Colon

[Lian-Guoxuan]

  
  My aunt is 26 years old. She got constipation 4 years ago and the doctor presented purgative for her illness. Gradually she has got dependence on this medicine with the dose increased, her illness became worse. Despite she has been to many hospitals for curing, no medicine is effect. She must have more and more purgative to help her. For these 2 years, so she is very worried about that what she can do if the purgative will be of no effect at all.
  She has been checked for her body, at last the doctor found that the colon is longer thirty centimeters than the normal person. And the colon¡¯s function is very weak, colon peristalsis slowly and coloptosis.
  To all experts on curing constipation.
  Please help her!
  My E-mail: ***@****
Dear Lian,
Prior to prescribing laxatives on a regular basis an evaluation of the colon is important. In evaluating patients with constipation it is important to first rule out a mechanical obstruction or a dilated colonic segment. This should be done with a barium enema. A flexible sigmoidoscopy to look at the lining of the left colon is also helpful. Blood tests to rule out disorders of the thyroid and parathyroid gland should be investigated routinely. Other metabolic, neurologic and endocrine disorders need to be considered as well. If the above tests are normal the next test to perform is a colonic transit time. In this test radioopaque markers are swallowed and x-rays are done at different intervals to follow the progression of markers along the colon. If that test is normal sometimes defecography is performed to evaluate anorectal morphology and dynamics during defecation.
The first line treatment for constipation, if no blockage is present, is to increase dietary fiber. An easy way to meet fiber requirements would be to try a cereal called FIBER ONE cereal. 2 ounces daily will give one 26 grams of fiber/day. Other bulking agents include methylcellulose (Citrucel) and psyllium (Metamucil). Using multiple oil or saline enemas twice daily for five days and then once daily for one to two weeks or using a solution such as Go-Lytely may be necessary. Laxatives such as lactulose  or stool softeners such as docusate sodium or mineral oil may also be used. Stimulant laxatives with senna and cascara can lead to melanosis coli (darkening of the colonic lining). Melanosis coli may lead to atony (paralysis) of the bowel with continued laxative dependence. Biofeedback and relaxation techniques can be used with or without medical therapy. In rare cases constipation may require a surgical approach. In any case, it is important to have close communication with a primary physician or gastroenterologist in order to plan further management. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians’ Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: constipation, evaluation, management