Chronic constipation in its fully developed form is apt to affect the general organism. This is not always the case, however, for there are many patients who suffer from constipation for years without making any complaint of their trouble. But as the disease progresses we frequently find some repercussion on the organism. Among the first of the reactions are general physical depression, disinclination to work, and an easy fatigability. We often find actual emaciation also, especially in patients who have the native conception that they can best treat their disease by starvation. Still more frequently do we have patients who complain of headache and dizziness. These head symptoms may declare themselves as a feeling of simple dull pressure and numbness or as severe migraine, which occurs infrequently at first, but then in gradually shorter and shorter intervals. While it would, of course, be an exaggeration to attribute every case of headache or migraine to intestinal disturbances, I have little doubt that cases of true migraine sometimes come under observation which are due to fecal retention alone and are completely curable by removal of this cause.
Heart Gets Affected
Unquestionably the organs of circulation, the heart and blood vessels, may become affected in sympathy with the disease. Cardiac troubles of this organ are not organic but functional and transitory, quickly subsiding with the cure of bowel difficulty, even though the latter has persisted for years. One form of this is what has been called “dyspeptic asthma”, the attacks of which occur as a rule in the night…………….. Such heart attacks are the result of a large accumulation of gas in the stomach and intestines pushing up the diaphragm and thereby interfering with the normal action of the heart. In time, the heart may become affected, or it may, as I have been able to demonstrate, remain free from any organic change.
Kidneys Get Affected
The kidneys also may suffer under the influence of obstinate and long continued constipation.
A more evident sign of the harmful working of constipation on the general system is the occasional appearance of fever (so called toxic fever).
The foregoing sequels of chronic constipation are grouped under the now popular term auto-intoxication.
Notwithstanding a constipation of many years duration the large intestine may remain absolutely normal. But it may in the course of time become the seat of complications of a more or less severe nature. First among these we may mention catarrh of the large intestine. As a result of the long retention of inspissated and sometimes stony-hard fecal masses (coproliths) we find irritation of the intestinal mucous membrane, with the discharge of a variable quantity of mucous.
We may distinguish catarrh of the caecum (typhlitis), of the sigmois flexure (sigmoiditis), and of the rectum (proctitis). In the most advanced cases the catarrh may involve the entire large intestine. That these local catarrhs may give rise to severe pain, or at least to great discomfort, hardly calls as proof. The symptoms are especially pronounced in cases of caecal catarrh (typhlitis). There is no doubt in my mind that chronic constipation may cause not only irritation but even a tumour growth in this especially predisposed bowel segment. This opinion was formely strongly opposed, but-to-day, when most people had the appendix removed, it would do no violence to the fact to deny the possibility of an acute inflammation of the caecum. We often see patients who, after the removal of the appendix, have a brief period of health, but soon begin to comfort a new of pressure and pain in the right iliac fossa, undoubtedly due to fecal stagnation and catarrh in this portion of the intestine. Such a diagnosis appears simple after the removal of the appendix, but it is easily mistaken for appendicitis before that operation.
Haemorrhoids, as is generally known, are dialted veins near the rectum or in its mucous membrane. They are due solely to local disease of the rectum – most commonly to constipation, especially when it occurs in the lowest part of the bowels.
Other Diseases due to Constipation
Among other diseases often associated with a slow intestinal peristalsis are those of the liver and bile passages. The best example of this is afforded by gall-stone disease. Of many patients of this kind whom I have observed I can recall very few who said that their intestinal functions were normal, and not one who complained of diarrhoea. Almost ninety percent of my patients with this trouble – of women fully ninety-five percent – suffered from chronic constipation. This is of practical significance in that it demonstrates that regulation of the bowels is an essential factor in the betterment or cure of gall stone disease.
Sluggishness of the bowels and constipation are likewise seen in diabetes. In former times diabetics were advised to consume large quantities of meat, but aside from the modern view that a large intake of proteins increases the excretion of sugar, is the fact that it also causes a notable slowing of peristalsis.
In gout also the occurrence of chronic constipation, either in its simple form or accompanied by severe colic, is frequently observed. The latter variety is sometimes called intestinal gout. A close relation must exist between the condition of the intestinal tract and gout, for the experience of many physicians has shown that the attacks of gout often alternate with diarrhoea in such a way that the former disappears suddenly upon the appearance of profuse watery stools.