Chronic constipation is difficulty in passage of stools caused by infrequent bowel movements. It may persists for several weeks or longer. It is generally described as having fewer than three bowel movements a week.
Occasional constipation is very common, but some people experience chronic constipation that can interfere with their ability to do their daily activities. Treatment for chronic constipation depends on the underlying cause. In some cases though, a cause for chronic constipation is never found.
Symptoms
Signs and symptoms of chronic constipation include:
- Having lumpy or hard stools,
- Passing fewer than three stools a week,
- Straining to have bowel movements,
- Feeling as though there's a blockage in the rectum that prevents bowel movements,
- Needing help to empty the rectum, such as using the hands to press on the abdomen and using a finger to remove stool from the rectum,
- Feeling as though you can't completely empty the stool from the rectum.
Constipation may be considered chronic if the person has experienced two or more of these symptoms in the last three months or so.
Causes
Constipation most commonly occurs when waste or stool moves too slowly through the digestive system due to blockages in the colon or rectum (anal fissure, bowel obstruction, colon cancer, narrowing of the colon, other abdominal cancer that presses on the colon, rectal cancer or rectocele).
Neurological problems around the colon and rectum can affect the nerves that cause muscles in the colon and rectum to contract and move stool through the intestines. Causes include autonomic neuropathy, multiple sclerosis, Parkinson's disease, spinal cord injury and stroke.
Problems with the pelvic muscles involved in having a bowel movement may cause chronic constipation, including:
- Inability to relax the pelvic muscles to allow for a bowel movement (anismus),
- Pelvic muscles don't coordinate relaxation and contraction correctly (dyssynergia),
- Weakened pelvic muscles.
Risk factors
Factors that may increase the risk of chronic constipation include:
- Eating a diet that's low in fiber,
- Being an older adult,
- Being a woman,
- Being dehydrated,
- Taking certain medications, including sedatives, narcotics or certain medications to lower blood pressure,
- Getting little or no physical activity.
Complications
Complications of chronic constipation include:
- Torn skin in the anus (anal fissure).
- Swollen veins in the anus (hemorrhoids).
- Stool that can't be expelled (fecal impaction).
- Intestine that protrudes from the anus (rectal prolapse).
Treatment
Diet and lifestyle changes to increase the speed at which stool moves through the intestines is usually the beginning of the treatment for chronic constipation. They include:
- Increase of the fiber intake,
- Physical activity most days of the week,
- Allowing enough time in the bathroom to have a bowel movement without distractions and feeling rushed.
Several types of laxatives and other medications that draw water are also available to help with the problem.
The last resort, surgery may be an option if other treatment has been tried unsuccessfully and the chronic constipation is caused by rectocele, anal fissure or stricture, although surgery to remove the colon is rarely necessary.
Prevention
The keys to preventing chronic constipation are simple enough. You should drink adequate amounts of water, six to eight glasses a day. The food must include fruits, vegetables and grains. And also, regular exercise.
