Young woman at the doctor's
Chronic constipation can be caused by numerous factors, such as lifestyle, diet, medication, or an underlying condition.

Living with Chronic Constipation

Constipation is undoubtedly one of the most prevalent digestive illnesses in the United States. Chronic constipation accounts for about 2.5 million doctor visits, as well as medication expenditures of several hundreds of millions of dollars in the U.S. on an annual basis. In addition to making you feel bloated, irritable, and headachy, relieving constipation, particularly chronic constipation, can be time-consuming and costly.

What Is Chronic Constipation?

Constipation is characterized by tough, irregular, or perceived partial emptying of the bowels.

While occasional constipation is very prevalent, some individuals suffer from chronic constipation, which is defined as constipation that persists for three months or longer.

Symptoms of Chronic Constipation

The most predominant symptoms of chronic constipation are intensified pressure and excess strain when passing stools. Other symptoms include:

  • Having less than three bowel movements a week
  • Stomach ache
  • Stomach cramps
  • Appetite loss
  • Feeling nauseous and bloated
  • Having stiff or lumpy stools
  • Feeling as if your rectum is blocked
  • Feeling as if you can’t fully get rid of the stool from your rectum
  • Requiring assistance to empty your rectum – for instance, pressing on your abdomen with hands or removing stool from your rectum with a finger

Causes of Chronic Constipation

Chronic constipation occurs when stool moves too slowly through the intestines and cannot be passed effectively through the rectum, resulting in a hard and dry stool. Several things can cause chronic constipation, including:

Colon or Rectum Blockages

Colon or rectum blockages can slow, or stop, the movement of stool
Conditions that can lead to blockages include:

  • Anal fissures
  • Colorectal cancer
  • Bowel obstruction
  • Bowel stricture
  • Abdominal cancer that places pressure on the colon
  • Rectocele (rectal bulge through the vaginal wall)

Colon and Rectum Nerve Damage

Conditions that affect nerves around the colon and rectum that can lead to chronic constipation include:

  • Stroke
  • Spinal cord injury
  • Multiple sclerosis
  • Parkinson’s disease
  • Neuropathy

Pelvic Floor Muscle Issues

Issues with the pelvic floor muscles can hinder bowel movements and lead to chronic constipation, including:

  • Pelvic floor muscle weakness
  • The inability of the pelvic floor muscles to relax to allow for the passage of stool
  • Inability of the pelvic floor muscles to relax and contract properly
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Absence of Fiber in the Diet

People who consume foods that are poor in fiber have a higher likelihood of suffering from chronic constipation. Fiber fosters bowel movements and helps to prevent constipation.

It’s imperative to ensure that your diet is full of foods rich in fiber, such as vegetables, fruits, and whole grains rather than low fiber foods such as meat, cheese, and eggs.

Physical Inactivity

Physically inactive people have a higher chance of suffering from chronic constipation, particularly elderly individuals. The chances of having constipation are considerably high for people who have been bedridden for an extended period.

Although a scientific justification doesn’t exist, some professionals believe that physical inactivity slows down metabolism, making the digestive process in the body happen slowly.

Hormonal Changes

Conditions that interfere with hormone production that can lead to chronic constipation include:

  • Pregnancy
  • Diabetes
  • Hyperparathyroidism
  • Hypothyroidism

Aging

Age is another common cause of chronic constipation. As you get older, your metabolism slows down significantly, leading to less intestinal activity. Additionally, the muscles of the digestive tract become weak, further adding to the problem.

Medications

Some of the medications used to treat certain medical conditions may contribute to chronic constipation, including:

  • Opiate pain relievers (i.e., morphine and codeine)
  • Medications used in the treatment of epilepsy
  • Diuretics that help the kidneys get rid of fluid from the blood
  • Tricyclic antidepressants
  • Anticholinergic agents for treating muscle spasms
  • Antidiarrheal agents
  • Calcium agents

Changes in Routine

When you travel, your regular routine changes. This change can sometimes affect your digestive tract and lead to constipation. Eating meals, going to bed, getting up, or visiting the toilet at different times may increase the risk of constipation.

Treatment for Chronic Constipation

In most cases, constipation goes away by itself without any treatment or effect on your health.

Treatment of chronic constipation can range from lifestyle changes like doing more exercise, drinking more water, managing stress, staying hydrated, and eating more fiber, to taking laxatives, prescription medications, and in some cases, surgery.

Physiotherapy, including pelvic floor strengthening, may also be beneficial in some cases.

It’s important to know the cause of constipation; sometimes an underlying medical condition or illness may be the cause. Patients with chronic constipation may have a daily diary for recording their bowel movements. A bowel diary may help both the medical professional and the patient determine the cause of chronic constipation and figure out optimal treatment.

Chronic Constipation Diet

People with chronic constipation should consume 18 to 30 grams of fiber daily. Examples of fiber-rich foods include fortified cereals, vegetables, and fresh fruits.

Probiotics are other important ingredients in the diet of a person with chronic constipation. They produce short-chain fatty acids and lactic acid that enhance gut movements, streamlining the process of passing stool.

Examples of foods rich in probiotics include yogurt, kimchi, and sauerkraut. It’s also incredibly important for individuals with chronic constipation to drink a sufficient amount of water to stay hydrated.

Conclusion


Although chronic constipation may not be life-threatening, it can cause a lot of discomforts and hinder your ability to perform your day-to-day tasks. It can also develop into more severe conditions like rectal bleeding, hemorrhoids or swollen veins in the rectum, or anal fissure.

Therefore, it’s important to deal with symptoms of constipation as soon as they appear by consuming a healthy diet, exercising, managing stress, staying hydrated, and taking medication as necessary.