Health Guide

Constipation and Abdominal Pain

Written by Mystic on Monday, May 12, 2008

Other names :
Bound up.


Introduction :
Difficulty in passing firm faecal motions.


Types :
What are considered to be normal bowel habits varies dramatically from one person to another. Some consider it normal to pass a motion three times a day, others once a week. Provided there are no symptoms or complications, neither of these extremes requires treatment.


Cause :
There is no doubt that the most common causes of constipation are poor diet and poor toiletry habits. The excess intake of junk foods with little or no fibre and excess sugars, leaves nothing for the lower bowel to work on, and constipation results. The repeated postponement of nature’s call can lead to excessive distension of the lower gut, and dry hard stools. Once the gut becomes distended, the urge is reduced, and the problem becomes self perpetuating. Other causes of constipation vary from dehydration, inactivity (invalids in bed for long periods), pregnancy and the side effects of many medications (eg: codeine), to diseases as diverse as an underactive thyroid gland, gut tumours, psychiatric conditions and diabetes.


Incidence :
Everyone suffers from this problem at some time, but some more so than others. The incidence gradually increases with age and is far more common in the elderly than the young. To get some idea of how common the problem is in the community, just check a chemist’s shelves. There are scores of treatments available for the management of constipation.


Revention :
Once the constipation is relieved, preventing its recurrence is important. The best time to go to the toilet is after a large meal, because there is a reflex (the gastro-colic reflex) that stimulates the large bowel after the stomach is filled. Setting aside the time after the main meal of the day on a regular basis can often improve personal habits, and prevent considerable discomfort.


Investigations :
In severe cases, special x-rays of the lower gut, or a colonoscopy (passing a flexible tube through the anus into the gut) may be performed.


Course :
To be medically significant, constipation must cause discomfort in the abdomen, pain around the anus, bleeding, tears (both pronunciations of the word are appropriate), piles or some other problem.


Treatment :
The best way to deal with the problem is to change the diet. This involves avoiding white bread, pastries, biscuits, sweets and chocolates. Fibre containing foods such as cereals, vegetables, fruit and plenty of fluids should be taken. If dietary measures are not successful, fibre supplements may be used. These are available in tablet, liquid and granule form. Laxatives are the next step, but these should be used cautiously, particularly in children, as dependence can rapidly develop. Thesemedications vary in effectiveness and strength, but the weakest one to work is the best one to use. Paraffin, other oils, senna and cascara should be tried first. As a last resort, enemas may be used to clear out the lower gut, but once again, these should be used as infrequently as possible.


Complications :
Chronic constipation should not be ignored, but must be assessed by a doctor to ensure that there is no serious underlying cause. If a cause is found, that is treated; if no cause is found, the constipation itself is relieved.

What I need to know about Constipation

Eczema in Babies

Written by Mystic on Saturday, May 10, 2008

Eczema
Skin is dry, irritable and itchy and reacts adversely to scratching. Most affected areas are on the face and areas that rub when baby crawls. More often than not a hereditary problem.

To prevent:

• Prevention may not be possible if condition is hereditary. Your doctor's advice should be sought.
• Avoidance of woollen and synthetic clothes and chlorinated swimming pools is preferable.

To treat:

• Your doctor's recommendation may involve cortisone creams, moisturisers and a change of diet.

Cradle Cap in Babies

Written by Mystic on Saturday, May 10, 2008

Cradle cap
Either crusty sores or wet patches. Are more prevalent on the scalp of very young babies. May be caused by an accumulation of dust or dirt or by excessive amounts of the scalp's natural oils. "Seborrhoea" can also affect eyebrows, ears and skin creases around the nose, neck, armpits, umbilicus and groin.

To prevent:

• Prevention is not possible but cradle cap is not harmful, just unattractive.

To treat:

• Soften crusts with a gentle massage using sorbolene and glycerine or petroleum jelly pre-bedtime. Gently wash with soap and water next day. Repeat until all crusts have been removed.

