Constipation

Constipation in a young child as seen by X-ray. Circles represent areas of fecal matter (stool is opaque white surrounded by black bowel gas).
ICD-10	K59.0
ICD-9	564.0
DiseasesDB	3080
MedlinePlus	003125
eMedicine	med/2833
MeSH	D003248

Constipation (also known as costiveness,^[1] dyschezia,^[2] and dyssynergic defaecation^[2]) refers to bowel movements that are infrequent or hard to pass.^[2] Constipation is a common cause of painful defecation. Severe constipation includes obstipation (failure to pass stools or gas) and fecal impaction (see also Bowel obstruction).

Constipation is common; in the general population incidence of constipation varies from 2 to 30%.^[3]

Constipation is a symptom with many causes. These causes are of two types: obstructed defecation and colonic slow transit (or hypomobility). About 50% of patients evaluated for constipation at tertiary referral hospitals have obstructed defecation.^[3] This type of constipation has mechanical and functional causes. Causes of colonic slow transit constipation include diet, hormones, side effects of medications, and heavy metal toxicity.

Treatments include changes in dietary habits, laxatives, enemas, biofeedback, and surgery. Because constipation is a symptom, not a disease, effective treatment of constipation may require first determining the cause.

Definition[link]

Types 1 and 2 on the Bristol Stool Chart indicate constipation

The definition of constipation includes the following:^[4][5][6][7]

• infrequent bowel movements (typically three times or fewer per week)
• difficulty during defecation (straining during more than 25% of bowel movements or a subjective sensation of hard stools), or
• the sensation of incomplete bowel evacuation.

The Rome III criteria are widely used to diagnose chronic constipation, and are helpful in separating cases of chronic functional constipation from less-serious instances.^[8]

Children[link]

Constipation in children usually occurs at three distinct points in time: after starting formula or processed foods (while an infant), during toilet training in toddlerhood, and soon after starting school (as in a kindergarten) ^[9]

After birth, most infants pass 4-5 soft liquid bowel movements (BM) a day. Breast-fed infants usually tend to have more BM compared to formula-fed infants. Some breast-fed infants have a BM after each feed, whereas others have only one BM every 2–3 days. Infants who are breast-fed rarely develop constipation.^[10] By the age of two years, a child will usually have 1–2 bowel movements per day and by four years of age, a child will have one bowel movement per day.^[11]

Causes[link]

The causes of constipation can be divided into congenital, primary, and secondary.^[2] The most common cause is primary and not life threatening.^[12] In the elderly, causes include: insufficient dietary fiber intake, inadequate fluid intake, decreased physical activity, side effects of medications, hypothyroidism, and obstruction by colorectal cancer.^[13]

Constipation with no known organic cause, i.e. no medical explanation, exhibits gender differences in prevalence: females are more often affected than males.^[14]

Primary[link]

Primary or functional constipation is ongoing symptoms for greater than six months not due to any underlying cause such as medication side effects or an underlying medical condition.^[2][15] It is not associated with abdominal pain thus distinguishing it from irritable bowel syndrome.^[2] It is the most common cause of constipation.^[2]

Diet[link]

Constipation can be caused or exacerbated by a low fiber diet, low liquid intake, or dieting.^[5][6]

Medication[link]

Many medications have constipation as a side effect. Some include (but are not limited to); opioids (e.g. common pain killers), diuretics, antidepressants, antihistamines, antispasmodics, anticonvulsants, and aluminum antacids ^[5][8]

Metabolic & muscular[link]

Metabolic and endocrine problems which may lead to constipation include: hypercalcemia, hypothyroidism, diabetes mellitus, cystic fibrosis, and celiac disease.^[5][12] Constipation is also common in individuals with muscular and myotonic dystrophy.^[5]

Structural and functional abnormalities[link]

Constipation has a number of structural (mechanical, morphological, anatomical) causes, including: spinal cord lesions, Parkinsons, colon cancer, anal fissures, proctitis, and pelvic floor dysfunction.^[12]

Constipation also has functional (neurological) causes, including anismus, descending perineum syndrome, and Hirschsprung's disease.^[3] In infants, Hirschsprung's disease is the most common medical disorder associated with constipation. Anismus occurs in a small minority of persons with chronic constipation or obstructed defecation.^[16]

Psychological[link]

Voluntary withholding of the stool is a common cause of constipation.^[5] The choice to withhold can be due to factors such as fear of pain, fear of public restrooms, or laziness.^[5] When a child holds in the stool a combination of encouragement, fluids, fiber, and laxatives may be useful to overcome the problem.^[17]

Diagnosis[link]

The diagnosis is essentially made from the patient's description of the symptoms. Bowel movements that are difficult to pass, very firm, or made up of small hard pellets (like those excreted by rabbits) qualify as constipation, even if they occur every day. Other symptoms related to constipation can include bloating, distension, abdominal pain, headaches, a feeling of fatigue and nervous exhaustion, or a sense of incomplete emptying.^[18]

Inquiring about dietary habits will often reveal a low intake of dietary fiber, inadequate amounts of fluids, poor ambulation or immobility, or medications that are associated with constipation.^[5][6]

During physical examination, scybala^[19] (manually palpable lumps of stool) may be detected on palpation of the abdomen. Rectal examination gives an impression of the anal sphincter tone and whether the lower rectum contains any feces or not. Rectal examination also gives information on the consistency of the stool, presence of hemorrhoids, admixture of blood and whether any tumors, polyps or abnormalities are present. Physical examination may be done manually by the physician, or by using a colonoscope. X-rays of the abdomen, generally only performed if bowel obstruction is suspected, may reveal extensive impacted fecal matter in the colon, and confirm or rule out other causes of similar symptoms.^[5][6]

