Chronic Constipation

Overview

Constipation may come and go and can cause pain and discomfort. But when it happens for weeks, months, or years, you may have chronic constipation. Chronic constipation can affect the quality of your life. But you can work with your doctor to learn how to manage it with different treatments.

What causes it?

If there is no other health problem, the cause of chronic constipation is often related to two problems with your colon. It may be because your colon doesn't move stool along well. Or, once the stool gets to the rectum, you can't pass it out of your body easily. And those problems can be caused by:

• Diet, especially if you don't eat enough fruits, vegetables, and fiber.
• Not drinking enough fluids. Or drinking too much coffee or alcohol, which can act like diuretics.
• Not getting enough activity.
• Medicines, such as antidepressants, water pills (diuretics), iron, and pain medicines.
• Changes in your daily routines from travel or changes in your school or job.
• Getting older.
• Stress.
• A history of emotional, physical, or sexual abuse.
• Problems relaxing the anus or pelvic floor muscles.

Sometimes, no cause is found. In that case, your doctor may diagnose you with a type of irritable bowel syndrome.

What are the symptoms?

The symptoms include having less than three bowel movements a week. You may also have straining or hard, painful stools. Some people also have bleeding from hemorrhoids or anal fissures. Or you may feel that you don't completely empty your bowels.

How is it treated?

There are many ways to treat chronic constipation, depending on what's causing it. Many people need to combine treatments. You may have already tried increasing activity or changing your diet.

Your doctor may also suggest some of these treatments.

Fiber.

Fiber helps keep water in your stool, making it softer and easier to pass.

Drinking more water.

Your body needs water to be able to pass stool.

Laxatives.

Some foods have a natural laxative effect, like prunes. There are also laxative medicines. One type (osmotic) holds water in the intestine to make it easier to pass stool. The other type (stimulant) increases movement in the intestine.

Stool softeners.

These keep stool soft.

Prescription medicines.

Some medicines may help with your bowels. But others can make constipation worse. Talk with your doctor about everything you take. You may be able to switch to a different medicine that will not cause constipation.

Biofeedback.

This can help retrain your pelvic floor muscles to know when to relax and when to push.