of the myenteric plexus. Psychological
Voluntary withholding of the stool is a common cause of constipation. The choice to withhold can be due to factors such as fear of pain, fear of public restrooms, or laziness. When a child holds in the stool a combination of encouragement, fluids, fiber, and laxatives may be useful to overcome the problem. Early intervention with withholding is important as this can lead to anal fissures. Congenital
A number of diseases present at birth can result in constipation in children. They are as a group uncommon with Hirschsprungs disease (HD) being the most common.