Everyone experiences constipation at some point. Most cases of constipation are short-term or acute. These often occur following a change in diet or exercise habits and are treatable with over-the-counter medications. In rarer cases, constipation may be chronic, meaning symptoms are long-lasting.
Definition of Chronic Constipation
Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.
Constipation is generally described as having fewer than three bowel movements a week.Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. Chronic constipation may also cause people to strain excessively in order to have a bowel movement.
Common Causes of Constipation
The most common triggers of constipation include: the slow movement of stool through the colon, difficulty eating a balanced diet, a lack of fiber from fruit and vegetables, inadequate fluid intake leading to dehydration
lack of exercise leads to slowed digestion, irritable bowel syndrome, side effects of medications, mental health problems, including stress, anxiety, depression and
Less Common Causes
Less common causes of constipation include:
hormonal imbalances, such as hyperthyroidism, conditions that affect the metabolism, such as diabetes,
disorders that affect the brain and spine, such as Parkinson’s disease,
inflammation linked to diverticular disease or proctitis, an obstruction in the intestines or rectum and
family history of constipation
Certain dietary supplements and medications can also trigger constipation. These include iron supplements,
calcium supplements, antacids, diuretics,
antihistamines, calcium channel blockers, certain antidepressants, antipsychotics,
anticonvulsants, medications to treat Parkinson’s disease
It may not always be possible to determine what causes constipation. Chronic constipation that occurs without a known trigger is known as chronic idiopathic constipation.
Signs and symptoms of chronic constipation include:passing fewer than three stools a week,having lumpy or hard stools, straining to have bowel movements,feeling as though there’s a blockage in the rectum that prevents bowel movements, feeling as though you can’t completely empty the stool from your rectumb and needing help to empty your rectum, such as using your hands to press on your abdomen.
Constipation may be considered chronic if you’ve experienced two or more of these symptoms for the last three months.
Risk Factors for Constipation
Factors that may increase the risk of chronic constipation include:being an older adult, being a woman, being dehydrated, eating a diet that’s low in fiber,
getting little or no physical activity, taking certain medications, including sedatives, opioid pain medications, some antidepressants or medications to lower blood pressure , and having a mental health condition such as depression or an eating disorder.
Short-term constipation typically does not cause complications and can usually be treated with self-care. For example, if you are simply constipated due to a change in your diet, you may feel full or bloated, but will not have any long-term complications. However chronic constipation can cause complications.
Hemorrhoids are swollen and inflamed veins in the rectum or anus. They can occur inside or outside and are usually not serious.
External hemorrhoids may cause itchiness or pain when having a bowel movement. Internal hemorrhoids typically do not cause pain and, instead, you may see bright red-streaked stool in the toilet.
Anal fissures are usually the result of some form of trauma to the anus, like hard stool. Anal fissures are usually painful and may also cause itching. You may also notice blood on the toilet tissue or on the stool.
Rectal prolapse occurs when the last portion of your colon, the rectum, protrudes beyond the anus and is visible on the outside of your body. It isn’t necessarily painful, and in many cases will go away without treatment. It should be evaluated by your healthcare provider, though.
Fecal impaction is a state of prolonged constipation. It occurs when the stool is so hard that it cannot pass with a normal bowel movement. It can cause abdominal pain and cramping, among other symptoms. It often must be treated with medications or procedures such as enemas or water irrigation.
Complications in Children
In children, specifically, those who are avoiding bowel movements because of pain, they may have stool collected in the colon and rectum. Sometimes, it will leak out, a condition that is referred to as encopresis(soiling).
Complications in the Elderly
It is reported that the prevalence of constipation increases with age, especially those over the age of 65 years.
Researchers state that chronic constipation can lead to fecal impaction and fecal incontinence. They state that in severe cases, fecal impaction can cause stercoral ulcerations, intestinal obstruction, or bowel perforation. If left untreated, these complications can be life-threatening.
Older people can also experience a lower quality of life due to complications and discomfort from constipation.
The following can help you avoid developing chronic constipation.
Eat plenty of fresh fruits, vegetables, and legumes such as beans and lentils. The fiber found in citrus fruits and legumes stimulates the growth of colonic flora, which increases the stool weight and the amount of bacteria in the stool. Encouraging the growth of certain bacteria in the colon may help promote a healthy intestine.
Eat fewer foods with low amounts of fiber such as processed foods, and dairy and meat products.Drink plenty of fluids.Stay as active as possible and try to get regular exercise.Try to manage stress.Don’t ignore the urge to pass stool.Try to create a regular schedule for bowel movements,especially after a meal.
Make sure children who begin to eat solid foods get plenty of fiber in their diet .