Chronic constipation (symptoms present at least three days per month for more than three months) associated with abdominal discomfort is often diagnosed as irritable bowel syndrome (IBS) when no obvious cause is found.^[20]

Colonic propagating pressure wave sequences (PSs) are responsible for discrete movements of the bowel contents and are vital for normal defecation. Deficiencies in PS frequency, amplitude and extent of propagation are all implicated in severe defecatory dysfunction (SDD). Mechanisms that can normalise these aberrant motor patterns may help rectify the problem. Recently the novel therapy of sacral nerve stimulation (SNS) has been utilized for the treatment of severe constipation.^[21]

Criteria[link]

The Rome II Criteria for constipation require at least two of the following symptoms for 12 weeks or more over the period of a year:^[22]

• Straining with more than one-fourth of defecations
• Hard stool with more than one-fourth of defecations
• Feeling of incomplete evacuation with more than one-fourth of defecations
• Sensation of anorectal obstruction with more than one-fourth of defecations
• Manual maneuvers to facilitate more than one-fourth of defecations
• Fewer than three bowel movements per week
• Insufficient criteria for irritable bowel syndrome

Prevention[link]

Constipation is usually easier to prevent than to treat. Following the relief of constipation, maintenance with adequate exercise, fluid intake, and high fiber diet is recommended.^[5] Children benefit from scheduled toilet breaks, once early in the morning and 30 minutes after meals.^[5][23]

Treatment[link]

The main treatment of constipation involves the increased intake of water and fiber (either dietary or as supplements).^[12] The routine use of laxatives is discouraged, as having bowel movements may come to be dependent upon their use. Enemas can be used to provide a form of mechanical stimulation. However, enemas are generally useful only for stool in the rectum, not in the intestinal tract.

Laxatives[link]

If laxatives are used, milk of magnesia is recommended as a first-line agent due to its low cost and safety.^[12] Stimulants should only be used if this is not effective.^[12] In cases of chronic constipation, prokinetics may be used to improve gastrointestinal motility. A number of new agents have shown positive outcomes in chronic constipation; these include prucalopride,^[24] and lubiprostone.^[25]

Physical intervention[link]

Constipation that resists the above measures may require physical intervention such as manual disimpaction (the physical removal of impacted stool using the hands; see Fecal impaction).

Pediatric[link]

Lactulose and milk of magnesia have been compared with polyethylene glycol (PEG) in children. All had similar side effects, but PEG was more effective at treating constipation.^[26][27] Osmotic laxatives are recommended over stimulant laxatives.^[28]

Prognosis[link]

Complications that can arise from constipation include hemorrhoids, anal fissures, rectal prolapse, and fecal impaction.^{[5][6][23][29]} Straining to pass stool may lead to hemorrhoids. In later stages of constipation, the abdomen may become distended, hard and diffusely tender. Severe cases ("fecal impaction" or malignant constipation) may exhibit symptoms of bowel obstruction (vomiting, very tender abdomen) and encopresis, where soft stool from the small intestine bypasses the mass of impacted fecal matter in the colon.

Epidemiology[link]

Constipation is the most common digestive complaint in the United States as per survey data.^[30] Depending on the definition employed, it occurs in 2% to 20% of the population.^[12][31] It is more common in women, the elderly and children.^[31] The reasons it occurs more frequently in the elderly is felt to be due to an increasing number of health problems as humans age and decreased physical activity.^[15]

• 12% of the population worldwide reports having constipation.^[32]
• Chronic constipation accounts for 3% of all visits annually to pediatric outpatient clinics^[5].
• Constipation-related healthcare costs total $6.9 billion in the US annually.^[12]
• More than four million Americans have frequent constipation, accounting for 2.5 million physician visits a year.^[29]
• Around $725 million is spent on laxative products each year in America.^[29]

See also[link]

• Bowel management

References[link]

External links[link]

• 09-129b. at Merck Manual of Diagnosis and Therapy Home Edition
• Constipation - Introduction (UK NHS site)
• MedlinePlus Overview constipation
• Constipation Guideline - the World Gastroenterology Organisation (WGO)
• Constipation treatment guide - Canadian Society for Gastrointestinal Endoscopy

Screamin' Jay Hawkins
Screamin' Jay Hawkins in concert Photo: Jean-Luc Ourlin
Background information
Birth name	Jalacy Hawkins
Born	(1929-07-18)July 18, 1929 Cleveland, Ohio
Died	February 12, 2000(2000-02-12) (aged 70) Neuilly-sur-Seine, France
Genres	Rhythm and blues, soul, shock rock
Occupations	Musician, songwriter, actor, producer
Years active	1946–2000

Jalacy Hawkins (July 18, 1929, Cleveland, Ohio – February 12, 2000, Neuilly-sur-Seine, France), best known as Screamin' Jay Hawkins was an American musician, singer, and actor. Famed chiefly for his powerful, operatic vocal delivery and wildly theatrical performances of songs such as "I Put a Spell on You", Hawkins sometimes used macabre props onstage, making him one of the few early shock rockers.^[1]

Early career[link]

Born and raised in Cleveland, Ohio, Hawkins studied classical piano as a child and learned guitar in his twenties.^[2] His initial goal was to become an opera singer (Hawkins has cited Paul Robeson as his musical idol in interviews),^[3] but when his initial ambitions failed he began his career as a conventional blues singer and pianist.

