Constipation is a common digestive complaint. While the symptoms vary, you can feel bloated, irritable, and generally uncomfortable when constipated. Long-term or chronic constipation can be especially difficult to deal with and affects over 63 million people in the U.S.
What is Chronic Constipation?
Chronic constipation is characterized by infrequent bowel movements or difficulty passing stools for several weeks or longer. For many people, chronic constipation is the feeling that you need to have a bowel movement, but it won't happen no matter how hard you try or how long you sit on the toilet. People with chronic constipation often have hard, formed, or small stools, or a combination that makes people strain excessively when trying to have a bowel movement.
Typically, the medical definition of chronic constipation is having a bowel movement frequency of fewer than three times a week that continues for several months. While occasional constipation is a common issue that affects almost everyone from time to time, chronic constipation can interfere with a person's ability to go about their everyday activities.
Being constipated can interfere with your performance at work and cause you to miss social and recreational activities. The discomfort of chronic constipation can be debilitating and can also cause stress and anxiety. In addition to the discomfort chronic constipation causes, the fear of not knowing the cause can add to your worries.
There are several common symptoms of constipation, and the condition may be considered chronic if you have two or more of these symptoms in the past few months:
- Having fewer than three bowel movements per week
- Having hard or formed stools
- Having to strain excessively to try and have a bowel movement
- Feeling like you have a blockage preventing you from pooping
- Feeling as if you can not completely empty your bowels
- Needing to help empty your rectum by applying pressure to your abdomen with your hands or using a finger to remove a stool
What Causes Chronic Constipation?
The digestion of food and the absorption of the vitamins, minerals, and nutrients the body needs to stay healthy is a complex process. When you eat food, it passes to the stomach, where gastric acid begins to break it down until it passes into the small intestine.
Most of the digestive process happens in the small intestine. Here, the partially digested food mixes with a number of enzymes that complete the digestion process. As it breaks down, the intestines absorb moisture and nutrients from the food. Usually, this process continues until a stool is formed and muscle contractions in the intestines force it out of the rectum.
Hard, formed stools are commonly associated with constipation, and many experts believe that the over-absorption of water from the stool is connected with chronic constipation. Another theory is that abnormal hormonal responses to ingested food may trigger chronic constipation.
Blockages in the colon or rectum are one serious cause of chronic constipation. Blockages may slow or stop the movement of your stool and have several possible causes, including:
- bowel obstructions
- anal fissures
- colon cancer
- rectal cancer
- other abdominal cancers that affect the colon
- narrowing of the colon
Neurological problems affecting the nerves and muscles in the colon and rectum area that move stool through the intestines are also a possible cause. Issues with the pelvic muscles can also contribute to chronic constipation if they won't relax properly to allow a bowel movement or if they don't coordinate relaxation and contraction correctly.
Still, in many cases, the condition is triggered by lifestyle choices. For example, constipation may be caused by not eating a well-balanced diet or a diet lacking in fiber. Inadequate water intake or dehydration and lack of physical activity can also slow the digestive system.
How to Treat Chronic Constipation?
Typically, the first step in treating chronic constipation is to make any significant diet and lifestyle modifications that may be necessary. For instance, stop eating processed foods and cut down on dairy and meat products that are low in fiber.
Instead, increase the number of high fiber foods in your diets, such as beans, fruits, vegetables, whole-grain cereals, and bran. Try to eat six to seven servings of vegetables and two or three servings of fruit every day. A plant-based, whole food diet is ideal for supporting normal bowel function.
Drink plenty of fluids and stay hydrated because water softens stools, allowing them to easily pass through the intestines and rectum.
In addition to diet modifications, increase your physical activity and try to get more exercise. Staying as active as possible will help relieve stress, and don't ignore the urge to have a bowel movement.
If diet and exercise don't bring you constipation relief, over-the-counter medications may be an effective solution. OTC solutions include:
- fiber supplements,
- stool softeners
- lubricants, such as olive oil
- stimulants, which cause the intestines to contract
- enemas and suppositories to provide lubrication and stimulation
In some cases, OTC laxatives and remedies are not enough to solve the issue, so your physician may prescribe a prescription medication. There are a number of prescription drugs, such as lubiprostone and linaclotide, that are generally effective in treating chronic constipation.
While the need for surgery due to fecal impaction is rare, there are instances where it is necessary. For example, surgical interventions are occasionally needed to remove a bowel blockage or part of a diseased colon.
Contact The Professionals at GI Associates
Chronic constipation affects nearly 15% of all adults and 30% of adults over age 60. While the symptoms vary among individuals, chronic constipation is one of the most common gastrointestinal issues in the U.S., accounting for over two million doctor visits each year. At GI Associates, we are the leaders in the field of gastroenterology. Our goal is to help diagnose your condition and provide you with the tools and knowledge to live healthily and deal with your gastrointestinal issues.
At GI Associates, our team of dedicated professionals is committed to excellence in everything we do. We strive to provide the highest level of comfort and service for our patients. To learn more about how GI Associates can help with your chronic constipation, contact us today.