Prickly Heat in babies

Written by Mystic on Saturday, May 10, 2008

Prickly heat
During hot humid weather the pores of a baby's skin can become blocked preventing the sweat from evaporating. Rashes can then appear on the neck, in the creases behind the knees, inside the elbows, under the arms, the groin and on the back and chest.

To prevent:

• Apply an anti-rash baby product at nappy change time.
• Avoid over-dressing or over-heating your baby.

To treat:

• A soothing bath followed by a suitable anti-rash baby product

Nappy Rash in Babies

Written by Mystic on Saturday, May 10, 2008

At birth a baby's skin is delicate, supple and sensitive having been carefully protected in the mother's womb. After birth this fragile skin comes into contact with the harsh elements of the environment and the way each baby reacts to these external influences as well as internal ones varies greatly.

Nappy rash
Nappies create a moist warm environment which is in direct contact with a baby's skin. Wet warm skin is easily affected by irritants associated with the baby's motions and urine, and friction, chafing and harmful bacteria.

To prevent:

• Change nappies frequently - a new baby will need changing at least six times every twenty-four hours
• Clean baby's bottom well especially in the folds of the skin
• Allow nappy-free time whenever possible
• Apply a moisturiser or barrier cream

To treat:

• A doctor or pharmacist should check any rash as diarrhoea, medication, food intolerance or a thrush infection could be the cause

Colic In Babies

Written by Mystic on Saturday, May 10, 2008

Other names :
Infantile colic, six week colic.


Introduction :
Intermittent spasms of the intestine causing crying in babies.


Cause :
There are many arguments about infantile colic, whether it really exists, what causes it, what (if anything) should be used to treat it, and if it is a disease restricted to western society rather than infants of all economic and ethnic backgrounds. It is probably caused by a spontaneous spasm of the small intestine, but no reason for this spasm has ever been proved. Changes in diet and formula, different foods for the mother of breast fed infants, alterations to feeding times and positions, vitamin and naturopathic supplements, increases or decreases in the degree of attention paid to the child have all been tried to ease the problem. Some experts blame anxiety in the mother, particularly with a first child in a family without extended family support, for causing anxiety in the infant, and subsequent gut spasms. Mothers of babies who have suffered are in no doubt that it is a real entity.


Incidence :
A very common problem between 1 and 4 months of age.


Prevention :
Mothers who have sufficient physical and emotional support, and are relaxed about their mothering, seem to have babies who suffer less colic.


Investigations :
There are no tests that can be performed to confirm the diagnosis, and there are no clinical examinations that can be considered objectively.


Course :
As a new mother begins to establish a routine in her management of her infant, the pattern may be rudely shattered by the onset of six week colic. The baby starts screaming for no apparent reason, draws the legs up and looks pale. After a few minutes, the attack subsides, and although a little reticent, the infant appears quite normal again. After another short interval, the screaming starts again. This pattern can repeat itself for quite some time, several times a day. Eventually, usually at 12 to 16 weeks of age, the colic eases, the mother relaxes, and the treatment being tried at that time is credited with a miraculous cure.


Treatment :
Changing the feeding position, rate of feeding, frequency of feeding, and time of feeding may all help. If these ideas do not help, numerous gut antispasmodics (see Medication Table) of varying efficacy are available over the counter from chemists. Paracetamol drops are often the most effective and safest treatment. Anxiety in the mother can be transmitted to the baby, and this often exacerbates the problem. If mother and/or child are very distressed, doctors can treat the mother's anxiety with appropriate medications.


Diet :
Changing the formula is rarely beneficial, but breast fed babies are less likely to develop colic than bottle fed ones.


Complications :
These babies should be checked by a doctor to ensure that there is no more serious cause for their apparent stomach pain


Outcome :
Infantile colic always goes away in due course, and assistance from family and friends in caring for the baby can often give a new mother a little free time for herself, to gather her composure, and prepare for the next interrupted night of intermittent screaming.


