Dealing with constipation can be frustrating, especially when it feels like your body isn’t cooperating. If you struggle to pass stool (poop) regularly, feel bloated, or experience discomfort, it can affect your mood and energy. When this issue persists over time, it is considered chronic.
Chronic Constipation occurs when passing stool becomes difficult or occurs less often than three times a week. Several factors, including low fiber intake, dehydration, certain medications, medical conditions, or genetic factors, can cause it. Being aware of these causes, recognizing the signs of constipation, and knowing how to treat it will help you manage it effectively and feel more comfortable.
This article explains its common causes, symptoms, potential complications, and effective treatments.
What is Chronic Constipation?
Chronic Constipation is more than just occasionally having trouble passing stool. You will find yourself straining regularly, passing hard or lumpy stools, or going fewer than three times a week. It often develops when bowel movements slow down or the intestines don’t move stool efficiently. Doctors will usually consider constipation chronic if symptoms:
- Last 3 months or more
- Do not improve with changes in diet or exercise
- Only improve with prescription medications
Chronic Constipation affects millions of people, and the frequency of its occurrence can vary depending on age, gender, and lifestyle. Around 16% of people, particularly adults, experience it worldwide.
The condition becomes more common with age, affecting around 33.5% of older adults aged 60 to 110. In North America alone, up to 63 million people meet the criteria for chronic constipation, showing how common the condition is.
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What are the symptoms of Chronic Constipation?
Chronic Constipation isn’t only about infrequent bowel movements. It can bring a range of uncomfortable symptoms that impact your daily life. Such symptoms are,
- Fewer than three bowel movements weekly
- Hard, dry, or lumpy stools
- Straining or discomfort while passing stool
- A sensation that not all stool has passed or incomplete emptying
- A feeling of blockage or obstruction in the rectum
- Abdominal bloating, pain, or discomfort
- Occasional leakage of liquid stool (overflow Diarrhea)
- Passing excessive gas or frequent burping
What causes Chronic Constipation?
This condition can happen for many reasons, and often more than one factor is involved. What you eat, how much water you drink, your activity level, the medicines you take, and even some health conditions can all affect your bowel movements.
Let’s look into such causes in detail.
Lifestyle and dietary factors
Your daily habits can significantly impact constipation. Here’s how your lifestyle habits and food intake can affect your bowel movements.
- Not eating enough fiber from fruits, vegetables, and whole grains can make stool hard and difficult to pass.
- Drinking too little water or other fluids can slow down digestion.
- A lack of regular exercise can reduce bowel activity.
- Ignoring the urge to go when your body signals can worsen constipation.
Medical conditions
If your constipation is persistent, an underlying medical condition could be the cause. Some of the conditions are,
- Metabolic or hormonal disorders like Diabetes or Hypothyroidism can slow digestion and cause constipation.
- Neurological conditions like Parkinson’s disease (PD), Multiple Sclerosis (MS), stroke, or spinal cord injuries may affect bowel movements.
- Gastrointestinal issues such as Irritable Bowel Syndrome (IBS) or other functional digestive problems can lead to Chronic Constipation.
- Pregnancy can cause constipation due to hormonal and physical changes in the body.
- Blockages in the colon or rectum, including structural lesions, tumors, strictures, or prolapse, can make passing stool difficult.
Medications
Some medications you take can slow down your bowel movements and lead to constipation. These include,
- Painkillers, especially Opioids
- Blood pressure medications
- Antidepressents
- AntiParkinsons (medicines for treating Parkinson’s)
- Antacids containing aluminum or calcium
If you notice constipation after starting a new medicine, it can likely be the cause. Don’t stop taking the medicine without consulting your doctor. They will discuss alternatives, dosage adjustments, or strategies like increasing fiber and fluids to help ease constipation while staying on your treatment.
Other factors
Besides diet, lifestyle, medications, and medical conditions, other factors can contribute to Chronic Constipation. Those include,
- Aging, travel, and routine changes can slow digestion.
- Psychological factors like stress, anxiety, or depression may contribute to irregular bowel movements.
- In some cases, no specific cause is found, which is called Idiopathic Chronic Constipation.
- Genetic factors can play a role in Chronic Constipation. If constipation runs in your family, your genes may be partly responsible for slower digestion and irregular bowel habits.
How is Chronic Constipation diagnosed
When you see a doctor for irregular bowel movements, they usually start with a detailed discussion and physical check-up before proceeding to any special tests.
Your doctor will ask how often you pass stools and their appearance, usually using the Bristol Stool Form Scale (BSFS). They may also check whether you feel unrelieved after passing stools, tend to ignore the urge to go, rely on hand support during bowel movements, and when your constipation started, including any connection to diet, stress, or medications.
Then, the following tests will be done to determine the underlying cause.
- Physical examination: A rectal exam is often done to check for fissures, hemorrhoids, pain, anal sphincter tone, and whether your pelvic floor muscles function properly when pushing stool out.
- Basic tests: Sometimes, your doctor may order blood or urine tests to rule out thyroid issues, Diabetes, or electrolyte imbalances, but routine testing isn’t usually needed.
- Endoscopy: If you show signs such as rectal bleeding, Anemia, or unexplained weight loss, your doctor may recommend a Flexible Sigmoidoscopy (FS) or colonoscopy (examination of the colon) to look for issues like inflammation, ulcers, or Colon Cancer.
- Anorectal manometry: If basic steps don’t clarify your constipation, your doctor might recommend anorectal manometry, which uses a small balloon-tipped tube to evaluate how your rectal and anal muscles work. This test can identify Pelvic Floor Dysfunction, Hirschsprung disease, megacolon, or nerve and muscle problems that affect bowel movements.
