Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer. Treatment for chronic constipation depends in part on the underlying cause.
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.
What are the signs of constipation?
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. Make an appointment with your doctor if you experience unexplained and persistent changes in your bowel habits.
What causes constipation?
Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract or cannot be eliminated effectively from the rectum, which may cause the stool to become hard and dry. Chronic constipation has many possible causes.
Blockages in the colon or rectum may slow or stop stool movement. Causes include:
Narrowing of the colon (bowel stricture)
Other abdominal cancer that presses on the colon
Rectum bulge through the back wall of the vagina (rectocele)
Neurological problems can affect the nerves that cause muscles in the colon and rectum to contract and move stool through the intestines. Causes include:
Spinal cord injury
Problems with the pelvic muscles involved in having a bowel movement may cause chronic constipation. These problems may include:
Inability to relax the pelvic muscles to allow for a bowel movement (anismus)
Pelvic muscles don’t coordinate relaxation and contraction correctly (dyssynergia)
Weakened pelvic muscles
Hormones help balance fluids in your body. Diseases and conditions that upset the balance of hormones may lead to constipation, including:
Overactive parathyroid gland (hyperparathyroidism)
Underactive thyroid (hypothyroidism)
Complications of constipation
Swollen veins in your anus (hemorrhoids). Straining to have a bowel movement may cause swelling in the veins in and around your anus.
Torn skin in your anus (anal fissure). A large or hard stool can cause tiny tears in the anus.
Stool that can’t be expelled (fecal impaction). Chronic constipation may cause an accumulation of hardened stool that gets stuck in your intestines.
Intestine that protrudes from the anus (rectal prolapse). Straining to have a bowel movement can cause a small amount of the rectum to stretch and protrude from the anus.