John Perry<[log in to unmask]> wrote:
< Since the mid 1980s, Gastroenterologists and colorectal surgeons have
generally been persuaded by research that about half of all cases of
constipation are "functional" constipation; that is, caused by the inability
to relax the anal sphincter and pelvic floor when trying to empty the bowels.
The condition is variously known as "anismus" or "paradoxical contractions"
and other names. It is so widely recognized now that a famous surgeon
(Kjipers) once said that he would never operate on a patient until functional
constipation had been ruled out by his biofeedback associate.>
*** While it is tempting to attribute constipation to mechanical causes like
this, a great deal of constipation can be produced by dehydration of the
stools associated with inadequate intake of roughage which binds water or
simply failing to evacuate the bowels as soon as a sensation of fullness
occurs. The longer that one waits to evacuate the bowels, the greater the
loss of water from the stools into the body and the greater the likelihood of
constipation.
<The condition is variously known as "anismus" or "paradoxical contractions"
and other names. It is so widely recognized now that a famous surgeon
(Kjipers) once said that he would never operate on a patient until functional
constipation had been ruled out by his biofeedback associate.
.... Several years ago I started writing that most "Low Back Pain" was really
"Crotch Pain"; it's just easier
for the patient to ascribe the pain to the muscle's attachment, rather than
body. This observation was
based on measurement of anal sphincter EMG with inserted sensors.>
A few years ago I developed an "Anismus Index" for the PerryMeter Pelvic
Muscle Rehabilitation software.
It consists of (1) a measure of the muscle at rest, (2) a measure during
strong contraction, and (3) a measure
during attempted defecation or "push out".>
*** Of course, this sort of measurement is of no great relevance to spinal
patients with severe chronic back pain whose lesions do not permit voluntary
contraction or relaxation of the anal sphincter. Their need to defaecate
relies largely on hyperreflexia to warn them when to go to the bathroom for
manual dilling (evacuation). Thus, their type of back pain should have
nothing to do with constipation.
It is difficult to attribute "most back pain" to any single cause, especially
crotch pain. The high prevalence of back pain among those who sit for long
periods, especially in vehicles which impose low frequency vibration on body
structures, suggests that there are acute and chronic mechanical causes of
back pain, as well. It may be that nonspecific 'crotch pain',
constipation, vibration loading, fatigue, certain postural mechanisms and so
forth can serve as triggers, but this does not mean that they are direct
causes of back pain. While correlations are simple to identify via the use
of some very basic statistical means, precise causal relationships are far
more elusive.
Moreover, there are many athletes who suffer from back pain related to
training, yet who suffer from loose bowels or diarrhoea, so this would also
appear to refer to another type of back pain which does not relate to
constipation.
< ...So, IMHO, your observation of a relationship between "low back pain" and
"constipation" is entirely on the mark, Henry! >
***While this may be true, it is also well known that longitudinal loading of
the spine produces loss of fluid from the intervertebral discs, so that, once
again, we come across another tissue dehydration process. Similarly,
powerful muscle contraction can also produce local muscle ischaemia and
dehydration. Thus, we might infer that both constipation and back pain may
relate to imbalances in tissue hydration (or oxidation or nutrition
associated with dehydration or local ischaemia). It would be interesting
trying to ascertain if constipation or dehydration are "causes" of some types
of back pain or if these processes simply are a few of many indicators
associated with back pain. Some research also suggests that certain
psychological issues or states seem to relate to back pain, so that this
issue is one which stretches way beyond one of individual mechanical or
postural causes.
Dr Mel C Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/
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