By Faozat Aragbaiye

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Constipation is a common digestive complaint. Most bouts of constipation are short-term, or “acute.” However, some people experience long-term symptoms, known as chronic constipation.
Chronic constipation can be uncomfortable and can interfere with a person’s day-to-day functioning. While some causes of the condition are relatively benign and highly treatable, others can be more serious.
Everyone experiences constipation at some point. Most cases of constipation are short-term or acute. These often occur following a change in diet or exercise habits, and is treatable with over-the-counter (OTC) medications.
In rarer cases, constipation may be chronic, meaning symptoms are long-lasting. Constipation is considered chronic under these conditions:
lasts for 3 months or more
disrupts a person’s life and daily functioning,
does not resolve following a change in diet or exercise
only resolves with prescription medications.
■Causes
Although people with chronic constipation experience similar symptoms, the cause of constipation may vary.
▪︎Common causes
The most common triggers of constipation include:
slow movement of stool through the colon
difficulty eating a balanced diet, with a lack of fiber from fruit and vegetables
inadequate fluid intake leading to dehydration
lack of exercise leading to slowed digestion
irritable bowel syndrome
side effects of medications
mental health problems, including: stress anxiety depression eating disorders
▪︎Less common causes
Less common causes of constipation include:
hormonal imbalances, such as hyperthyroidism
conditions that affect the metabolism, such as diabetes
disorders that affect the brain and spine, such as Parkinson’s disease
celiac disease
inflammation linked to diverticular disease or proctitisan
obstruction in the intestines or rectum
family history of constipation
▪︎Other causes
Certain dietary supplements and medications can also trigger constipation. These include:
iron supplements
calcium supplements
antacids
diuretics
antihistamines
calcium channel blockers
certain antidepressants
antipsychotic
santiconvulsants
medications to treat Parkinson’s disease
▪︎Unknown causes
It may not always be possible to determine what causes constipation. Chronic constipation that occurs without a known trigger is known as chronic idiopathic constipation.
■ Risk factors
The following groups are at increased risk of experiencing chronic constipation:
people over the age of 65 years
females, particularly those who are pregnant
people with limited mobility
people taking certain medications
7people with mental health conditions, such as anxiety, depression, or an eating
■Symptoms
To receive a diagnosis of chronic constipation, a person must experience at least three of the following symptoms within a 3-month period:
passing fewer than three stools a week
passing stools that are hard, lumpy or pebble-like
straining to empty the bowel
feeling that the rectum is not completely empty after a bowel movement
feeling as if there is a blockage in the rectum
needing help to empty the rectum, either by pressing on the abdomen or by inserting a finger to remove a lodged stool
▪︎Secondary symptoms of chronic constipation include:
bloating
nausea
abdominal pain
loss of appetite
■Treatment
Treatments for chronic constipation may vary according to its severity and its underlying cause. Some possible treatment options are the followings:
▪︎Diet and lifestyle changes
The first-line treatment for chronic constipation is to make any necessary diet and lifestyle changes. These may include:
i)Increasing fiber intake
Dietary fiber adds bulk to the stool, enabling it to pass through the intestines more quickly. A doctor may advise gradually increasing fiber intake by introducing more fruit and vegetables into the diet. Switching from refined grains to whole grains will also help boost fiber intake.
ii)Staying hydrated
Water softens stools, allowing them to pass smoothly through the intestines and rectum.
iii)Increasing physical activity
Regular movement increases muscle activity in the intestines, helping stools pass through the digestive system. Therefore, increasing physical activity encourages more regular bowel movements.
iv)Going to the bathroom when the urge arises
If a person routinely ignores their body’s signals to poop, they may no longer experience the urge for a bowel movement, which can worsen constipation.
▪︎OTC medications
If diet and lifestyle changes are not effective, a person may wish to try OTC medications to soften the stool or increase bowel movements. Some options include:
i)fiber supplements, such as psyllium, which add bulk to the stool
ii)stool softeners, such as Surfak, which draw water from the intestines to moisten the stool
iii)osmotics, such as Phillips’ Milk of Magnesia, which increase fluid in the colon
iv)lubricants, such as olive oil, which help the stool pass smoothly
v)stimulants, such as Senokot, which cause the intestines to contract
vi)enemas and suppositories to provide lubrication and stimulation
▪︎Prescription medications
If OTC laxatives and natural remedies do not alleviate a person’s constipation, a doctor may recommend a prescription medication. The drugs lubiprostoneTrusted Source (Amitiza) and linaclotideTrusted Source (Linzess) are generally effective in treating chronic constipation.
▪︎Biofeedback training
Biofeedback training (BT) is a type of behavioral therapy that aims to treat constipation and other types of bowel dysfunction.
BT involves learning how to relax and tighten the pelvic muscles that support the bladder and bowel. Relaxing these muscles at the right time can increase the likelihood of a successful bowel movement.
During BT, a therapist may insert a long tube called a catheter into the rectum to measure tension in the muscles. They will then talk the person through a series of exercises to help relax and tighten the muscles.
▪︎Surgery
Surgery for chronic constipation is rare. However, a person may require surgical interventions to remove a bowel blockage or part of a diseased colon.
■Prevention
The best way to prevent constipation is to adopt lifestyle habits that promote good digestion. Examples include:
eating a balanced diet
drinking plenty of fluids
exercising regularly
getting enough sleep
sticking to regular sleeping and waking times
going to the bathroom when the urge arises
■Complications
Passing hard stools or constantly straining to poop can lead to complications, such as:
anal fissures, which are small tears inside the anus
hemorrhoids, which are swollen veins in the anus
fecal impaction, an accumulation of hardened stool inside the intestine
rectal prolapse, where an area of the rectum stretches and protrudes from the anus