Constipation can be acute or chronic. S.H. Ravanduzi identified 4 grades of chronic constipation (1988).
Grade 1 – defecation delays for up to three days with moderate abdominal tenderness. Working capacity is not impaired.
Grade 2 – defecation delays for 4-6 days with marked stomachaches and painful movement of feces. Symptoms of intoxication in the form of increased fatigue and decreased performance. Psychological issues, manifestations of asthenia and astheno-neurotic syndrome.
Grade 3 – defecation delays for 7-15 days. Severe pain syndrome, dramatic work decrement, and developing symptoms of neurasthenia, hysteria and depression.
Grade 4 – absence of defecation for more than 15 days. Abdominal pain is almost constant. Serious psychological issues with the symptoms of hypochondria and depression. The person is incapable to work and may become handicapped.
The causes of constipation can be as follows:- mechanical obstacles to the advancement of intestinal contents (tumors, clusters of parasites, intestinal inversion, hernias, fecal stones)
- inflammatory bowel diseases
- rectal diseases (hemorrhoids, anal fissures, anorectal abscesses)
- malformations of the intestinal tract
- unhealthy diets
- hypodynamia
- pathologies of the central and peripheral nervous systems
- intoxication
- prolonged administration of medications
- endocrine system dysfunction
- electrolyte imbalance
- bile duct obstruction
- intestinal dysbacteriosis (may be both the cause of constipation and its consequence)
- distress and other diseases that cause intestinal reflex impairment.