Chronic Constipation

Constipation is a common complaint characterized by infrequent bowel movement or difficulty in passing stool. Many people experience occasional constipation which most commonly resolves on its own. However, chronic constipation that lasts several weeks or longer significantly impacts the quality of one’s life and should be evaluated by a doctor. Chronic constipation can affect anyone, but it is most common in women and the elderly. Many symptoms of chronic constipation can be addressed by lifestyle modifications and occasional use of laxatives.

Symptoms 

 

Constipation can be experienced and thus defined in various ways. In chronic constipation two or more of the following symptoms usually persist for 3 months or longer:

 

  • Fewer than three stools a week

  • Hard, lumpy or small amount of stool

  • Straining while passing stool

  • Feeling of incomplete emptying of the bowel

  • Feeling of intestinal obstruction that prevents bowel movement

  • Need for manual assistance in removing the stool from the bowel or the rectum

Causes

 

There are many causes for constipation, but the most common ones are:

 

  • Lack of fiber in diet and inactive lifestyle

  • Organic gastrointestinal disorders (with obvious physical or physiological reasons, such as colon cancer or blockage of the bowel)

  • Functional gastrointestinal disorders (irritable bowel syndrome)

  • Hormone imbalance (pregnancy, diabetes, hypothyroidism)

  • Use of certain drugs (opiates, antidepressants, iron supplements, antacids…)

  • Neurological and psychiatric disorders (Parkinson’s disease, spinal cord injury, depression)

 

As causes of constipation vary from inadequate diet to serious problems such as colon cancer, it is important to be aware of your bowel habits and to immediately consult your doctor if you notice a sudden change.

Diagnosis

 

Constipation is diagnosed based on the symptoms and physical examination. In some cases, to find an underlying cause for constipation, additional tests, such as blood test or colonoscopy, are performed.

Treatment

 

As causes for constipation vary, so does the treatment. In general, idiopathic constipation (without an obvious cause) can be successfully managed by dietary and lifestyle changes as well as the occasional use of laxatives.

Lifestyle Medicine

Be physically active

 

A sedentary lifestyle has been associated with constipation. Results of the scientific studies that evaluated the role of exercise in relieving constipation are inconclusive. In people who are already active, increase in physical activity is not likely to prevent constipation. However, a more active lifestyle will have a positive effect on the sedentary population. Any type of physical activity such as walking, gardening or dancing counts toward exercise. Yoga is a particularly good choice for people experiencing constipation. Yoga postures that focus on abdominal region might help alleviate bloating and abdominal pain and get your bowels moving.

Modify your diet

Dietary changes offer a safe, efficient and inexpensive way to improve symptoms of constipation.  Although it may not be immediately effective, adopting a healthy diet will be a long lasting solution. Importantly, it will minimize the need for laxatives, which offer a quick fix but also bring about the risk of dependency.

Increased intake of dietary fiber and fluids is the advice most commonly given to people with chronic constipation.

Improve your bowel habits

 

Bowel emptying involves a complex coordination of a number of muscles – diaphragm, intestinal, abdominal and pelvic floor muscles. From training those muscles to abdominal massage - there are a number of effective strategies to help improve your bowel habits. For example, bowel training aims to establish regular patterns of bowel elimination, while abdominal breathing strengthens abdominal muscles that help in propulsion of stool.

Boosters

Laxatives

 

 

In many cases, lifestyle modifications, a high-fiber diet and exercise, successfully relieve constipation. However, on occasion, additional help is needed. Laxatives are medications used to treat constipation. Based on their mechanism of action, they can be categorized into four different groups: stool softeners, bulk-forming, osmotic and stimulant laxatives. Consult your doctor to find the one that is most suitable for you. 

Last updated: December 7, 2016

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