December is Constipation Awareness Month and, in recognition of this observance, we thought we'd revisit a claim that it was chronic constipation that led to Elvis Presley's death. In a , Fox News correspondent Hollie McKay reported that, according to Elvis' now-retired personal physician, Dr. “Nick” Nichopoulos, The King’s autopsy revealed that his large intestine was twice the diameter and twice the length of a normal colon.
Kay, quoting Dr. Nick, went on to say that something called “Hershberger’s disease” could have been the underlying cause (This is just a careless mistake because what Dr. Nick was referring to is Hirschsprung’s Disease, an unlikely explanation of Elvis’ constipation because this disease — also known as aganglionic megacolon — is a congenital disease of newborn children who, if untreated by surgical excision of the aganglionic segment, die within a few weeks).
Kay, quoting Dr. Nick, went on to say that something called “Hershberger’s disease” could have been the underlying cause (This is just a careless mistake because what Dr. Nick was referring to is Hirschsprung’s Disease, an unlikely explanation of Elvis’ constipation because this disease — also known as aganglionic megacolon — is a congenital disease of newborn children who, if untreated by surgical excision of the aganglionic segment, die within a few weeks).
People seem to be very interested in, even obsessed with, their bowel habits and advertisers take advantage of this. How many radio commercials have you heard about treatments to remove pounds of waste plastered “on the colon wall like spackle or paste.” And how many celebrities have you heard about who use “” to address any of a number of health problems caused by “toxins” in the body? And what about those TV commercials about the benefits of "probiotics" for digestive health?
The first thing for patients to understand is that constipation is a symptom, not a disease in itself. can lead to constipation and it’s important to know the cause to get the most appropriate treatment. To understand what causes constipation, it helps to educate patients about how the large intestine works.
The large intestine removes most of the water from stool and changes it to a solid waste. The large intestine then moves the stool through the rectum and anus as a bowel movement. Constipation occurs when stool passes through the large intestine too slowly. When stool stays in the large intestine too long, the intestine removes too much water, and the stool becomes hard and dry.
The large intestine removes most of the water from stool and changes it to a solid waste. The large intestine then moves the stool through the rectum and anus as a bowel movement. Constipation occurs when stool passes through the large intestine too slowly. When stool stays in the large intestine too long, the intestine removes too much water, and the stool becomes hard and dry.
How do you know if you’re constipated? Doctors and patients can and often do differ in what they mean by particular terms. Below are the so-called “Rome criteria” for constipation. You have to have two or more of these symptoms for at least three months:
- Straining at defecation at least 25% of the time
- Hard stools (see ) at least 25% of the time
- Incomplete emptying of the bowels at least 25% of the time
- Two or fewer bowel movements per week
- Eat a variety of foods especially vegetables, fruits, and whole grains
- Drink plenty of liquids
- Exercise regularly
- Visit the restroom as soon as you feel the urge to have a bowel movement
- Fiber-containing tablets and powders available at the drug store may help
Constipation is very prevalent in elderly patients as noted by Hippocrates who said, some 2,500 years ago, "the intestines tend to become sluggish with age."
For further information on the causes, work-up, and treatment of constipation we recommend the following articles:
For further information on the causes, work-up, and treatment of constipation we recommend the following articles: