The majority of cases of constipation may be clearly assigned to one of the above-defined classes. Not infrequently, however, cases are encountered which present most of the symptoms of the several classes of constipation. Colitis with spastic constipation is often observed in cases in which there is also a failure of the defecating mechanism to perform its work properly, and cumulative constipation.
The first point of importance in the treatment of constipation is hygiene. A person must by every means in his power endeavor to improve his general health. Chronic ill health always involves, either primarily or secondarily, a lowering of the vital status, and is in most cases not a result of a single error in habits of life, but of numerous infractions of the rules of healthy or biologic living. So many different factors are involved in the function of bowel movements, that it is highly essential that a person who is suffering from chronic constipation should seek by every available means to improve his general health, and thus increase the vigor of all his bodily functions.
If one's habits have been sedentary, he must make a radical change in his mode of life. When possible, a change from an indoor employment to an active occupation out-of-doors is most desirable. This in itself will in many cases be found quite sufficient to secure regular bowel movements.
If the circumstances of life have been such as to give rise to worry or nervous depression, some change should be effected by which the causes of irritation and depression may be gotten rid of, or the individual should, by the cultivation of optimism, endeavor to rise above the influence of his surroundings.
Constipation is in most cases simply one of the unhappy results of the artificial conditions imposed upon us by modern civilized life. The only escape from this terrible handicap of all useful human activities is to be found in a rational return to Nature, in the adoption, so far as is necessary to secure the physiological conditions, of natural and primitive habits, particularly in reference to diet, sleep, exercise, and out-of-door life.
Before proceeding further the reader who is making a serious study of this subject is asked to re-read carefully two of the preceding chapters, entitled, "Influences Which Normally Excite the Movements of the Colon" and "Influences Which Discourage or Lessen Intestinal Movements," bearing always in mind the fact that for the successful treatment of constipation every possible factor which aids bowel activity must be utilized, and that every factor which has a discouraging influence must be most carefully avoided.
Many of the causes of constipation, and many of the influences connected with every-day life which tend to produce this condition, have been already discussed with some detail, and need not be reconsidered here. The bearing of each one of these causes should be considered in each individual case, and not one unfavorable influence should be permitted to remain.
This has a very much more direct bearing upon the functions of the colon than might at first be supposed. Corsets and belts, as has already been shown, tend directly to produce constipation by hampering the movements of the diaphragm, preventing proper development and activity of the abdominal muscles, and causing displacement of the colon and other viscera into the lower portion of the abdomen. Excess of clothing tends in the same direction by overheating the body and producing excessive perspiration and relaxation of the muscular structures of the abdomen, and perhaps also of the intestines.
Finally, as regards hygiene, every person who is suffering from constipation and really desires to be delivered from the miseries attendant upon this condition should be careful to avoid all habits and influences which tend to retard or discourage bowel action and will most assiduously cultivate every influence and habit which tends to encourage intestinal activity.
Every person who undertakes to combat constipation should know at the start that his efforts if thoroughgoing and persistent may be expected to win. There are many thousands of sufferers who have become utterly discouraged through unsuccessful efforts and have become convinced that the malady is incurable, and that nothing more can be done than to mitigate the evils of the malady as much as possible by laxative drugs and the use of the enema, withstanding their well-known evil effects. There are many thousands of others who depend wholly upon the use of laxative drugs or mineral waters for bowel movements and who are unaware of the harmful effects which inevitably result from the long continued use of drugs which force bowel movement by creating an artificial irritation. The majority of such persons are always looking for some new laxative drug to take the place of one which has lost its effects, fully believing that there is no other way of doing. There is apparently a widespread belief that constipation is incurable. This hopeless view, quite generally held by physicians as well as the laity, is the very natural result of the wrong methods which are generally employed, and the great ignorance concerning the intimate nature and causes of constipation. This ignorance has been quite excusable, however, because of the lack of scientific knowledge respecting the physiology of bowel action. But now that the light of new discovery has illuminated this dark corner of human physiology, the treatment of constipation is no longer necessarily a hopeless groping in the dark but may be made a regular organized campaign against an enemy whose nature and favorite haunts are known and against which recent medical science has provided efficient weapons.
And a veritable campaign the effort must be if success is to be attained in really grave cases. But victory may be attained in every case. It must be understood, however, that there is no panacea for constipation. There is no one simple means by which all cases may be cured, and some cases require the simultaneous employment of almost every known rational remedy. A very few cases require the aid of surgery; and even surgery seldom succeeds when made the sole reliance. Fortunately surgery is very rarely needed when all other means are efficiently used.