He served in the United States Army Air Force in the Pacific theater during World War II,^{[verification needed]} primarily as an entertainer. Although he claimed to have been tortured for some time as a prisoner of war, stories of the circumstances of his actual capture vary. According to the documentary I Put a Spell on Me, upon liberation he blew his chief tormentor's head off by taping a hand-grenade into his mouth and pulling the pin. Hawkins was an avid and formidable boxer.^{[citation needed]} In 1949, he was the middleweight boxing champion of Alaska.^{[citation needed]}

In 1951, Hawkins joined guitarist Tiny Grimes's band, and was subsequently featured on some of Grimes's recordings.^[3] When Hawkins became a solo performer, he often performed in a stylish wardrobe of leopard skins, red leather and wild hats.

"I Put a Spell on You"[link]

His most successful recording, "I Put a Spell on You" (1956), was selected as one of The Rock and Roll Hall of Fame's 500 Songs that Shaped Rock and Roll. According to the AllMusic Guide to the Blues, "Hawkins originally envisioned the tune as a refined ballad."^[3] The entire band was intoxicated during a recording session where "Hawkins screamed, grunted, and gurgled his way through the tune with utter drunken abandon."^[3] The resulting performance was no ballad but instead a "raw, guttural track" that became his greatest commercial success and reportedly surpassed a million copies in sales,^[4][5] although it failed to make the Billboard pop or R&B charts.^[6][7]

The performance was mesmerizing, although Hawkins himself blacked out and was unable to remember the session.^[5] Afterward he had to relearn the song from the recorded version.^[5] Meanwhile the record label released a second version of the single, removing most of the grunts that had embellished the original performance; this was in response to complaints about the recording's overt sexuality.^[5] Nonetheless it was banned from radio in some areas.

Soon after the release of "I Put a Spell on You", radio disc jockey Alan Freed offered Hawkins $300 to emerge from a coffin onstage.^[4] Hawkins accepted and soon created an outlandish stage persona in which performances began with the coffin and included "gold and leopard skin costumes and notable voodoo stage props, such as his smoking skull on a stick – named Henry – and rubber snakes."^[4] These props were suggestive of voodoo, but also presented with comic overtones that invited comparison to "a black Vincent Price."^[2][5]

Later career[link]

Hawkins' later releases included "Constipation Blues", "Orange Colored Sky", and "Feast of the Mau Mau". Nothing he released, however, had the monumental success of "I Put a Spell on You". In fact, "Constipation Blues" has been described as "gross".^[8] In Paris in 1999 and at the Taste of Chicago festival, he actually performed the song with a toilet onstage.^[9]

He continued to tour and record through the 1960s and 1970s, particularly in Europe, where he was very popular. He appeared in performance (as himself) in the Alan Freed bio-pic American Hot Wax in 1978. Subsequently, filmmaker Jim Jarmusch featured "I Put a Spell on You" on the soundtrack – and deep in the plot – of his film Stranger Than Paradise (1983) and then Hawkins himself as a hotel night clerk in his Mystery Train and in roles in Álex de la Iglesia's Perdita Durango and Bill Duke's adaptation of Chester Himes' A Rage in Harlem.

His 1957 single "Frenzy" (found on the early 1980s compilation of the same name) was included in the compilation CD, Songs in the Key of X: Music from and Inspired by the X-Files, in 1996.^[10] This song was featured in the show's Season 2 episode "Humbug". It was also covered by the band Batmobile.^{[citation needed]} "I Put a Spell on You" was featured during the show and over the credits of Episode 303 of The Simpsons.^[11]

In 1983, Hawkins relocated to the New York area. In 1984 and 1985, Hawkins collaborated with garage rockers The Fuzztones, resulting in "Screamin' Jay Hawkins and The Fuzztones Live" album recorded at Irving Plaza in December 1984. They perform in the 1986 movie Joey^[12]

In July 1991, Hawkins released his album Black Music for White People.^[13] The record features covers of two Tom Waits compositions: "Heart Attack and Vine"^[14] (which, later that year, was used in a European Levi's advertisement without Waits' permission, resulting in a lawsuit),^[15] and "Ice Cream Man" (which, contrary to popular belief,^{[citation needed]} is a Waits original, and not a cover of the John Brim classic).^[16] Hawkins also covered the Waits song, "Whistlin' Past the Graveyard", for his album Somethin' Funny Goin' On. In 1993, his version of "Heart Attack and Vine" became his only UK hit, reaching # 42 on the UK singles chart.^[17]

When Dread Zeppelin recorded their "disco" album, It's Not Unusual in 1992, producer Jah Paul Jo asked Hawkins to guest. He performed the songs "Jungle Boogie" and "Disco Inferno".

