When you have difficult passage of your stools or you have infrequent bowel movements which last few weeks or longer, then you have chronic constipation. Almost every single person has one constipation in its life. But we know that we feel better when we have regular bowel movements and when we can feel safe and healthy. There are some individuals who have one or two bowel movements per day while there are other individuals who have bowel movements three times per day. It is not the same length between two bowel movements. It depends from person to person. If you do not have bowel movements more than three days, then the bowel becomes tougher and harder to pass. This is not serious disease if it not lasts long period. If you have fewer than 3 bowel movements per one week, then you have constipation [1]. Constipation is very common condition. Also there are some cases when people have chronic constipation which means that they cannot do the everyday activities in normal way. When you have chronic constipation, then it can cause you excessive straining to have a bowel movement and many other signs and symptoms. Your doctor will see which the underlying cause for your condition is. Also there are some cases when you have chronic constipation and your doctor has not discovered the real cause for your chronic constipation.
Following are the signs and symptoms of constipation [2]
- Straining to have bowel movements
- Passing fewer than three stools a week [1]
- Feeling as though there’s a blockage in your rectum that prevents bowel movements
- Having lumpy or hard stools
- Needing help to empty your rectum, such as using your hands to press your abdomen and using a finger to remove the stool from your rectum
- Feeling as though you cannot completely empty the stool from your rectum
If you have experienced two or more of the mentioned signs and symptoms in the last 3 months, then this is chronic type of constipation. If you have noticed that you have persistent and unexplained changes in your bowel habits, then you should visit your doctor.
Causes of Constipation
When the stool or waste moves too slowly through your digestive tract which causes it to become dry and hard, then you have constipation. If you suffer from chronic constipation, then this condition can be caused by:
- Blockages in the colon or rectum: If you have blockages in your rectum or in your colon, then this condition can stop or slow the bowel movement. There are many causes which can lead to blockages in your colon or rectum such as rectal cancer, anal fissure, rectocele, bowel obstruction, colon cancer, other abdominal cancer that presses on the colon and narrowing of the colon (bowel stricture). [3]
- Problems with the nerves around the colon and rectum: If you have some neurological problem, then this can affect your nerves which are causing the muscles in your rectum and colon to contract and move the stool through your intestines. There are many causes which can lead to this problem such as stroke, spinal cord injury, autonomic neuropathy, Parkinson’s disease and multiple sclerosis. [4]
- Difficulty with the muscles involved in the elimination: If you have problems with your pelvic muscles which are involved in the bowel movement, then this can lead to chronic constipation. There are many causes which can lead to this problem such as weakened pelvic muscles, inability to relax the pelvic muscles to allow for bowel movements (anismus) and pelvic muscles don’t coordinate relaxation and contraction correctly (dyssynergia).
- Conditions that affect hormones in the body: Our hormones are having one of the biggest roles and this is to balance the fluids in our body. There are many conditions and diseases which can lead to chronic constipation or constipation such as pregnancy, diabetes, underactive thyroid (hypothyroidsm) and overactive parathyroid gland (hyperparathyroidism). [5]
Risk factors:
- Being a woman
- Being dehydrated
- Being an older adult
- Taking certain medications including narcotics, sedatives or certain medications to lower the blood pressure [6]
- Eating a diet that is low in fiber [7]
- Getting little or no physical activity
Above are some factors which can increase your risk of getting chronic constipation
References:
[1] Basson MD. Constipation. Medscape. 2020. Retrieved from emedicine.medscape.com/article/184704-overview
[2] Chu H, Hou X. Understanding of constipation symptoms and the diagnosis and management of constipation in Chinese physicians. PLoS One. 2016;11(3):e0152801. doi:10.1371/journal.pone.0152801
[3] Andrews CN, Storr M. The pathophysiology of chronic constipation. Canadian Journal of Gastroenterology. 2011;25(SupplB):16B–21B.
[4] Winge K, Rasmussen D, Werdelin LM. Constipation in neurological diseases. Journal of Neurology, Neurosurgery & Psychiatry. 2003;74:13-9.
[5] Lauritano EC, Bilotta AL, Gabrielli M, et al. Association between hypothyroidism and small intestinal bacterial overgrowth. The Journal of Clinical Endocrinology & Metabolism. 2007;92(11):4180-4.
[6] van Dijk KN, de Vries CS, van den Berg PB, et al. Constipation as an adverse effect of drug use in nursing home patients: an overestimated risk. British Journal of Clinical Pharmacology. 1998;46(3):255–61. doi:10.1046/j.1365-2125.1998.00777.x
[7] Ho KS, Tan CYM, Daud MAM, Seow-Choen F. Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms. World Journal of Gastroenterology. 2012;18(33):4593–6.
doi:10.3748/wjg.v18.i33.4593
