What is Constipation?
Constipation is characterized by infrequent or hard-to-pass bowel movements. These symptoms typically occur when stool moves through the colon a bit too slow and the fluid portion that typically helps with excretion is reabsorbed by your body. This causes the stool to be hard, dry, and a bit more difficult to pass.
What Makes Constipation Chronic?
In cases of chronic constipation, a patient may experience constipation for weeks at a time or on an ongoing basis. To some, chronic constipation consists of feeling like you need to have a bowel movement, but it just won’t happen. In chronic constipation, you make also experience hard, or formed stools, small stools or a combination of them. In general, chronic constipation is classified as passing less than three stools per week that lasts for several months.
Causes of Constipation and Chronic Constipation:
Occasional constipation is normal and can be caused by a lack of fiber incorporated into the diet, as well as stress, lack of sleep, lack of exercise, age and certain types of medications (such as pain relievers and opioids). Resisting the urge to have a bowel movement can contribute to constipation along with traveling, which can also cause a shift in bowel habits.
Resisting the urge to pass a bowel movement can also lead to constipation, as this can tell your brain to turn off that signal, which will make it hard for that muscle to relax and allow the stool through.
Chronic constipation can be caused and influenced by similar factors, but when observed for a prolonged period of time, can often be attributed to a medicine or prescribed drug, bowel obstruction, diabetes, anxiety, hypothyroidism, insufficient hydration, physical inactivity, and diseases such as irritable bowel syndrome (IBS).
Other causes of constipation or chronic constipation include:
- Weakened pelvic floor muscles
- Blockages in the colon or rectum
- Multiple sclerosis
- Nerve dysfunction or damage
- Parkin’s disease
- Pregnancy
In particular, your at higher- risk of experiencing chronic constipation increases if you’re an older adult, a woman, are physically inactive or have a mental health condition like depression or an eating disorder.
Symptoms of Constipation and Chronic Constipation
Symptoms of constipation vary across the board, but generally include:
- Three or less stools per week
- Stools that are hard, dry or lumpy
- Having to strain when passing stools
- A feeling of incomplete bowel emptying after passing a stool
- A sensation that the rectum is blocked
- Stomach pain
- Needing to use a finger to help the stool pass
As a result of these symptoms, patients may also experience complications, such as hemorrhoids, anal fissures, fecal impaction (hard stools backed up into the colon), and rectal prolapse.
Diagnosing Constipation:
In diagnosing constipation, your doctor will ask about your medical history and lifestyle habits. Upon physical examination and checking your vital signs, they may poke and prod your abdomen to check for pain, tenderness, swelling and/or lumps. A rectal exam may also be warranted.
Chronic constipation occurs when a patient experience two or more of these symptoms for three months or more.
Your doctor may order additional testing as needed, which can include blood or urine tests, imaging, a colonoscopy, a colorectal transit study, or other bowel function tests to get a better idea of what may be causing the constipation.
Treating Constipation:
Treatment for constipation is often quite simple and noninvasive. You may be asked to take inventory of what you eat and drink and make necessary changes. Your doctor will likely recommend increasing your water intake by two to four glasses per day in addition to keeping a food log to track which foods may constipate you. Your doctor will likely recommend increasing exercise in accordance with the CDC guidelines.
Your posture on the toilet may also be affecting your ability to produce bowel movements. Raising your feet, leaning back or squatting and bearing down may make passing stool easier.
Your doctor may recommend avoiding the following foods and drinks:
- Caffeinated drinks
- Sweetened drinks
- Processed meats
- Fried food
- Refined carbs
- White bread
- Pasta
- Potatoes
- Meat
- Eggs
- Cheese
In contrast, your doctor may recommend incorporating the following for gut regularity:
- Fruits
- Vegetables
- Whole grains
- Prunes
- Bran cereal
- Oranges
- Pineapples
- Berries
- Mangos
- Avocados
- Papaya
- Over-the-counter fiber supplements (Metamucil, MiraLAX, Citrucel, Benefiber, etc.)
- Mild stool softeners or laxatives
Depending on which medications you may be taking that can cause constipation, your doctor may also recommend switching to another drug or ask you to hold the drug and refrain from taking it. It’s important that you do not change medications or stop medications without first consulting your physician.
There are a slew of medications that can be prescribed to relieve constipation if further conservative treatment options are not moving the needle. In more serious cases of constipation and chronic constipation, surgery may be needed to fix a blockage in the colon (obstruction), a narrowing portion of the intestine (stricture), a tear in the anus (anal fissure), or the collapse of the rectum into the vagina (rectal prolapse).
In long-term or chronic constipation, your doctor may need to treat another underlying disease or condition that may be contributing to your constipation.
If you suspect you’re dealing with constipation or chronic constipation, it’s important to discuss with your care provider as soon as possible for relief.