Constipation
便秘

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Definition
定義－－怎樣才算便秘

Constipation refers to infrequent or hard stools, or difficulty passing stools. Constipation may involve pain during the passage of a bowel movement, inability to pass a bowel movement after straining or pushing for more than 10 minutes, or no bowel movements after more than 3 days. Infants who are still exclusively breastfed may go 7 days without a stool.

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Alternative Names of Constipation
同義詞

Irregularity of bowels 大便不正常;
 Lack of regular bowel movements 無正常大便

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Considerations 便秘綜論
Normal patterns of bowel elimination vary widely from person to person and you may not have a bowel movement every day. While some healthy people have consistently soft or near-runny stools, others have consistently firm stools, but no difficulty passing them.

When the stool is hard, infrequent, and requires significant effort to pass, you have constipation. The passage of large, wide stools may tear the mucosal membrane of the anus, especially in children. This can cause bleeding and the possibility of an anal fissure.

The most common cause of bowel incontinence, ironically, is constipation. Constipation causes the muscles of the anus and intestines to stretch and weaken (the anus is the opening through which stool leaves the body). The weakened muscles will prevent the rectum from closing tightly, thus resulting in leakage of stool (the rectum connects to the anus). Weakened intestinal muscles will also slow down the bowels, making it difficult to pass stools and further worsening the constipation.

Chronic stretching of the anal and intestinal muscles can also make the nerves of the anus and rectum less responsive to the presence of stool in the rectum.

The ability to hold stool and maintain continence requires normal function of the rectum, anus, and the nervous system. Additionally, the person must possess the physical and psychological ability to recognize and appropriately respond to the urge to defecate.

Problems with incontinence should be reported to the health care provider. Incontinence is not a hopeless situation. Proper treatment can help the majority of people, and often the problem can be eliminated altogether.

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Common Causes
便秘成因

Constipation is most often caused by a low-fiber diet, lack of physical activity, not drinking enough water, or delay in going to bowel when you have the urge to defecate. Stress and travel can also contribute to constipation or other changes in bowel habits.

Other times, diseases of the bowel (such as irritable bowel syndrome), pregnancy, certain medical conditions (like an underactive thyroid or cystic fibrosis), mental health problems, neurological diseases, or medications may be the reason for your constipation. More serious causes, like colon cancer, are much less common.

Constipation in children often occurs if they hold back bowel movements when they aren't ready for toilet training or are afraid of it.

* Chronic constipation or impacted stool in the rectum, leading to diarrhea and stool leakage around the impacted stool (see encopresis)

* Severe diarrhea that overwhelms the ability to control passage of stool

* In women, injury to the anal muscles due to childbirth

* Stress of unfamiliar environment

* Decreased awareness of sensation of bowel fullness

* Nerve or muscle damage (from stroke, trauma, tumor, or radiation)

* Emotional problems

* Gynecological, prostate, or rectal surgery

* Severe hemorrhoids or rectal prolapse

* Colectomy or bowel surgery

* Chronic laxative abuse

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Home Care 自療

Treatment of bowel incontinence should begin with identifying the cause of the incontinence. There are several ways to help achieve normal bowel function and strengthen the rectal muscles.

Children and adults should get enough fiber in their diet. Vegetables, fresh fruits, dried fruits, and whole wheat, bran, or oatmeal cereals are excellent sources of fiber. To reap the benefits of fiber, drink plenty of fluids to help pass the stool.

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For infants with constipation
幼兒便秘

* Over 2 months old -- try 2-4 ounces of fruit juice (grape, pear, apple, cherry, or prune) twice a day.

* Over 4 months old -- if the baby has begun solid foods, try baby foods with high-fiber content (peas, beans, apricots, prunes, peaches, pears, plums, spinach) twice a day.

DO NOT give laxatives or enemas to children under 6-year old without first asking your doctor.

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Regular exercise 適當適量運動

Regular exercise is also important in establishing regular bowel movements. If you are confined to a wheelchair or bed, change position frequently and perform abdominal contraction exercises and leg raises. A physical therapist can recommend exercises appropriate for your physical abilities.

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Stool softeners 軟便劑

Stool softeners, such as the Herbal "RE-JU Slimming Capsule, 妙之美秀丸" sold on the runner  ↓  of this www.dr-constipation website; or those Western medicine containing decumate sodium) may help. Additionally, bulk laxatives such as psyllium may help add fluid and bulk to the stool. Suppositories or gentle laxatives, such as milk of magnesia liquid, may establish regular bowel movements.

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Enemas or laxatives should be reserved for severe cases only. These methods should be used only if fiber, fluids, and stool softeners do not provide enough relief.

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Reference:

healthline.com/adamcontent/constipation

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intestine.com/start.php?HotKeysDomain=1863647139
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參考資料：

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風濕關節炎筋肌痛 www.reju.org ; 失眠 www.sleepist.com；

自製益生菌奶 www.88chan.com； 歌星.樂隊www.hkband.org

 防便秘便血肚瀉痔漏腸癌 www.dr-constipation.com  ;