Disorders of the Gastrointestinal System, 2nd Edition
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CASE STUDY 13 Connie is a 50-year-old small business owner. She recently fulfilled a long-wished-for dream and opened a craft shop specializing in knitting and embroidery products. Before opening her shop, Connie worked as a buyer for an exclusive women’s boutique. Connie is accus- tomed to stressful work situations and working long hours and enjoys an active career chal- lenge. She also has to deal with something just as challenging but less enjoyable: Chronic constipation. Connie has suffered from constipation for most of her adult life and just shrugs it off as “something I have to live with—it is probably because of my stressful career.” Connie does not realize that the stress and long hours also contribute to her having little or no time to exercise, and she usually eats fast food or skips meals altogether. She does not always stop to drink water as often as she should during the day either. Her constipation seems to be worsening, and she feels bloated and uncomfortable several days a week. Connie finally decides to tell her doctor about this problem and seek relief from an issue that has troubled her for years. Connie is not alone in dealing with chronic consti- pation, also referred to as inactive colon, lazy colon, colonic stasis, or atonic constipation. Besides causing feelings of bloating and abdominal discomfort, an inactive colon can also lead to fecal impaction. Question Which of the following goals is appropriate for a patient with chronic constipation? The patient increases their intake of:
a. Milk and cheese. b. Bread and pasta. c. Fruits and vegetables. d. Lean meats.
Answer/Rationale: The correct answer is c. The most common causes of constipation are a diet low in fiber or one high in fats, such as cheese, eggs, and red meat. Fiber is the part of fruits, vegetables, and grains that the body cannot digest. Constipation
lon). More recently, Irritable bowel syn - drome with constipation (IBS-C) has been added as a diagnosis for those that meet IBS criteria (Basson, 2020). Constipation is a common gastroin- testinal complaint in the U.S., and up to 15% of individuals in the U.S. complain of frequent constipation (Basson, 2020). Pa- tients who report constipation and seek medical intervention are most often wom- en and adults 65 years of age and older. Pregnant individuals also report constipa- tion fairly often, as do postpartum indi- viduals and those who have just had sur- gery (Basson, 2020).
Constipation means different things to different people. Bowel habits vary among people. Some people believe they are constipated unless they have a bowel movement daily. For others, hav- ing a bowel movement every other day is normal. There is a wide range of what is considered normal. Normal patterns of bowel movements range from as many as three times a day or three times a week, depending on the individual. Constipa- tion is generally defined as having a bow - el movement less often than three times a week. Constipation can be self-limiting and short- term or chronic (inactive co-
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