Further information:
Maternal and Child Welfare clinics are run by state governments in many suburbs of major cities, and most country towns. Residential accommodation is available for mother and their babies who are having serious problems coping.


Related conditions
Irritable Bowel Syndrome.

What is Cleft Lip

Written by Mystic on Saturday, May 10, 2008

Cleft Lip

What is other name :
Hare lip.


Introduction :
One or two off centre splits in the upper lip that may involve the palate (roof of the mouth).


Types :
Can vary from a barely noticeable notch in the upper lip, to a complete wide split of the upper lip and full length of the palate.

Cause :
From four to seven weeks after conception in the womb, each of us has a double cleft lip; and from the fifth to twelfth weeks, each of us has a cleft palate. For virtually everyone, these clefts of the lip and palate close naturally before we are born. Closure does not occur naturally in late pregnancy or after birth.


Incidence :
In about one person in 800, the clefts in the lip and palate do not close naturally before birth.


Investigations :
Sophisticated x-rays and CT scans of the face and skull will be undertaken before any surgical repair to accurately gauge the extent of the problem.


Screening :
May sometimes be detected late in pregnancy by an ultrasound scan of the foetus.


Treatment :
These children need special medical, dental and speech therapy treatment, especially during their early development. The aims of the team of specialists treating these people are threefold. Firstly, and most importantly, to ensure that the developing child has good speech through to adult life. Secondly, to enhance facial attractiveness; and thirdly, to produce the best possible jaw function and dental bite. The reason for good speech having the highest priority during treatment is that no matter how facially attractive a person may be, if that person cannot speak clearly and well, his/her social and personal development will be severely restricted. Directly related to good speech is good hearing. Most children with a cleft palate need careful monitoring to ensure their hearing is adequate. It is important that these children maintain good general health, and particularly to avoid infections or surgery to their tonsils and adenoids. Surgical repair of the cleft lip is normally done between two and six months after birth. Infants with a double cleft lip must have special dental treatment to reshape their upper jaw prior to surgical repair of the lip. The dental treatment starts immediately after birth, and requires a high degree of cooperation from the parents. This period is very emotional and demanding for the parents, but becomes most rewarding after the lip repair is done. The palate repair is normally done at about one year of age, and this is the critical operation for the child's speech. Most children with a cleft palate have an upper jaw which does not grow is well as the lower jaw, thus special dental and orthodontic care is necessary until the child has finished growing, to ensure the jaws and teeth develop in the correct relationship to each other. The vital periods for correct specialist care are when the adult teeth appear at seven or eight years, and during the rapid growth stage between 11 and 13 years. The ability to bite, chew and smile effectively are essential for both comfort and appearance. An attractive face and clear speech are added benefits of good care.


Outcome :
Modern surgery now makes it possible to correct poor speech in people who have a cleft palate, no matter how old they are. Older patients who have a poor bite because of a too small or too large upper or lower jaw can also be helped by this surgical technique. Cleft palate and lip are no longer the gross social stigmas of earlier years.


Further information:
Parents and children can benefit from the assistance offered by support groups such as Cleft-Pals that exist in most capital cities.

Best Contraception Methods

Written by Mystic on Tuesday, May 06, 2008

Contraception

Introduction :
Prevention of pregnancy during sexual intercourse.


Types :
Contraception is a matter that will concern everyone of us in one way or another during our lives, but many people are ignorant of the basic principles involved. Contraception is possible through three basic methods:-

1. Preventing the sperm from reaching the egg.


Coitus interruptus -
This is withdrawing the penis from the woman's vagina before the sperm are discharged at ejaculation. This is very unsafe as some sperm are released before ejaculation is felt by the man.


Penile sheath -
Also known as the condom or French letter, the penile sheath is a fine latex rubber glove that is fitted over the penis before intercourse. Used correctly and carefully it is a quite reliable form of contraception, although it may come off or rupture occasionally. It has the added advantage of giving some protection against venereal diseases including AIDS.


