Chronic Constipation

People with Chronic Constipation can develop problems that affect their ability to continue their activities.

Chronic Constipation causes difficult stool evacuation for several weeks or more, in the vast majority of cases you can have less than three bowel movements per week.

People who suffer from Chronic Constipation can develop other problems that affect their ability to continue their daily activities.

Treatment can vary depending on the cause of the problem. However, in some cases it is difficult to establish the cause of Chronic Constipation.

Causes
Most Chronic Constipation cases occur when there is a blockage that prevents stool from being properly evacuated, causing it to become hard and dry.

Following are some of the most common causes of constipation:

Blockage in the colon or rectum may be due to various conditions such as: rectal cancer, colon cancer, anal fissure, narrowing of the colon, etc.
Problems in the nerves located around the colon and rectum, some of the causes of these are: Parkinson's disease, stroke, spinal cord injury, multiple sclerosis, among others
Bowel movement problems
Diseases and conditions that involve the balance of body hormones such as: Diabetes, pregnancy, Hypothyroidism, among others

Symptoms
In Chronic Constipation, the following symptoms can occur:

Having less than three bowel movements per week
Hard or dry stools
Try harder to have a bowel movement
Having a feeling of a blockage in the rectum that prevents bowel movements
Having a sense of not being able to empty your rectum
Need to use your hands to press on the abdomen to empty the rectum

If you have had more than two symptoms in the last three months, this could be considered as chronic constipation.

Risk factors
Risk factors that increase the likelihood of chronic constipation are: Consumption of some medications, such as sedatives, narcotics, antidepressants, among others

Age, it is more frequent in older people
Being dehydrated
Lack of physical activity
Eating a low fiber diet
Gender, women suffer more from this condition
Having a mental disorder

Diagnosis of chronic constipation

The Gastroenterologist will perform a physical exam, digital rectal exam, questions based on your symptoms, lifestyle, medical history along with some laboratory tests.

Following are some of the most common tests that the Gastroenterologist may require to diagnose chronic constipation:

Blood test
Sigmoidoscopy allows you to analyze your rectum and the lower part of your colon
Colonoscopy, through a flexible tube that carries a camera, allows the colon to be examined
Anorectal manometry helps measure the coordination of the muscles you use to pass stool
Balloon ejection test measures the time it takes to expel a balloon that has been filled with water and placed in the rectum
Colonic transit study, the doctor supplies you with a pill that has a wireless recording device, which allows you to record the advance of the pill through the colon for several days and will show the results on x-rays

Treatment of chronic constipation
Common treatment of Chronic Constipation options include having a healthy lifestyle; this helps to improve quality of life.

Following are the most common recommendations for chronic constipation:

Eating healthy
Eat fiber (whole grains)
Eat fruits and vegetables
Maintain a low-salt diet
Do regular and continued physical exercise
Taking laxatives that are selled over the counter
Pelvic muscle exercise
Relax, take what you need to do a bowel movement in the bathroom

If over-the-counter medications do not work, go to your Gastroenterologist who may prescribe other medications such as:

Medicines that carry water to the intestines. (Lubiprostone and linaclotide)
Misoprostol, probenecid and colchicine, and onabotulinumtoxin

If the cause of chronic constipation is a blockage and treatments and medications have not worked, surgery could be an option.

Living with chronic constipation
Follow the treatment provided by your Gastroenterologist.

We give you some recommendations to consider that could help reduce discomfort:

Manage stress
Increase water consumption
Get regular and continued exercise
Eat foods with dietary fiber
Drink a glass of water with an empty stomach
Try to have a fixed schedule for eating the main meals
Schedule an uninterrupted time to go to the bathroom
Don't ignore the need to evacuate
Try to sleep 8 hours a day and have a fixed sleep schedule

When should I see a doctor?
It's important to consult a specialist in Gastroenterology to diagnose chronic constipation and to be able to start a treatment that helps you control your symptoms.

When consulting your Gastroenterologist, try to keep a record of your pain with a detailed description of the symptoms, duration, and what you think triggered them. Also, mention any medications you are taking.

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