Hawkins also toured with The Clash and Nick Cave during this period, and not only became a fixture of blues festivals, but appeared at many film festivals as well.^{[citation needed]}

Hawkins died on February 12, 2000 after surgery to treat an aneurysm.^[18] He left behind many children by many women; an estimated 55 at the time of his death, and upon investigation, that number "soon became perhaps 75 offspring".^[19]

Influence[link]

Although Hawkins was not a major success as a recording artist, his highly theatrical performances from "I Put a Spell On You" onward earned him a steady career as a live performer for decades afterward, and influenced subsequent acts.^[2] He opened for Fats Domino, Tiny Grimes and the Rolling Stones.^[2] This exposure in turn influenced rock groups such as The Cramps, Screaming Lord Sutch, Black Sabbath, Arthur Brown, Dread Zeppelin, The Horrors, Marilyn Manson, Alice Cooper and Glenn Danzig.^[2]

Discography[link]

Albums[link]

• 1958 At Home with Screamin' Jay Hawkins (Okeh/Epic) - other editions entitled Screamin' Jay Hawkins and I Put a Spell on You
• 1965 The Night and Day of Screamin' Jay Hawkins (Planet/52e Rue Est) - also entitled In the Night and Day of Screamin' Jay Hawkins
• 1969 What That Is! (Philips)
• 1970 Because Is in Your Mind (Armpitrubber) (Philips)
• 1972 Portrait of a Man and His Woman (Hotline) - also entitled I Put a Spell on You and Blues Shouter
• 1977 I Put a Spell on You (Versatile—recordings from 1966–76)
• 1979 Screamin' the Blues (Red Lightnin'--recordings from 1953–70)
• 1983 Real Life (Zeta)
• 1984 Screamin' Jay Hawkins and The Fuzztones Live (Midnight Records) - live
• 1988 At Home with Jay in The Wee Wee Hours (Midnight Records) - live
• 1988 Live & Crazy (Blue Phoenix) - live
• 1990 The Art of Screamin' Jay Hawkins (Spivey)
• 1991 Black Music For White People (Bizarre/Straight Records/Planet Records)
• 1991 I Shake My Stick at You (Aim)
• 1993 Stone Crazy (Bizarre/Straight/Planet)
• 1994 Somethin' Funny Goin' On (Bizarre/Straight/Planet)
• 1993 Rated X (Sting S) - live
• 1998 At Last (Last Call)
• 1999 Live at the Olympia, Paris (Last Call) - live with one new studio recording

Singles[link]

• 1956 "I Put a Spell On You" / "Little Demon" [OKeh 7072]
• 1957 "You Made Me Love You" / "Darling, Please Forgive Me" [OKeh 7084]
• 1957 "Frenzy" / "Person to Person" [OKeh 7087]
• 1958 "Alligator Wine" / "There's Something Wrong With You" [OKeh 7101]
• 1958 "Armpit #6" / "The Past" [Red Top 126]
• 1962 "I Hear Voices" / "Just Don't Care" [Enrica 1010]
• 1962 "Ashes" / "Nitty Gritty" w/ Shoutin' Pat (Newborn) [Chancellor 1117]
• 1966 "Poor Folks" / "Your Kind of Love" [Providence 411]
• 1970 "Do You Really Love Me" / "Constipation Blues" [Philips 40645]
• 1973 "Monkberry Moon Delight" / "Sweet Ginny" [Queen Bee 1313]

Multi-artist samplers and budget compilations[link]

• 1962 Screamin' Jay Hawkins and Lillian Briggs (Coronet)
• 1963 A Night at Forbidden City (Sounds of Hawaii)
• 1988 Screamin' Jay Hawkins- I Put A Spell On You (Elvira Presents: Haunted Hits LP)
• 1990 Screamin' Jay Hawkins- I Put A Spell On You (Elvira Presents: Haunted Hits CD Re-Release)
• 1994 Screamin' Jay Hawkins- Little Demon (Elvira Presents: Monster Hits CD)
• 1996 Screamin' Jay Hawkins - Frenzy (Songs in the Key of X - The X Files)

Filmography[link]

• American Hot Wax (As himself, 1978)
• Mystery Train (Jim Jarmusch, 1989)
• A Rage in Harlem (As Himself, 1991)
• Perdita Durango, also known as Dance with the Devil (Álex de la Iglesia, 1997)
• Peut-être (As club singer, Cedric Klapish 1999)
• Screamin' Jay Hawkins: I Put a Spell On Me (Nicholas Triandafyllidis, 2001)^[20]

References[link]

External links[link]

• Podcast of an interview with Screamin' Jay Hawkins, recorded in 1987.
• Screamin' Jay Hawkins at the Internet Movie Database
• Detailed web site on Hawkins
• Reviews on Hawkins' records
• Screamin' Jay Hawkins at Allmusic
• Transcription of 1983 interview on British radio
• Screamin' Jay Hawkins discography, Singles, EP's, LP/CD
• Screamin' Jay Hawkins Guest Appearance With Dread Zeppelin

Avril Lavigne
Avril Lavigne during a performance in Italy, September 2011.
Background information
Birth name	Avril Ramona Lavigne
Born	(1984-09-27) 27 September 1984 (age 27) Belleville, Ontario, Canada
Origin	Napanee, Ontario, Canada
Genres	Pop rock, power pop, pop punk
Occupations	Singer-songwriter, Fashion Designer
Instruments	Vocals, guitar, piano, drums
Years active	2000–present
Labels	Epic, RCA, Arista
Associated acts	Evan Taubenfeld, Deryck Whibley
Website	www.avrillavigne.com
Notable instruments
Squier Signature Telecaster model guitar

Avril Ramona Lavigne (pronunciation: /ˈævrɨl ləˈviːn/; AV-ril lə-VEEN; born 27 September 1984) is a Canadian singer-songwriter. She was born in Belleville, Ontario, but spent most of her youth in the small town of Napanee. By the age of 15, she had appeared on stage with Shania Twain; by 16, she had signed a two-album recording contract with Arista Records worth more than $2 million. In 2002, when she was 17 years old, Lavigne broke onto the music scene with her debut album Let Go.