The diaphragm -
This is a rubber ring with a loose, thin sheet of rubber covering the hole in the ring. It is fitted very carefully into the woman's vagina to cover the opening into the womb (the cervix) so that it is impossible for sperm to swim around it. Initial fitting and instruction should be by a doctor. Reasonably safe and effective, particularly if used with spermicidal creams or foams.


Spermicidal creams and foams -
These are placed in the woman's vagina before intercourse, and kill the sperm that contact them. Not highly reliable when used alone, and best used as additional protection.

Cervical cap -
This is a small rubber cap fixed firmly and semi-permanently to the cervix by a doctor. Not widely used in Australia.

Medroxyprogesterone injections -
This injection is given every three months to prevent ovulation. Only recently made generally available in Australia, but widely used overseas. Trade names include Depo-Provera and Depo-Ralovera (see Medication Table).

3. Prevention of implantation of the egg in the wall of the womb. There is only one contraceptive that works this way.

Diet:
There is no diet that can act as a contraceptive.

Outcome :
It is much safer to take the contraceptive pill for many years than it is to have one pregnancy, and that is the realistic basis on which to judge the safety of any contraceptive.


Further information:
Family Planning clinics exis in every major city. Public and private women's clinics are widely available. Centres promoting the Billing's and other methods of natural family planning are run by the Catholic Church.


Medical curiosity :
Casanova de Seingalt, the 18th. Century adventurer and philanderer, was one of many who have used the ancient form of contraception now known as the condom. Casanova's success was possible due to the fact that he refined the device by using a thin pig's bladder to fashion a malecontraceptive, rather than the coarser leather or gut devices used in earlier times. One of the oldest methods of contraception known to womankind is the intrauterine device (IUD). In the era of Egypt's Cleopatra, small gold trinkets were inserted by the court physicians to prevent pregnancy in the courtesans. At the same time, camel herders pushed pebbles into their female camels' wombs to stop them conceiving while on long caravan treks.

Other Methods:

Periodic Abstinence

Sterilisation

Tubal ligation
Vasectomy

Contraceptive pill

The Intrauterine Device

Birth Control Complications

Written by Mystic on Tuesday, May 06, 2008

Although the contraceptive pill is very safe, there are some women who should not use it. Those who have had blood clots, severe liver disease, strokes or bad migraines must not take the pill. Heavy smokers, obese women and those with diabetes must be observed closely, and probably should not use the pill after 35 years of age. Medroxyprogesterone injections are generally very safe, and by far the most reliable of the reversible forms of contraception, but problems can include headaches, abnormal vaginal bleeding, and the contraceptive effect lasting far longer than desired.

The complications of a tubal ligation are few, the main ones being bleeding and infection. The operation is safe and effective, and it is extremely rare for pregnancy to occur afterwards. The woman's menstrual cycle is not affected in any way, but if the contraceptive pill is ceased after the operation, her periods may become heavier and uncomfortable due to the loss of control offered by the pill. This sometimes leads to the misconception that hysterectomies are needed after a tube tie. After a vasectomy there may be some bruising and discomfort of the scrotum for a few days after the operation, but other complications are rare. Not all women are suited to the use of IUDs. Only about 40% of women still have them in place a year after insertion. Sometimes they can fall out, they may cause heavy and painful periods, or rarely they can cause infections of the uterus resulting in permanent infertility. During insertion, it very rarely may penetrate the uterus to cause serious peritonitis. The devices seem to have fewer side effects in women who have had a pregnancy, but there are smaller devices available for women who have had no children.

