Chronic constipation is a common problem where a person has either infrequent, incomplete, or difficult bowel movements for at least two months.
This condition can be divided into two categories: primary constipation—or functional constipation—and secondary constipation.
Primary and secondary constipation
Primary constipation is caused by intrinsic issues with anorectal or colonic functioning, while secondary constipation is caused by medications, diseases, and other external factors.
Primary constipation can further divide into categories of slow-transit, normal transit, and outlet obstruction constipation.
Slow and normal transit and outlet obstruction constipation
Slow-transit constipation occurs when the large intestine has reduced motility due to nerve abnormalities. For normal-transit constipation, a person may have normal looking stools and normal frequency but still feel like they are backed-up. For outlet obstruction constipation, a person may have difficulty completely emptying the rectum, thus requiring many visits to the restroom.
There are numerous conditions and illnesses that can make chronic constipation a symptom or a side effect. Conditions like inflammatory bowel disease (IBD), colon lesions, colon cancer, thyroid disorders, diabetes, Parkinson’s disease, and the like can all cause constipation. Some medications, like those used to prevent seizures, can cause this condition as well.
Chronic constipation can also be caused by poor habits, such as eating a diet low in fiber and not staying hydrated. Sometimes constipation is psychosomatic in its nature since it can especially affect those who’ve gone through trauma, abuse, or depression. Lastly, studies have shown that constipation can become more prevalent as a person ages and that the condition is more common in women.
Constipation causes bowel movements that are incomplete, difficult to pass, or infrequent. However, since each person has different bowel habits, these symptoms can be different from person to person.
For instance, adults can often have as little as three bowel movements a week while others may have as much as twenty-one. Other symptoms include anal fissures, rectal bleeding, straining, pain in the lower abdomen, bloating, and very hard of very lumpy stools that won’t empty the rectum.
Chronic constipation is often caused by a primary health condition which affects digestion or muscle function. Colon stricture or lesions on the colon, perhaps caused by conditions like colon cancer, can inhibit normal digestive and bowel movements. Diabetes and thyroid disorders are also known to lead to chronic constipation. Conditions like Parkinson’s disease which affect the nervous system can also inhibit normal bowel function and cause constipation.
It’s common for pregnant women to suffer from chronic constipation. This is because the body produces increased levels of progesterone which relaxes muscles throughout the body, including in the colon, meaning that food moves much less quickly through the intestines.
Certain medications are also known to cause constipation. Pain medications, blood pressure medication and antispasmodics and anti-seizure medications are all common causes of chronic constipation.
Sometimes it is not a problem with the function of the colon that is to blame for constipation, but an issue with defecation. Conditions like rectal prolapse, where the rectum protrudes from the anus, and rectocele, where the rectum bulges into the vagina, can lead to the incomplete voiding of the bowels and create impacted stools which become harder and harder to pass. Alternatively, there could be dysfunction of the pelvic floor muscles when controlling the rectum and anal sphincter, which hinders proper evacuation.
If the patient’s chronic constipation is caused by a secondary condition, he or she will need to talk to a doctor about managing their illness and/or changing medications.
Taking fiber supplements, eating fruits and vegetables, and drinking more water can help to ease the passage of stools. Patients may use over-the-counter laxatives can be used in moderation to soften stools and probiotics to build up gut flora and aid digestion. Exercising and reducing stressors are both recommended. If a person’s chronic constipation isn’t relieved by lifestyle changes, then he or she should see a doctor to see if the constipation is a symptom for a secondary illness.
Chronic constipation caused by an underlying condition cannot always be prevented, but it may be alleviated through treatment of the primary condition. However, a healthy diet and exercise regime may help to reduce the risk of chronic constipation in people who have conditions which might cause it.
Eating plenty of fiber is very important in the prevention of constipation because fiber affects the texture of stools and can help them pass regularly and easily. Both soluble and insoluble fiber is needed for healthy bowel movements, but adding a little extra insoluble fiber into the diet might be particularly helpful for chronic constipation. It can be found in whole wheat, brown rice, seeds and the skin of fruits. Drinking plenty of fluids will also help to keep stools soft and could help to relieve constipation.
Exercise can help to get the digestive system and bowels moving, so incorporate regular activity into your routine. It doesn’t necessarily have to be high-intensity exercise; a short walk once or twice each day could be enough to keep bowel movements regular.