Constipation

Chronic constipation is infrequent bowel movements or the difficult passage of stools that persists for several weeks or longer. Constipation is generally described as having fewer than three bowel movements a week.

Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. Chronic constipation may also cause excessive straining to have a bowel movement and other signs and symptoms.  Treatment for chronic constipation depends on the underlying cause. Though, in some cases, a cause for chronic constipation is never found.

Symptoms

Signs and symptoms of chronic constipation include:

  • Passing fewer than three stools a week
  • Having lumpy or hard stools
  • Straining to have bowel movements
  • Feeling as though there’s a blockage in your rectum that prevents bowel movements
  • Feeling as though you can’t completely empty the stool from your rectum
  • Needing help to empty your rectum, such as using your hands to press on your abdomen and using a finger to remove stool from your rectum

Constipation may be considered chronic if you’ve experienced two or more of these symptoms for the last three months.

Causes

Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing it to become hard and dry.
Chronic constipation has many causes:

  • Anal fissure
  • Bowel obstruction/blockages
  • Colon cancer
  • Narrowing of the colon (bowel stricture)
  • Other abdominal cancer that presses on the colon
  • Rectal cancer
  • Rectocele

There can also be problems with the nerves around the colon and rectum, difficulty in engaging the muscles involved in elimination and/or conditions that affect hormones in the body, all which may cause or contribute to constipation.

Common Tests and Diagnosis

Tests and procedures used to diagnose chronic constipation may include:

  • Examination of the rectum and lower, or sigmoid, colon (sigmoidoscopy).   In this procedure, your doctor inserts a lighted, flexible tube into your anus to examine your rectum and the lower portion of your colon.
  • Examination of the rectum and entire colon (colonoscopy). This diagnostic procedure allows your doctor to examine the entire colon with a flexible, camera-equipped tube.
  • Evaluation of anal sphincter muscle function (anorectal manometry). In this procedure, your doctor inserts a narrow, flexible tube into your anus and rectum and then inflates a small balloon at the tip of the tube. The device is then pulled back through the sphincter muscle. This procedure allows your doctor to measure the coordination of the muscles you use to move your bowels.
  • Evaluation of how well food moves through the colon (colonic transit study). In this procedure, you’ll swallow a capsule containing markers that show up on X-rays taken over several days. Your doctor will look for signs of intestinal muscle dysfunction and how well food moves through your colon.

Treatment for chronic constipation usually begins with diet and lifestyle changes meant to increase the speed at which stool moves through your intestines. If those changes don’t help, your Webster Wellness physician may recommend medications or surgery.