The Intrauterine Device - Birth Control

Written by Mystic on Tuesday, May 06, 2008

The intrauterine device -
The intrauterine device is a piece of plastic shaped like a7, T or S, that may be covered by a thin coil of copper wire. It is inserted by a doctor through the vagina and cervix to sit inside the uterus (womb). The intrauterine device acts by irritating the lining of the womb (uterus), and preventing the development of the pregnancy. The insertion of the device is done very simply by your own doctor, and takes only a few minutes. It is usually quite pain free. Through a speculum (a collapsible metal tube) a doctor will examine the entrance to the womb (the cervix) and check the shape and size of the uterus. Then, while holding the cervix carefully with a special pair of forceps, the IUD is slowly pushed through the cervix canal into the uterus. It is only 3mm. in diameter when inserted, but once inside the uterus it springs open to its "7", "T" or "S" shape and is held in position by the arms of the device pushing on the uterine walls. It is normal to insert the intrauterine device immediately after a menstrual period, but may be inserted at other times if the woman wants immediate protection Once in place, the woman is not aware of its presence. After each period she should feel for the fine thread which will normally hang into the vagina. This is used to remove the intrauterine device at a later time. The device can remain in place for two or three years before its needs to be changed, but a doctor should check it every year, when you should also have a routine Pap smear test. The intrauterine device has one great advantage - you cannot forget to take it or use it. Once in place it can be relied upon to give 97% protection against pregnancy. When you want to become pregnant, or no longer require contraception, the device is easily removed. Your doctor will merely pull on the short thread left outside the uterus (but inside the vagina), and the intrauterine device will fold up on itself, enabling it to be gently withdrawn.

Contraceptive pill - Birth Control

Written by Mystic on Tuesday, May 06, 2008

Contraceptive pill -
The oral contraceptive pill is the safest and most effective form of reversible contraception. There are many different dosage forms and strengths, so that most women can find one that meets their needs. The main types are the constant dose two hormone pill, the two or three phase two hormone pill (hormone doses vary during month), and the one hormone mini-pill (see Medication Table). The pill has several positive benefits besides almost perfect prevention of pregnancy. It regulates irregular periods, reduces menstrual pain and premenstrual tension, may increase the size of the breasts, reduces the severity of acne in some women, and libido (the desire for sex) is often increased. It even reduces the incidence of some types of cancer.

Two different hormones control the menstrual cycle. At the time of ovulation, the levels of one hormone drops, and the other rises, triggering the egg's release from the ovary. When the hormones revert to their previous level two weeks later, the lining of the womb is no longer able to survive and breaks away, giving the woman a period. The pill maintains a more constant hormone level, and thus prevents the release of the egg. With the triphasic pills, the level of both hormones rises at the normal time of ovulation, and then drops slightly thereafter to give a more natural hormonal cycle to the woman, while still preventing the release of an egg. When the pill is stopped (or the sugar pills started) at the end of the month, the sudden drop in hormone levels cause a period to start.If taken correctly, the pill is very effective as a contraceptive. But missing a pill, or suffering from diarrhoea or vomiting can have a very pregnant result. Some antibiotics can also interfere with the pil. A few women do have unwanted side effects from the contraceptive pill. These can include headaches, break through bleeding, nausea, breast tenderness, increased appetite and mood changes. If these problems occur, they can be assessed by a doctor, and a pill containing a different balance of hormones can be prescribed.

There is no need these days to take a break from the pill every year or so. This may have been the case in earlier years, but is no longer necessary. The effects of the pill are readily reversible. If you decide to become pregnant, you could find yourself in that state in as little as two weeks after ceasing it, with no adverse effects on the mother or child.