All these tests allow the doctor to understand your bowel habits, rule out serious issues, and determine the underlying cause. This will also help to manage the condition effectively so you can feel better and maintain healthy bowel habits.
How to treat Chronic Constipation
Managing Chronic Constipation usually involves lifestyle changes, diet adjustments, and sometimes medical treatments. The proper approach to relieving constipation depends on its cause and severity. Making simple changes at home can often reduce it, but medications or medical procedures can help if needed.
Let’s look into such options in detail.
Lifestyle changes
You can start by making simple adjustments to your daily habits to manage Chronic Constipation. How you move, eat, and hydrate directly impacts how well your digestive system works. Here’s what you can do to adopt a healthy lifestyle.
- Stay active by walking, jogging, or doing yoga to help your intestines move stool faster and smoothly.
- Drink plenty of water to keep stools soft.
- Stick to a regular bathroom routine.
- Go when you feel the urge, don’t hold it in.
- Take breaks from sitting too long, more than 30-60 minutes and move around. It will strengthen intestinal muscles, promoting stool movement and reducing constipation risk.
Dietary adjustments
Some foods can slow down your bowels and make constipation worse, so it’s essential to watch what you eat and drink. Here are simple dietary changes that can help keep you regular and improve your digestion.
- Eat more fiber, such as fruits, veggies, whole grains, beans, and nuts, to stimulate your intestines contract and move stool more efficiently.
- Increase fiber slowly to prevent gas or bloating.
- Add probiotics like yogurt, kefir, sauerkraut, or other fermented foods to reduce bloating, constipation symptoms, and improve stool consistency.
- Avoid processed and refined foods that worsen constipation.
- Limit dairy if it seems to trigger constipation.
- Drink around 1-2 liters of water so the fiber can work effectively.
Over-the-counter supplements
If simple lifestyle and diet changes aren’t enough, you can try over-the-counter (OTC) supplements for better bowel movements. These are widely available and often provide a quick, short-term solution:
- Fiber supplements, like psyllium husk, methylcellulose, or wheat dextrin, can bulk up stool and make it easier to pass. Take it with plenty of water either in the morning or a few hours before bedtime to regulate bowel movements.
- Osmotic laxatives, such as Polyethylene Glycol or milk of Magnesia, will pull water into your intestines, softening stool and improving movement. Take it once daily, preferably at night to allow the laxative work overnight.
- Stool softeners, like Docusate Sodium, keep stools moist, which helps if you have hard stools or regular but hard bowel movements. Take once or twice daily, with or without food, ideally with plenty of fluids to help with its effectiveness.
- Stimulant laxatives, such as Bisacodyl or Senna, make your intestines contract to push stool through, but these should be used sparingly under a doctor’s guidance to avoid dependence. Take it before bedtime for it to work in the morning.
Prescription medications
Your doctor may also prescribe medications to help relieve Chronic Constipation. Different prescription medicines work in other ways:
- Chloride channel activators (Lubiprostone / Amitiza): These increase fluids in your digestive tract, making stool softer and easier to pass.
- Guanylate cyclase-C agonists (Linaclotide / Linzess, Plecanatide / Trulance): These help ease pain and improve how often you have bowel movements.
- Prucalopride: It is a newly examined Selective Serotonin Subtype 4 receptor agonist that has shown efficacy in managing this condition.
- Misoprostol and Colchicine: Your doctor may prescribe them if you do not find relief with the other treatments.
When to see a doctor
Most cases can be treated at home with lifestyle changes, diet adjustments, or OTC supplements. However, you should see a doctor if you see:
- Blood in your stool or black, tarry stools
- Severe or persistent abdominal pain or bloating
- Unexplained weight loss
- Constipation lasting more than a few weeks despite home remedies
- Vomiting or nausea along with constipation
- Sudden changes in your bowel habits
Conclusion
Chronic Constipation is a condition that can affect your daily life. You may notice fewer than three bowel movements a week, hard or lumpy stools, straining during bowel movements, a feeling of incomplete emptying, abdominal bloating, or occasional leakage of liquid stool.
Improving your diet, staying hydrated, being physically active, and maintaining a regular bathroom routine can ease these symptoms and support healthier digestion. When lifestyle changes aren’t enough, over-the-counter supplements or prescription medications can help, and seeing a doctor ensures no serious underlying condition.
By recognizing the signs early and taking consistent steps, you can feel more comfortable, stay regular, and prevent constipation from disrupting your daily life.
Frequently Asked Questions
What can happen if I am constipated for too long?
If you stay constipated for too long, you may experience bloating, abdominal pain, hemorrhoids, or anal fissures from straining. In rare cases, severe Chronic Constipation can lead to fecal impaction or other complications.
Can Chronic Constipation cause Cancer?
No, this condition itself does not cause Cancer. However, if you notice persistent changes in your bowel habits, blood in your stool, or other unusual symptoms, you must see a doctor to rule out any severe conditions.
What will empty my bowels immediately every morning?
In the morning, drink warm water with lemon to stimulate your bowel movements and stay hydrated. Eat fiber-rich foods like whole grains and fruits to improve digestion and regularity in bowel movements. You can also take probiotics to support your gut and help regulate your bowel movement.
Can lack of sleep cause constipation?
Yes, poor sleep can slow down your digestive system and affect hormones that control bowel movements. This makes it harder to pass stool regularly. Getting enough rest, along with a healthy diet and proper hydration, can help improve digestion.
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