Many Americans have difficulty moving their bowels. Many things contribute to this problem. Some causes include diet and activity level and others are unknown.
This article will describe some of the more common bowel problems.
Anatomy and physiology
The large bowel consists of the colon (5 feet long) and the
rectum (8 inches long). Many time the rectum is referred to as the opening where
stool emerges, but that is actually the anus. The rectum is just upstream from
that area. Just upstream from the large bowel is the small bowel.
The colon's main function is to process the 3 pints of liquid
stool it receives each day into a manageable amount of solid stool, ready for
evacuation. The rectum coordinates the process of evacuation. Normally, a
person can pass up to 150 grams of solid stool daily. However there is a lot of
variation in the amount of stool a normal person passes. This can vary from 3
times daily to 3 times per week.
Functional disorders
Functional disorders are disorders in which the bowel looks
normal but doesn't work properly. These are the most common problems affecting
the colon and rectum. The direct cause is frequently unknown.
Constipation
Constipation is defined as small, hard, difficult, or infrequent
stools. Constipation may be caused by:
- inadequate "roughage" or fiber in the diet
- not enough oral fluid
- poor habits, especially putting off the call to stool
- movement problems in the large bowel, including slow or uncoordinated movement
A person who is constipated may strain during a bowel movement
or just pass very hard stool. Passage of hard stool may contribute to the
development of anal problems such as fissures (painful cracks in the anal tissue
lining) or hemorrhoids.
Treatment of constipation may include eating more fiber and improving stool consistency. If these treatment methods don't work, laxatives or enemas may be recommended.
Irritable bowel (sensitive colon; spastic colon)
Irritable or sensitive bowel is a condition in which the colon
muscle contracts in an abnormal fashion, which may lead to several
problems. Some patients have predominantly diarrhea, others constipation, and
others mixed constipation and diarrhea. The abnormal contraction can lead
to high pressure that builds up in the colon causing abdominal cramps, gas,
bloating, and sometimes extreme urgency.
Treatment includes avoiding foods that make the problems worse,
tailoring diet alteration to the particular symptoms, managing stress, and medications.
Structural disorders