Vasectomy - Birth Control

Written by Mystic on Tuesday, May 06, 2008

Vasectomy
Most men are very anxious about a vasectomy, as they are not sure what happens and are concerned that it may affect their libido or masculinity. This is not so. Sperm are produced by the testes throughout adult life at a relatively constant rate. The sperm enter a complex network of small tubules which unite to form the sperm tube (vas deferens). The sperm pass along this tube to a storage sac (the seminal vescicle) in the groin where they await the next ejaculation. The walls of the sperm storage sac secrete a fluid which nourishes the sperm, and along with an exudate from the prostate gland, forms 95% of the semen passed by the man during intercourse. When he ejaculates, the sperm and supporting fluid (called semen when combined) pass down the sperm tube to its junction with the urethra, and then along this tube to the outside of the penis. In the operation, a local anaesthetic numbs the side of the scrotum, and through a small incision, the doctor cuts, burns and ties the sperm tube (vas deferens) so no further sperm can pass along it from the testes. This may be done in the doctor's rooms, or as a day patient in a private hospital.

The procedure is very simple and brief, and no pain is felt.The man is not immediately sterile after the operation. Because sperm are stored in the sac above where the tube is tied, this must be emptied by about a dozen ejaculations over the next few weeks. It is normal to have a test done about six weeks after the operation to check that no sperm are getting through or remaining in storage. The couple can stop their other contraceptive measures after this test is confirmed. The male hormones which establish and maintain masculinity are also produced in the testicles. These are no affected in any way by the operation as they enter the blood stream directly from the testes and continue to function normally. The man's ejaculation is not affected either, as the fluid from the sperm storage sac is passed as normal.

2. Preventing the release of the egg (ovum) from the ovary.

Tubal ligation - Birth Control

Written by Mystic on Tuesday, May 06, 2008

Tubal ligation

A tubal ligation can be done by an open procedure or laparoscopy. In the open operation the surgeon (usually a gynaecologist) makes a horizontal cut about 7cm. long just above the pubic bone to gain access to the fallopian tubes and then ties or clamps them. The scar should be below the line of all but the briefest of bikinis. The commoner and simpler operation is a laparoscopy. Two small cuts are made in the abdomen, one in the belly button and one low down on one side. Each is 1cm. long. Through these small cuts, long stainless-steel tubes are placed. The surgeon looks through one, and operates with very long, fine instruments through the other.

The Fallopian tubes are closed with metal clips and electrically burnt in this procedure, which takes only 15 minutes under a general or local anaesthetic in a hospital or clinic. Laparoscopy can also be done through a cut in the top of the vagina, which avoids any scars, but is technically more difficult and sex must be avoided for several weeks. Only an overnight stay is required in hospital with these procedures. With laparoscopy there is only minor lower abdominal discomfort for a few days, and normal work can be resumed after a week. Recovery is a little slower with the open operation.If the circumstances are appropriate, and if arranged with theobstetrician beforehand, tubal ligation can be performed at the same time as a Caesarean section.

Sterilisation - Birth Control

Written by Mystic on Tuesday, May 06, 2008

Sterilisation

Tying the fallopian tubes in a woman or the vas deferens in a man to give permanent infertility. A couple may decide that their family is complete, and that under no circumstances do they want more children. This must be a decision of the couple, and not the individual woman, as the ability to have children is a joint property, not an individual one. Once the decision has been made, a further decision to choose between a male vasectomy or female tubal ligation (tube tie) is necessary. Because both these operations are designed to be permanent, even the most extenuating circumstances, including the death of a child or marriage break-up, must be taken into consideration. Some individuals do succeed in having micro-surgical repair of their vas deferens or fallopian tube, but the success rate is only about 65%, and it is not a factor that should be considered when contemplating sterilisation.

Periodic Abstinence - Birth Control

Written by Mystic on Tuesday, May 06, 2008

Periodic abstinence


Natural family planning is really a form of periodic abstinence from sex, or not having sex at those times of the month when a woman is fertile. The trick is knowing just what are the safe and not so safe times. Obviously, it is essential for both sexual partners in this situation to cooperate fully in the contraceptive process. The man must be as aware of the woman's cycle as she is herself. For this reason alone, this method of contraception does not suit all couples. There are many different ways of calculating the fertile time of the month. The most common is a simple mathematical calculation, as a woman usually ovulates 14 days before her next period starts. If the woman has a regular cycle, there is no problem, but if her cycle varies significantly, other clues to ovulation must be observed. Changes in body temperature can give a guide to ovulation, as the temperature first dips, then rises about half a degree centigrade at the time of ovulation. Changes in vaginal secretions also occur just before ovulation, and these can be noted on a glass slide. Breast tenderness and lower abdominal pain may be other relevant signs in some women.