Let Go made Lavigne the youngest female soloist to reach No. 1 in the UK, and the album was certified four-times platinum by the Recording Industry Association of America. By 2009, over 16 million copies had been sold worldwide. Her breakthrough single, "Complicated", peaked at No. 1 in many countries around the world, as did the album Let Go. Her second album, Under My Skin, was released in 2004 and was her first album to peak at No. 1 on the U.S. Billboard 200, eventually selling more than 10 million copies worldwide. The Best Damn Thing, Lavigne’s third album, was released in 2007, becoming her third No. 1 album in the UK Albums Chart and featuring her first U.S. Billboard Hot 100 No. 1 single, "Girlfriend". Lavigne has scored six number-one singles worldwide, including "Complicated", "Sk8er Boi", "I'm with You", "My Happy Ending", "Nobody's Home", and "Girlfriend". With more than 30 million copies of her albums sold worldwide, Lavigne is one of the top-selling artists releasing albums in the U.S., with over 10.25 million copies certified by the RIAA. Her fourth studio album, Goodbye Lullaby, was released in March 2011. Goodbye Lullaby gave Lavigne her fourth top 10 album on the U.S. Billboard 200 and the UK Albums Chart and her third No. 1 album in both Japan and Australia. Three months after the release of Goodbye Lullaby, Lavigne began work on her fifth album, which will be released on Epic Records following her departure from RCA Records.

Lavigne branched out from recording music, pursuing careers in feature film acting and designing clothes and perfumes. She voiced a character in the animated film, Over the Hedge, in 2006. That same year, she made her on-screen feature film debut in Fast Food Nation. In 2008, Lavigne introduced her clothing line, Abbey Dawn, and in 2009, she released her first perfume, Black Star, which was followed by her second perfume, Forbidden Rose, in 2010 and her third perfume, Wild Rose, in 2011. In July 2006, Lavigne married her boyfriend of two years, Deryck Whibley, lead singer and guitarist for Sum 41. The marriage lasted a little over three years, and in October 2009, Lavigne filed for divorce. Whibley and Lavigne continued to work together, with Whibley producing her fourth album, as well as Lavigne's single, "Alice", written for Tim Burton's film Alice in Wonderland.

Early life[link]

Avril Ramona Lavigne was born in Belleville, Ontario. Her father, Jean-Claude Lavigne, named her "Avril" after the French word for the month of April. At the age of two, she began singing church songs with her mother,^[1] Judith-Rosanne "Judy" (née Loshaw). Judy recognized her two-year-old daughter's talents after hearing her sing "Jesus Loves Me" in church.^[2] Lavigne has an older brother, Matthew, and a younger sister, Michelle,^[3] both of whom teased her when she sang. "My brother used to knock on the wall because I used to sing myself to sleep and he thought it was really annoying."^[2]

When Lavigne was five years old, the family moved to Napanee, Ontario,^[1] a town with a population of approximately 5,000.^[4][5][6] Although she struggled to pay attention in school, sometimes being kicked out of class for misbehaving, her parents supported her singing. Her father bought her a microphone, a drum kit, a keyboard, and several guitars, and converted their basement into a studio. When Lavigne was 14, her parents would take her to karaoke sessions.^[7] Lavigne also performed at country fairs, singing songs by Garth Brooks, The Dixie Chicks, and Shania Twain. She also began writing her own songs. Her first song was called "Can't Stop Thinking About You", about a teenage crush, which she described as "cheesy cute".^[8]

In 1999,^[9] Lavigne won a radio contest to perform with fellow Canadian singer Shania Twain at the Corel Centre (now Scotiabank Place) in Ottawa, before an audience of 20,000 people.^[1][4] Twain and Lavigne sang "What Made You Say That",^[1] and Lavigne told Twain that she was going to be "a famous singer".^[4] During a performance with the Lennox Community Theatre, Lavigne was spotted by local folksinger Stephen Medd. He invited her to contribute vocals on his song, "Touch the Sky", for his 1999 album, Quinte Spirit. She later sang on "Temple of Life" and "Two Rivers" for his follow-up album, My Window to You, in 2000. In December 1999, Lavigne was discovered by her first professional manager, Cliff Fabri, while singing country covers at a Chapters bookstore in Kingston, Ontario.^[1][4] Fabri sent out VHS tapes of Lavigne's home performances to several industry prospects, and Lavigne was visited by several executives.^[10] Mark Jowett, co-founder of the Canadian management firm Nettwerk, received a copy of Lavigne's karaoke performances recorded in her parents' basement.^[11] Jowett arranged for Lavigne to work with Peter Zizzo during the summer of 2000 in New York, where she wrote the song "Why". Lavigne was noticed by Arista Records on a subsequent trip to New York.^[10]

Lavigne would go on to sell more than 30 million copies of her albums worldwide,^[12] becoming one of the top-selling artists releasing albums in the U.S., with over 10.25 million copies certified by the RIAA.^[13] In 2009, Billboard named Lavigne the No. 10 pop artist in the "Best of the 2000s" chart.^[14] She was listed as the 28th overall best act of the decade based on album and single chart performance in the U.S.^[15]

Music career[link]

