What is Chronic Constipation ?

Constipation is a condition with varied meanings. Generally, constipation is when a person passes stool (feces) infrequently (i.e. less than three times per week).

But constipation is also labelled when the stools are too hard, too small, or difficult to pass.

When these symptoms persists for more than three months, then it is labeled as “chronic” constipation.

1. How Common is Chronic Constipation?

Constipation is a very common problem. In the United states, more than 2.5 million people visit their doctor annually for relief from constipation. The problem is more common in the elderly and in women.

2. Symptoms of Chronic Constipation

If you are suffering from chronic constipation, you will experience one or more of the following symptoms:

Passing fewer than three stools per week
Having hard stools
Straining to pass stools
Pain while passing stools
Feeling of incomplete emptying of the stool from your rectum

3. Causes of Chronic Constipation

Constipation occurs when stool passes too slowly through the digestive tract. This sluggish movement results in increased absorption of water and nutrients from the stool making it more dry and hard. Chronic constipation has a wide list of causes. Your doctor will need a detailed history, and perform an examination to identify the cause(s) of chronic constipation. Widely speaking, chronic constipation can be caused by any of the following:

Blockages in the colon or rectum
Problems with the nerves around the colon and rectum
Difficulty with the muscles involved in elimination
Conditions that affect hormones in the body

4. Risk Factors of Chronic Constipation

Chronic constipation is more commonly seen in certain high risk groups:

Elderly persons
Women
Dehydrated persons — especially those working in hot and humid climates
Those who eat diets low in fiber
Persons with a sedentary life style

5. Prevention of Chronic Constipation

Chronic constipation can be prevented by

Eating a high-fiber diet
Staying hydrated (drink 8 to 12 glasses of water daily)
Maintaining physical activity
Managing underlying medical issues that result in constipation

6. Complications of Chronic Constipation

Hemorrhoids
Anal fissures
Rectal prolapse
Anal abscesses
Anal fistula

7. Diagnosis of Chronic Constipation

Your doctor will first take a detailed history and will perform the relevant physical examination. Your doctor may also perform a digital rectal examination (DRE). It is a simple bedside procedure in which your doctor will insert a gloved finger into your anus to look for any abnormality. Proctoscopy or anoscopy is also usually performed. Anorectal maonometery may also be advised to evaluate the tone and function of anal sphincter muscle.

You doctor may also advise further testing to look for the metabolic causes of chronic constipation depending your general health and other symptoms.

8. Treatment of Chronic Constipation

If you or someone you know is suffering from a chronic constipation, you should consult your doctor and talk about your symptoms. Chronic constipation is often a treatable condition. The treatment depends upon underlying cause of chronic constipation. Most persons show improvement in their symptoms by following the guidelines:

Behavior changes — you should not ignore your body’s signals to pass stool. Whenever you feel the need to pass stool, especially after meals, you should go to the bathroom immediately.
Increase consumption of fiber.
Drinking plenty of water and staying hydrated – again, you should drink at least 8 – 12 glasses of water daily.
Use suppositories and enemas if needed – these are medicines that are given through anus and these help in facilitating the passage of stools.

9. Surgical Management of Chronic Constipation

Your doctor may advise for a surgery if management fails to relieve your constipation and your chronic constipation is caused by a blockage, rectocele or a bowel stricture.

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