Chronic constipation is characterized by irregular bowel motions or trouble passing stools that last for a few weeks or more. Generally speaking, constipation is defined as having less than three bowel motions per week.

Even if it happens frequently, some people have chronic constipation which makes it difficult for them to carry out their everyday activities. Those who are chronically constipated could also strain too much to pass a bowel movement.

The underlying cause of persistent constipation influences treatment options in part. Yet occasionally, no reason is ever identified.

Constipation: Causes

The most frequent causes of constipation are when waste or stool goes through the digestive tract too slowly or cannot be efficiently evacuated from the rectum, which can result in the stool being hard and dry. There are several potential reasons for chronic constipation.

Obstructions in the Rectum or Colon

Stool movement may be slowed or stopped by obstructions in the colon or rectum. Some causes are −

  • The skin surrounding the anus has little rips in it (anal fissures)

  • A gastrointestinal obstruction (bowel obstruction)

  • Stomach cancer

  • A contraction of the colon (bowel stricture)

  • Colon-pressuring abdominal cancers of another kind

  • Colon cancer

  • Rectum protrudes past the vagina's posterior wall (rectocele)

  • Nervous system issues in the colon and rectum

The nerves that control the contraction of the colon and rectum muscles and the passage of feces through the intestines might be impacted by neurological conditions. some causes are −

  • Nerve damage that affects how the body works (autonomic neuropathy)

  • Several sclerosis

  • Parkinson's condition

  • Spinal cord damage

  • Stroke

  • Having trouble using the muscles used for elimination

Chronic constipation may result from issues with the pelvic muscles needed to pass stools. These issues might involve −

  • Failure to enable the pelvic muscles to relax to facilitate a bowel movement (anismus)

  • Pelvic muscles that improperly balance relaxation and contraction (dyssynergia)

  • Diminished pelvic muscles

  • Conditions that have an impact on the body's hormones

Your body's fluid equilibrium is aided by hormones. Constipation can result from several illnesses and disorders, including −

  • Diabetes

  • Excessive parathyroid activity (hyperparathyroidism)

  • Pregnancy

  • Thyroid dysfunction (hypothyroidism)

Constipation: Symptoms

The patient with constipation mainly presents with the following symptoms that include −

  • Less than three stools per week being passed

  • Having stiff or lumpy stools

  • Struggling to go to the bathroom

  • Feeling as if your rectum is blocked and preventing bowel movements

  • Having the impression that you cannot fully expel the excrement from your rectum

  • Need assistance to empty your rectum, such as pressing with your hands on your belly and removing feces with a finger from your rectum

If you have had two or more of these symptoms over the past three months, your constipation may be regarded as chronic.

Chronic constipation can have the following side effects −

  • Your anus veins are swollen (hemorrhoids). The veins in and around your anus may bulge as a result of straining to go to the bathroom.

  • Ripped flesh in your ant (anal fissure). Little rips in the anus might be brought on by a big or hard stool.

  • Stool that won't go away (fecal impaction). A build-up of firm feces that becomes lodged in your intestines as a result of chronic constipation is possible.

  • Intestine that is visible via the anus (rectal prolapse). A little portion of the rectum may extend and protrude from the anus as a result of straining to go to the bathroom.

Constipation: Risk Factors

Several factors play an important role in the development of constipation which includes −

  • Having reached adulthood

  • Being female

  • Being thirsty

  • Eating a fiber-deficient diet

  • Getting very little to no exercise

  • Using certain medicines, such as sedatives, opioid painkillers, some antidepressants, or blood pressure-lowering drugs

  • The presence of a mental illness, such as depression or an eating disorder

Constipation: Diagnosis

The diagnosis of constipation is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes −

  • A blood test. Your physician will examine you for a systemic ailment like hypothyroidism or elevated calcium levels.

  • X-ray. Your doctor can assess whether our intestines are obstructed and whether there is stool in the colon by using an X-ray.

  • Rectum and lower, or sigmoid, colon examination (sigmoidoscopy). With this treatment, your doctor examines your rectum and the bottom part of your colon by inserting a flexible, lit tube into your anus.

  • The rectum and the whole colon are examined (colonoscopy). With the use of a flexible, camera-equipped tube, your doctor may inspect the whole colon during this diagnostic process.

  • The function of the anal sphincter muscle is assessed (anorectal manometry). Your doctor will perform this surgery by inserting a small, flexible tube into your rectum and anus.

Constipation: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Changes in Diet and Lifestyle

To cure your constipation, your doctor could suggest making the following changes −

  • Boost your consumption of fiber. When you consume more fiber, your stool weighs more and moves through your intestines more quickly. Increase your daily intake of fresh fruits and vegetables gradually. Choose cereals and slices of bread made from whole grains.

  • Your doctor could advise consuming a certain amount of grams of fiber per day. For every 1,000 calories in your regular diet, strive for 14 grams of fiber.

  • Starting gently and gradually increasing your intake of fiber over a few weeks may prevent bloating and gas from occurring if you suddenly increase your intake.

  • Try to work out most days of the week. Your intestines' muscles become more active when you exercise. On most days of the week, try to fit in some exercise. See your doctor to determine whether you are healthy enough to begin an exercise program if you don't currently exercise.


There are several kinds of laxatives. Each one functions a little bit differently to facilitate bowel movements. The following can be purchased without a prescription −

Vitamins with fiber. Fiber supplements give your feces more bulk. Bulky stools are softer and simpler to pass.

Constipation: Prevention

Some of the measures that can help to prevent constipation include −

  • Include a lot of high-fiber foods, such as beans, fruits, vegetables, whole grain cereals, and bran, in your diet.

  • Consume fewer low-fiber items, such as processed meals, dairy goods, and animal products.

  • Drink a lot of water.

  • Keep as active as you can, and make an effort to exercise frequently.

  • Be mindful of your tension.

  • Don't resist the impulse to urinate.

  • Strive to establish a routine for bowel motions, particularly after eating.

  • As kids start eating solid meals, make sure they get enough fiber in their diet.


Constipation is a widespread and frequently chronic condition that has a variety of symptoms and few proven effective treatment options. The universal alleviation of constipation symptoms and restoration of gastrointestinal motility are the two main objectives of therapy for individuals with chronic constipation.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 17-Apr-2023


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