[edit] 2000–03: Let Go

In November 2000,^[5] Ken Krongard, an A&R representative, invited Antonio "L.A." Reid, then head of Arista Records, to producer Peter Zizzo's Manhattan studio to hear Lavigne sing. Her 15-minute audition "so impressed" Reid that he immediately signed her to Arista with a deal worth $1.25 million for two albums and an extra $900,000 for a publishing advance.^[6][1] By this time, Lavigne had found that she fit in naturally with her hometown high school's skater clique, an image that carried through to her first album, but although she enjoyed skateboarding, school left her feeling insecure. Armed with a record deal, she dropped out to focus on her music career,^[5] but she still had to inform her parents of her decision. "I wasn't going to turn [the record deal] down. It's been my dream all my life. They knew how much I wanted this and how much I've put into it."^[16][8]

Reid gave A&R Joshua Sarubin the responsibility for overseeing Lavigne's development and the recording of her debut album.^[17] They spent several months in New York working with different co-writers trying to forge an individual sound for her. Sarubin told HitQuarters that for while they struggled finding her sound and although early collaborations with songwriter-producers including Sabelle Breer, Curt Frasca and Peter Zizzo resulted in some good songs, they didn't match her and her voice.^[17] It was only when Lavigne then went to Los Angeles in May 2001 and created two songs with The Matrix production team – including "Complicated" – that the record company felt she had made a major breakthrough.^[17] Lavigne then worked further with The Matrix and also with singer-songwriter Cliff Magness. Recording finished in January 2002.^[17]

Lavigne released her debut album, Let Go, on 4 June 2002 in the U.S., where it reached No. 2 on the Billboard 200. It peaked at No. 1 on the Australian, Canadian, and UK charts. This made Lavigne, at 17 years old, the youngest female soloist to have a No. 1 album in the UK until that time.^[18] By the end of 2002, the album was certified four-times platinum by the RIAA, making her the bestselling female artist of 2002 and Let Go the top-selling debut of the year.^[19] By May 2003, Let Go had accumulated over 1,000,000 sales in Canada, receiving a diamond certification from the Canadian Recording Industry Association.^[20] As of 2009, the album has sold over 16 million units worldwide,^[21] and the RIAA has certified the album six-times platinum, denoting shipments of over six million units in the U.S.^[22]

Lavigne's debut single and the album's lead single, "Complicated", peaked at No. 1 in Australia and No. 2 in the U.S. "Complicated" was one of the bestselling Canadian singles of 2002, and it was also featured on the teen television show, Dawson's Creek. "Complicated" later ranked on the Hot 100 Singles of the Decade list at No. 83.^[23]

Subsequent singles, "Sk8er Boi" and "I'm With You" reached the top ten in the U.S.^[24] Thanks to the success of her first three singles, Lavigne was the second artist in history to have three No. 1 songs from a debut album on the Billboard Mainstream Top 40.^[25] For the music video to "Complicated", Lavigne was named Best New Artist at the 2002 MTV Video Music Awards.^[26] She won four Juno Awards in 2003 out of six nominations,^[27] received a World Music Award for "World's Bestselling Canadian Singer", and was nominated for eight Grammy Awards, including Best New Artist and Song of the Year for "Complicated" (2003).^[28]

In 2002, Lavigne made a cameo appearance in the music video to "Hundred Million" by the pop punk band Treble Charger.^[29] In March 2003, Lavigne posed for the cover of Rolling Stone magazine^[30] and, later in May,^[31] performed "Fuel" during MTV's Icon tribute to Metallica.^[32] During her first headlining tour, the Try To Shut Me Up Tour, Lavigne covered Green Day's "Basket Case".^[33]

Lavigne was featured in the 2003 game, The Sims: Superstar, as a non-playable celebrity.^[34]

[edit] 2004–05: Under My Skin

Lavigne in Vancouver, Canada during the Live and By Surprise mall tour

Lavigne co-wrote "Breakaway" with Matthew Gerard, which was recorded by Kelly Clarkson for the soundtrack to the 2004 film The Princess Diaries 2: Royal Engagement.^[35] "Breakaway" would later be included on Clarkson's second album and released as the album's lead single. Lavigne covered the Goo Goo Dolls song "Iris", performed with the band's lead singer John Rzeznik at Fashion Rocks,^[36] and she posed for the cover of Maxim in October 2004.^[37] She also recorded the theme song for The SpongeBob SquarePants Movie. "I made the song a little more edgy", Lavigne said. "There are a lot of loud guitars, and we picked the tempo up a little and sang it with a little more attitude." Lavigne rearranged the song with the help of producer Butch Walker.^[38]

Lavigne's second studio album, Under My Skin, was released on 25 May 2004, debuting at No. 1 in several countries, including Australia, Mexico, Canada, Japan, the UK, and the U.S.^[39] The album has sold more than 10 million copies. Lavigne wrote most of the album's tracks with Canadian singer-songwriter Chantal Kreviazuk. Kreviazuk's husband, Our Lady Peace front man Raine Maida, co-produced the album, along with Butch Walker and Don Gilmore. Lavigne went on the Live and By Surprise twenty-one-city mall tour in the US and Canada to promote the album, accompanied by her guitarist, Evan Taubenfeld. Each performance consisted of a short live acoustic set of songs from the new album. At the end of 2004, Lavigne embarked on her first world tour, the Bonez Tour, which had stopovers in almost every continent and lasted for the entire 2005 year.

