Constipation is the most common gastrointestinal complaint, and it results in approximately 2.5 million doctor visits on an annual basis. Over 4 million people in the United States have chronic or frequent constipation, which can be uncomfortable and painful and can severely affect their quality of life. Read on to learn more about constipation, what causes chronic constipation, and what types of treatment are available. 

What Is Chronic Constipation?

In general, constipation is considered to be the inability to poop more than three times per week. Usually, constipated stools are hard and dry and can be difficult to pass, which can cause straining, leading to other medical problems. Everyone’s body is different; some people may have several bowel movements per day, while others are perfectly healthy having only three bowel movements a week. However, if that number drops under three, the person is considered to have constipation issues. Chronic constipation is constipation that occurs frequently and is not easily relieved by using laxatives. Chronic constipation is more common in women than in men.

What Causes Chronic Constipation? 

As everyone’s body is different, so are the reasons a person may be constipated or have fecal impaction. If you have hard and dry stools and suffer from constipation, this means that your colon has absorbed too much water, resulting in stools that have difficulty passing through the colon (also known as the large intestine). In addition to having dry stool, the colon’s movements are inefficient and sluggish, which also contributes to constipation. In general, constipation is caused by:

  • Dehydration (not enough liquid)
  • A low-fiber diet 
  • Putting off going to the bathroom (having a bowel movement)
  • Aging 
  • Pregnancy
  • Laxative abuse
  • Medications
  • Intestinal function problems
  • Lack of exercise 

When it comes to chronic constipation, there may be other root causes that may be more serious. Chronic constipation is associated with disorders and problems such as:

  • IBS (irritable bowel syndrome)
  • Lesions in the colon (this can be due to colon cancer, rectal cancer, or narrowing of the colon)
  • Thyroid disorders
  • Diverticular disease
  • Outlet dysfunction constipation, which is a breakdown of the pelvic floor muscles
  • Intestinal obstruction
  • Lupus
  • Parkinson’s disease
  • Diabetes

Those over 45-50 who suffer from chronic constipation should make an appointment with their healthcare provider to ensure that there isn’t a secondary problem. While not as common as some other causes, chronic constipation can be a marker for both colon and rectal cancer, so it’s a good idea just to check in to make sure everything’s okay. 

What Are the Symptoms of Chronic Constipation?

Chronic constipation is constipation that occurs often, and it is often characterized by:

  • The inability to completely empty the bowel
  • Nausea
  • Bloating 
  • Stomach cramps or a stomachache 
  • Less than three bowel movements per week
  • Hard, dry stools that are hard to pass

If you have these symptoms often, you may be suffering from chronic constipation.

How Does a Doctor Test for the Cause of Chronic Constipation?

If you visit your GI doctor due to constipation, they will likely perform diagnostic tests first to discover the root cause before they can treat you. The first tests would likely be blood and urine samples. These can let the doctor know if you have problems with your thyroid, have anemia, potential cancer, or some other problem. 

Your healthcare provider may order imaging tests. MRI (magnetic resonance imaging) or CT (completed topography) scans are often used to give the doctor an internal look at what may be causing your constipation. A colorectal transit study is another possibility. During this test, you’ll ingest a small amount of a radioactive substance, and your physician will time how long it takes to move through your digestive system and your intestines. 

Colonoscopy is another possibility. If you’re 45 or over or have severe chronic constipation, your doctor may order a colonoscopy so they can get a close-up look at your colon function. A colonoscope is a small tool that is inserted while you are under some form of anesthesia. During a colonoscopy, the doctor will take a sample (biopsy) of your colon to check for polyps, which are the hallmark of colorectal cancer. This test can rule out more serious issues, such as colon cancer. 

How to Treat Chronic Constipation 

Generally, constipation is treated with some lifestyle changes along with some over-the-counter medications, such as laxatives. Your doctor may recommend some of these “home remedies” or dietary changes to try to relieve your constipation. Some forms of constipation relief include:

  • High-fiber foods. A diet low in fiber can cause constipation, so your doctor may recommend you eat foods high in fiber, such as whole grains, fruits, wheat bran, prunes, and vegetables. Additionally, they may recommend you avoid fattier foods, such as eggs, meat, and cheese. 
  • Increasing your water intake. Ideally, you should be drinking half of your weight in water per day (if you are 180 pounds, you should be drinking 90 oz. of water). This may be tough for some, but any increase in water intake can help lubricate the colon. Drinks that can further dehydrate you include those containing caffeine and alcoholic beverages.
  • Starting an exercise regimen. Your physician may advise that you increase your physical activity. You can always start small with low-impact exercises, such as walking or yoga.
  • Use of laxatives. Your healthcare provider may suggest an over-the-counter laxative or prescribe you prescription laxatives to get your bowels moving. 
  • No cell phone usage. While you’re on the toilet, concentrate only on moving your bowels and not books, mobile phones, or tablets. 
  • Keeping a food diary. Writing down everything you eat and drink can help give insight as to what is causing your constipation.
  • Changing medications. Certain medications, such as opioids, can cause chronic constipation. Your doctor may switch medications or provide a specific drug to treat constipation caused by the medicine.

Other treatments for chronic constipation, if diet and lifestyle changes don’t work, include:

  • Biofeedback. If you have anorectal dysfunction as the cause of your constipation, biofeedback is often used to retrain the colon muscles.
  • Botox. Botox injections can help treat pelvic floor dysfunction, and they can also make going to the bathroom less painful and soften the stool.
  • Surgery. Having surgery is rare for constipation, but it is an option depending on what is causing your constipation. Surgery can be beneficial in cases of chronic constipation caused by rectal prolapse, intestinal blockage, anal fissure, or colon dysfunction. 

If constipation isn’t treated, you may be straining while making a bowel movement, leading to other gastrointestinal problems such as hemorrhoids.  To learn more about constipation, or if you need to be seen by a doctor regarding your chronic constipation, contact us at Carolina Digestive today. We provide a full spectrum of comprehensive and diagnostic care when it comes to gastrointestinal disorders and problems.