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This means the nerve signals are interrupted and are slower. This causes muscle contractions to be irregular and fewer, resulting in an increased colon transit time. [12] The feces stay in the colon for a longer period of time, meaning that more water is absorbed. This leads to harder stools and therefore increases the symptoms of constipation.
Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older. [12] Treatment of constipation depends on the underlying cause and the duration that it has been present. [4]
Functional constipation, also known as chronic idiopathic constipation (CIC), is defined by less than three bowel movements per week, hard stools, severe straining, the sensation of anorectal blockage, the feeling of incomplete evacuation, and the need for manual maneuvers during feces, without organic abnormalities.
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[70] [71] Worrisome features include onset at greater than 50 years of age, weight loss, blood in the stool, iron-deficiency anemia, or a family history of colon cancer, celiac disease, or inflammatory bowel disease. [7] The criteria for selecting tests and investigations also depends on the level of available medical resources. [72]
Some researchers have suggested that anismus is an over-diagnosed condition, since the standard investigations of digital rectal examination and anorectal manometry were shown to cause paradoxical sphincter contraction in healthy controls, who did not have constipation or incontinence. [1]
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