"Don't Tell Me", the lead single of the album, went to No. 1 in Argentina and Mexico and reached the top five in the UK and Canada and the top ten in Australia and Brazil. "My Happy Ending", the album's second single, went to No. 1 in Mexico and the top five in the UK and Australia. In the US, it reached the top ten of the Billboard Hot 100 and went to No. 1 in the Mainstream Top 40, making it her fourth-biggest hit there. The third single, "Nobody's Home", did not make the top 40 in the US, reaching No. 1 only in Mexico and Argentina. The fourth single from the album, "He Wasn't", reached top 40 positions in the UK and Australia and was not released in the U.S.^[41]

Lavigne won two World Music Awards in 2004 for "World's Best Pop/Rock Artist" and "World's Bestselling Canadian Artist". She received five Juno Award nominations in 2005, and picked up three, including "Artist of the Year". She won the award for "Favorite Female Singer" at the eighteenth annual Nickelodeon Kids' Choice Awards^[42] and was nominated in every MTV Award show shown around the world.

[edit] 2006–08: The Best Damn Thing

On 26 February 2006, Lavigne represented Canada at the closing ceremony of the Torino Olympics, performing her song "Who Knows" during the eight minute Vancouver 2010 portion.^[43]

While Lavigne was in the studio for her third studio album, Fox Entertainment Group approached her to write a song for the soundtrack to the 2006 fantasy-adventure film Eragon. She wrote and recorded two "ballad-type" songs, but only one, "Keep Holding On", was used for the film.^[44] Lavigne admitted that writing the song was challenging, making sure it flowed with the film. She emphasized that "Keep Holding On", which later appeared on the album, was not indicative of what the next album would be like.^[45][46]

Lavigne in 2008 performing in the Netherlands.

Lavigne's third album, The Best Damn Thing, was released on 17 April 2007, which Lavigne immediately promoted with a small tour. Its lead single, "Girlfriend", topped the Billboard Hot 100 the same week The Best Damn Thing debuted at No. 1 on the Billboard 200 chart. "Girlfriend" was Lavigne's first single to reach this No. 1 position.^[47] The single was a worldwide hit; it also peaked at No. 1 in Australia, Canada, Japan, and Italy and reached No. 2 in the UK and France. "Girlfriend" was recorded in Spanish, French, Italian, Portuguese, German, Japanese, and Mandarin. The International Federation of the Phonographic Industry ranked "Girlfriend" as the most-downloaded track worldwide in 2007, selling 7.3 million copies, including the versions recorded in eight different languages.^[48][12] "Girlfriend" ranked on the Hot 100 Singles of the Decade list at No. 94.^[49]

"When You're Gone", the second single, went to No. 3 in the UK, the top five in Australia and Italy, the top ten in Canada, and was close to reaching the top twenty in the U.S. In December 2007, Lavigne, with annual earnings of $12 million, was ranked number eight in the Forbes "Top 20 Earners Under 25".^[50] "Hot" was the third single and has been Lavigne's least successful single in the U.S., charting only at No. 95. In Canada, "Hot" made the top ten, and in Australia, the top 20. The Best Damn Thing has sold over 6 million copies worldwide.

During this era, Lavigne won nearly every award she was nominated for, including two World Music Awards for "World's Bestselling Canadian Artist" and "World's Best Pop/Rock Female Artist". She took her first two MTV Europe Music Awards, received one Teen Choice Awards for "Summer Single", and was nominated for five Juno awards.

In mid-2007, Lavigne was featured in a two-volume graphic novel, Avril Lavigne's Make 5 Wishes. She collaborated with artist Camilla D’Errico and writer Joshua Dysart on the manga, which was about a shy girl named Hana who, upon meeting her hero Avril Lavigne, learned to overcome her fears. Lavigne said, "I know that many of my fans read manga, and I'm really excited to be involved in creating stories that I know they will enjoy." The volumes were released on 10 April (one week prior to the release of The Best Damn Thing) and in July, respectively. The publication Young Adult Library Services nominated the series for "Great Graphic Novels for Teens".^[51]

In March 2008, Lavigne undertook a world tour named The Best Damn Tour to support the album. In that same month, she also appeared on the cover of Maxim for the second time of her career.^[52] In mid-August, Malaysia's Islamic opposition party, the Pan-Malaysian Islamic Party, attempted to ban Lavigne's show in Kuala Lumpur, judging her stage moves "too sexy". Her concert on 29 August was considered as promoting wrong values ahead of Malaysia's independence day on 31 August.^[53] On 21 August 2008, MTV reported that the concert had been approved by the Malaysian government.^[54]

[edit] 2009–11: Goodbye Lullaby

Lavigne singing in Florida during her Black Star Tour, May 2011.

Only a month after completing The Best Damn Tour, Lavigne began recording in her home studio in November 2008 with the song "Black Star",^[55] written to help promote her first fragrance of the same name.^[56] By July 2009, nine tracks had been recorded for the new album,^[55] including the songs "Fine", "Everybody Hurts" and "Darlin". Several of the tracks were written in Lavigne's youth. "Darlin" was the second song Lavigne wrote as a 15-year-old while living in Napanee, Ontario. Lavigne described the album as being about "life". She stated, "It's so easy for me to do a boy-bashing pop song, but to sit down and write honestly about something that's really close to me, something I've been through, it's a totally different thing."^[56] With the exception of the album's lead single, "What the Hell", Lavigne described the songs on the album as different from her earlier material: "I'm older now, so I think that comes across in my music, it's not as pop-rock".^[57]

In January 2010, while simultaneously writing and recording for her new album, Lavigne worked with Disney clothing designs inspired by Tim Burton's feature film, Alice in Wonderland. She asked the executives if she could write a song for the film. The result was the song "Alice",^[58] which was played over the end credits^[59] and included on the soundtrack, Almost Alice.^[60]

