Page 14 - Boca Club News - April '22

Page 14, Boca Club News
Medical Matters: Constipation

By Richard Nagler, M.D., a member Medical School for one year as an Assistant Professor of rest are complicit. Depression, Alzheimer’s dementia,
of Broken Sound Club and retired Medicine before opening his own successful private practice heart failure, hypercalcemia, low potassium levels and
physician. After graduating from the in Internal Medicine and Gastroenterology. During that autoimmune neuropathy may be involved. Medications
University of Pennsylvania and New time, he also served for ten years as Chief of Medicine at such as sedatives, opiates, anti-depressants and anti-
York University’s School of Medicine, Huntington Hospital in Huntington, N.Y. hypertensives, antacids, iron, anti-cholinergics, calcium
Dr. Nagler served his internship Constipation is a very common condition that is defined channel blockers, NSAIDS and levodopa for Parkinson’s
and residency at Baltimore City as infrequent bowel movements, or difficulty in the passage are important factors.
Hospital and Johns Hopkins. He of stool, that persists for several weeks or longer. Waste Constipation can result in such complications as internal
followed that with a Fellowship in material moves too slowly through the digestive tract, and external hemorrhoids—an anal fissure with tiny tears
Gastroenterology at Yale University School of Medicine, forming stool in the colon that becomes hard and dry and in the rectum—and fecal impaction, the accumulation
and was then Chief of Gastroenterology at Fitzimmons difficult to pass. People who suffer from constipation of very hard stool that can’t be expelled, causing severe
General Army Hospital in Denver. He returned to the Yale usually have fewer than three bowel movements a week. straining which can produce a rectal prolapse where the
Stools are lumpy and hard, and people strain to pass them rectum is stretched and protrudes outward.
from the rectum. They often feel that they need help to There are measures that can be taken to prevent
empty the rectum, using hands to press on the abdomen or constipation. These include a high-fiber diet with lots of
buttocks, and may even resort to using a finger to remove vegetables, fruits, whole grain cereals and bran, plenty
stool. Abdominal bloating and distension often accompany of fluids, regular exercise and stress reduction. Less
the condition. ingestion of processed foods, dairy and meat is helpful. It is
It is important to recognize that there are a variety important not to ignore the urge to have a bowel movement,
of specific medical causes of constipation that should to never feel rushed, and to try to have one especially right
be looked for in all cases. The irritable bowel syndrome after a meal to take advantage of the gastro colic reflex.
(IBS) is commonly involved. A partial bowel obstruction Treatment consists of adding bulk with fiber
in the form of a stricture as a complication of inflammatory supplements, such as Metamucil, Fibercom and Citrucel.
diseases such as Crohn’s and Ulcerative Colitis, Prune juice and stimulants that cause the intestines to
diverticulitis or cancer of the colon or rectum may be contract, such as Dulcolax and Senocot, are helpful. The
present. That is why it is important to look for occult osmotic laxatives containing magnesium and Miralax
(hidden) blood in the stool, weight loss, anorexia, fever, help move fluid through the colon; mineral oil can act
nausea and vomiting. as a lubricant and stool softeners like Colace and Surfak
It is essential to perform a colonoscopy and small bowel work. In addition, Fleet, soapsuds or tap water enemas and
x-ray in the initial evaluation of all cases. In addition, a glycerin suppositories are useful. Biofeedback techniques
painful anal fissure and a rectocele, which is a bulge of the and acupuncture to help relax the pelvic muscles have been
We AIM To Please rectum through the back wall of the vagina, can occur. A successful in some cases.
“SULLY” spinal cord injury, a stroke, Parkinson’s disease, Multiple It’s important, however, to understand that habitual
Driven in Class and Comfort Sclerosis and diabetes are all complicit. In women, laxative abuse can injure the nerves and muscles in the
rectum and colon, which will adversely affect peristalsis–
constipation can be due to weakening and damage to pelvic
At Reasonable Rates floor muscles or nerves as they age, especially if they’ve the rhythmic movement that propels stool to move
$59 to FLL and had vaginal childbirths or changes in the pelvic anatomy along in the intestine. This can result in the very serious
PBI Airports after a hysterectomy complication of toxic mega colon where it becomes flabby,
Large Groups and Statewide There are a number of risk factors involved in dilates massively, is unable to function and can perforate,
Transport constipation, including advancing age, being female, an resulting in peritonitis, which can be fatal. Volvulous,
A LLIA N T 561-716-0926 African American, of low socioeconomic status and less which is a sudden and very dangerous twisting of the colon
TRANSPORT Text or Call for Service education. Dehydration, loss of teeth, a diet deficient that causes obstruction with neurological complications,
in fiber, little or no physical activity and prolonged bed may also occur as well.

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