What Is Chronic Constipation?
Constipation is a problem with passing stool. How often you poop is different for each person. Some people poop several times a day and others poop only a few times a week. Passing fewer than three stools a week is usually considered constipation.
Chronic constipation is when you experience the symptoms of constipation for three months or longer. This may mean passing fewer stools than normal or having difficulty passing a bowel movement.
Causes of Chronic Constipation
Constipation occurs when stool moves too slowly through your large intestine (colon). When the stool moves slowly, your body absorbs too much water from the stool. This can make the stool hard and dry.
The most common cause of chronic constipation is evacuation disorder, or pelvic floor dysfunction. This disorder is caused by poor bowel training or habits that prevent muscles from relaxing properly.
Constipation can be caused by many things. Lifestyle, medical conditions, and medication can all play a part in causing constipation.
Lifestyle
-
Lifestyle factors are a common cause of constipation:
-
Not drinking enough water
-
Not eating enough fiber
-
Not exercising enough
-
Changes in your routine such as travel
-
Stress or depression
-
Ignoring the need to have a bowel movement
Medical Conditions
There are several medical conditions that may cause constipation:
-
Hypothyroidism (under active thyroid)
-
Neurological conditions
- Eating disorders
Almost any medical condition can cause changes in your bowel movements. In women, changes in hormones can also cause constipation. Ask your primary care provider if you think your medical or health condition is contributing to your constipation.
Medications
A common side effect of medication is constipation. Many medications may cause constipation:
-
Allergy medications
-
Antidepressants
-
Anti-seizure medications
-
High blood pressure medication
-
Pain relievers including opioids
If you think your medication may be causing chronic constipation, talk with your primary care provider or pharmacist.
How Common is Chronic Constipation?
Constipation is a common gastrointestinal complaint. Most people will experience constipation at some point in their life. Chronic constipation is present in up to 27% of the population. It is more common in women and older adults.
Chronic Constipation Symptoms
The most recognized symptom of constipation is having three or fewer bowel movements a week. Because how often you pass stools is unique to you, it’s important to know what to look for. There are many symptoms of constipation:
-
Passing fewer stools than normal (usually fewer than three stools a week)
-
Dry, hard, or lumpy stools
-
Straining to pass a bowel movement
-
Pain when passing stool
-
Bloating
-
Stomach pain and cramping
-
Feeling like you have not emptied your bowels completely
-
Feeling like your anus is blocked
If you are experiencing any of these symptoms for three months or longer, you may have chronic constipation.
Find a Gastroenterologist Near You
Diagnosing Constipation
Talk with your health care provider about your bowel movements. Your doctor will likely ask you questions about your bowel movement history:
-
How long you’ve been experiencing symptoms of constipation
-
What your stools look like
-
If you’ve noticed blood in the toilet or on toilet paper
-
What constipation relief methods you’ve tried
Your provider may perform a physical exam. This may include gently feeling your abdomen or inserting a gloved finger into your rectum (rectal exam). In some cases, your provider may suggest an X-ray of your abdomen to look for stool retention or fecal impaction.
Chronic Constipation Tests
Most people with constipation do not need further testing. If your provider thinks more tests are necessary, there are several options available:
-
Blood tests to check for thyroid issues and serum calcium levels
-
Sitz marker study: an X-ray test that checks your colon
-
MRI defecography: an MRI test that monitors how you defecate
-
Ballon expulsion test and anorectal manometry: these two tests are performed together by a nurse in an outpatient clinic. The tests check for rectal sensation and evacuation disorder.
Treating Chronic Constipation
Most cases of constipation can be treated at home. There are several ways that you can manage your chronic constipation:
-
Change the way you eat. Try a diet that’s high in fiber.
-
Drink enough water.
-
Get moving. Try a gentle walk after a meal.
-
Try a mild laxative or stool softener.
If none of these methods are helping, your provider may prescribe a medication to help ease your constipation.
Surgery is rarely needed to fix constipation.
Biofeedback Therapy
If your constipation is caused by evacuation disorder, you may benefit from biofeedback. Biofeedback is a behavioral therapy. It teaches you how to have a bowel movement. The therapy trains the nerves and muscles of your abdomen, rectum and anus to work together. It is done with the help of a computer by trained nurses or physical therapist. No preparation is required. A course of treatment usually requires six sessions. A session usually lasts 60 minutes.
Why Choose U of U Health?
U of U Health has year-after-year exceptional rankings as offering the best health care in the nation. It's not a surprise. We believe collaboration throughout our system — from physicians, researchers, biologists, and more — leads to the most imaginative care.
We have specialists, trained nurses, and the necessary equipment to check for constipation. Our trained physical therapists and nurses are trained to provide biofeedback.
Working together in a rich, collaborative clinical environment means our discoveries have a direct impact on the health of our patients. U of U Health isn't satisfied with just offering health care. We want to transform it.