On 28 February, Lavigne gave a performance at the concert portion of the Vancouver 2010 Winter Olympics closing ceremony, performing "My Happy Ending" and "Girlfriend".^[61] Lavigne was honoured to perform at the ceremonies, but she regretted not being able to attend the U.S. vs. Canada hockey match. "They had us on lockdown. We weren't allowed to leave our trailers, for security purposes."^[62]

In September 2010, Lavigne's third single from her debut album, "I'm With You", was sampled by Rihanna on the track "Cheers (Drink to That)", which is featured on Rihanna's fifth studio album, Loud.^[63][64] In August 2011, she was featured in the music video for Cheers (Drink To That). "It's exciting to me because that was always one of my favorite songs, and for it to come out 10 years ago and so now to have it sampled and back out on the radio is pretty dope".^[65] In December 2010, American singer Miranda Cosgrove released "Dancing Crazy", a song written by Lavigne, Max Martin and Shellback. It was also produced by Martin.^[66] On 23 September 2011, Lavigne appeared in the Hub network show Majors & Minors as a guest mentor, alongside other singers including Adam Lambert and Leona Lewis. About the show, Lavigne stated, "I sang for them, and they performed for me. I was just blown away. I got to talk to them about music and the music industry, and they were all just so excited".^[65]

The release dates for Goodbye Lullaby and its lead single were pushed back several times. In response to these delays, Lavigne said, "I write my own music and, therefore, it takes me longer to put out records 'cause I have to live my life to get inspiration",^[67] and that she had enough material for two records.^[67] In November, Lavigne was featured in Maxim, where she revealed that Goodbye Lullaby took two and a half years to complete,^[68] but she cited her record company as the reason for the album's delays, stating that the album had been completed for a year.^[69] Goodbye Lullaby was released on 8 March.^[70][57] The lead single, "What the Hell", premiered on Dick Clark's New Year's Rockin' Eve on 31 December.^[70]

2011–present: Fifth studio album[link]

Three months after the release of Goodbye Lullaby, Lavigne announced that work on her fifth studio album had already begun, with eight songs written so far. The new album will musically be the opposite of Goodbye Lullaby, with a release date rumored for sometime in 2012. ^[71] Lavigne explained, "[Goodbye Lullaby] was more mellow, [but] the next one will be pop and more fun again. I already have a song that I know is going to be a single, I just need to re-record it!"^[72][73][74] Later, in July 2011, Lavigne revealed the title of two of the songs from her fifth album as "Fine" and "Gone". The tracks were originally recorded for Goodbye Lullaby but never made the final cut. In late 2011, Lavigne confirmed that she had moved to Epic Records, which is now headed by L.A. Reid.^[75][76]

Production-wise, Lavigne stated in an interview with Virgin Radio 96 that she would begin production on the album in January 2012. ^[65] During recording, she has been confirmed to have worked with the hip hop production duo The Runners, ^[77] Chad Kroeger of rock band Nickelback and former member of rock band Evanescence David Hodges. ^[78] In April 2012, Lavigne confirmed that she had "finally" finished work on her fifth album and that she would be taking a short hiatus before releasing it and embarking on "[her] next artistic journey".^{[citation needed]}

Musical style and songwriting[link]

Avril Lavigne in February 2011.

Themes in Lavigne's music include messages of self-empowerment from a female or an adolescent view.^[79] Lavigne believes her "songs are about being yourself no matter what and going after your dreams even if your dreams are crazy and even if people tell you they're never going to come true."^[80] On her debut album, Let Go, Lavigne preferred the less mainstream songs, such as "Losing Grip", instead of her more radio-friendly singles, such as "Complicated", saying that "the songs I did with the Matrix... were good for my first record, but I don't want to be that pop anymore."^[81] Lavigne's second album, Under My Skin, had deeper personal themes underlying each song. Lavigne explained, "I've gone through so much, so that's what I talk about.... Like boys, like dating or relationships".^[82] In contrast, her third album, The Best Damn Thing, was not personal to her. "Some of the songs I wrote didn't even mean that much to me. It's not like some personal thing I'm going through."^[83] Her objective in writing the album was simply to "make it fun".^[84] Goodbye Lullaby, Lavigne's fourth album, was much more personal than her earlier records,^[55] with Lavigne describing the album as "more stripped down, deeper. All the songs are very emotional".^[85] Ian McKellen defined her as “... a punk chanteuse, a post-grunge valkyrie, with the wounded soul of a poet and the explosive pugnacity of a Canadian.” on the Craig Ferguson show in 2007. ^[86][87]

Growing up, Lavigne listened to Blink-182, Goo Goo Dolls, Matchbox Twenty and Shania Twain,^[81] and her influences include Courtney Love and Janis Joplin.^[82] Because of these influences, musical genres, and her personal style, the media often defined her as punk, something she denied being. Lavigne’s close friend and guitarist, Evan Taubenfeld, said, "It's a very touchy subject to a lot of people, but the point is that Avril isn't punk, but she never really pretended to claim to come from that scene. She had pop punk music and the media ended up doing the rest".^[88] Lavigne also commented on the matter: "I have been labeled like I'm this angry girl, [a] rebel... punk, and I am so not any of them."^[40]

Most of critics identify Lavigne as some form between teen pop and pop-punk: Publications such as The New York Times, Rolling Stone, NME, MusicMight, IGN and Popmatters have identified Avril Lavigne as a mix of rock, teen pop and pop-punk,^{[89][90][91][92][93][94]} influenced by a grungey pop-rock sound.^{[95][96][97][98][99]}