The Billing's method of contraception is a combination of the above factors. Because sperm can live for a number of days in the woman after ejaculation, and because the woman is fertile for two or three days after ovulation every month, sex must be avoided for six to eight days during every cycle. The failure rate of this method can vary widely, and depends a great deal on the couple's commitment to follow the rules strictly, and the woman's own ability to note her own bodily changes. The percentage of women falling pregnant in one year while using natural family planning as varied from 5% to 25% in different clinical studies. Natural family planning can be used in combination with other forms of contraception, such as condoms, spermicidal foam or diaphragms, which are used at the time of the month when pregnancy may occur. No couple should undertake this form of contraception without consulting a doctor who understands, and is prepared to teach, natural family planning.

Contraception: Periodic Abstinence

Help with Constipation

Written by Mystic on Tuesday, May 06, 2008

Constipation

Other names :
Bound up.


Introduction :
Difficulty in passing firm faecal motions.


Types :
What are considered to be normal bowel habits varies dramatically from one person to another. Some consider it normal to pass a motion three times a day, others once a week. Provided there are no symptoms or complications, neither of these extremes requires treatment.


Cause :
There is no doubt that the most common causes of constipation are poor diet and poor toiletry habits. The excess intake of junk foods with little or no fibre and excess sugars, leaves nothing for the lower bowel to work on, and constipation results. The repeated postponement of nature's call can lead to excessive distension of the lower gut, and dry hard stools. Once the gut becomes distended, the urge is reduced, and the problem becomes self perpetuating. Other causes of constipation vary from dehydration, inactivity (invalids in bed for long periods), pregnancy and the side effects of many medications (eg: codeine), to diseases as diverse as an underactive thyroid gland, gut tumours, psychiatric conditions and diabetes.


Incidence:
Everyone suffers from this problem at some time, but some more so than others. The incidence gradually increases with age and is far more common in the elderly than the young. To get some idea of how common the problem is in the community, just check a chemist's shelves. There are scores of treatments available for the management of constipation.


Revention :
Once the constipation is relieved, preventing its recurrence is important. The best time to go to the toilet is after a large meal, because there is a reflex (the gastro-colic reflex) that stimulates the large bowel after the stomach is filled. Setting aside the time after the main meal of the day on a regular basis can often improve personal habits, and prevent considerable discomfort.


Investigations :
In severe cases, special x-rays of the lower gut, or a colonoscopy (passing a flexible tube through the anus into the gut) may be performed.


Course :
To be medically significant, constipation must cause discomfort in theabdomen, pain around the anus, bleeding, tears (both pronunciations of the word are appropriate), piles or some other problem.


Treatment :
The best way to deal with the problem is to change the diet. This involves avoiding white bread, pastries, biscuits, sweets and chocolates. Fibre containing foods such as cereals, vegetables, fruit and plenty of fluids should be taken. If dietary measures are not successful, fibre supplements may be used. These are available in tablet, liquid and granule form. Laxatives are the next step, but these should be used cautiously, particularly in children, as dependence can rapidly develop. Thesemedications vary in effectiveness and strength, but the weakest one to work is the best one to use. Paraffin, other oils, senna and cascara should be tried first. As a last resort, enemas may be used to clear out the lower gut, but once again, these should be used as infrequently as possible.


Complications:
Chronic constipation should not be ignored, but must be assessed by a doctor to ensure that there is no serious underlying cause. If a cause is found, that is treated; if no cause is found, the constipation itself is relieved.

Related Sites:

What I need to know about Constipation

Constipation during Pregnancy