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Chronic Constipation

Having fewer than three bowel movements a week is termed as constipation. Chronic constipation is difficulty in passing stools, persisting for weeks together. While constipation does trouble all of us from time to time, chronic constipation can severely affect one’s quality of life and even cause injury through excessive straining. Treatment for constipation would depend on what’s causing it, although sometimes, there isn’t a medical explanation.

What are the usual symptoms of chronic constipation?

Some such signs and symptoms include:

# Passing fewer than three stools per week

# Struggling with lumpy or hard stools

# Having to strain for bowel movement

# Sense of a blockage in your rectum impeding bowel movement

# Feeling of incomplete evacuation

What are the known causes of chronic constipation?

Constipation is mostly triggered by slow movement of stools through the digestive track or difficulty in passing stools easily through the rectum. When this happens, stools become hard and dry.

There could be a number of reasons for chronic constipation. Some of these are:

# Obstruction in the colon or rectum: This could be caused by anal fissures (tiny skin tears around the anus), bowel obstruction, colon cancer, bowel stricture or narrowing of the colon, abdominal cancers putting pressure on the colon, rectal cancer or rectocele (bulging of the rectum through the back wall of the vagina).

# Neurological problems: Sometimes, the nerves that induce contraction in the muscles of the colon and rectum to help move stool through the intestines, are affected by neurological disorders like autonomic neuropathy, multiple sclerosis, Parkinson’s disease, stroke or a spinal cord injury.

# Pelvic muscle issues: Chronic constipation can also be caused by problems with the pelvic muscles that help in bowel movement. A few such issues are: Anismus or when a person is unable to relax the pelvic muscles to facilitate bowel movement; dyssynergia which is lack of sync in contraction and relaxation of pelvic muscles; pelvic muscles that have become weak.

# Hormonal imbalance: Conditions and diseases that disturb hormonal balance could trigger constipation as well. Some of these conditions could be diabetes, hyperparathyroidism or overactive parathyroid gland, hypothyroidism and pregnancy.

What are some of the complications of chronic constipation that might need medical attention?

Some painful and uncomfortable complications of chronic constipation are:

# Hemorrhoids: This is a condition in which the veins in and around the anus get swollen from straining to have a bowel movement.

# Anal fissure: This is a skin tear in the anus caused by a large or hard stool.

# Fecal impaction: Chronic constipation can lead to collection of hardened stool that can’t be emptied and gets stuck in the gut.

# Rectal prolapse: Excessive straining can lead to protrusion of a section of the rectum from the anus.

What are the usual treatment protocols for treating chronic constipation?

# Changes in diet and lifestyle: The doctor might suggest adding more fibre to your diet to add to the weight of the stool to ensure speedier movement through the intestines. Fresh fruits and vegetables help. However, a sudden increase in fibre intake could lead to bloating and discomfort from gas. So, it’s advisable to add fibre gradually to your diet.

# Getting into an exercise regimen: It’s important to exercise in some form regularly since any type of physical activity increases intestinal muscle activity which helps with bowel movement.

# Don’t suppress the urge to go: You shouldn’t put off going to the washroom if you need to and give yourself enough time for proper bowel movement without worrying about other things.

# Using laxatives: There are several different types of laxatives that the doctor might prescribe, depending on the severity of your condition. These could include fibre supplements, osmotic laxatives, stimulants, lubricants, stool softeners, suppositories or enemas.

# Medications: Sometimes, your doctor might prescribe a specific medication, more so if you have IBS or irritable bowel syndrome. Such medications could include medicines that draw water to your intestines to speed up stool movement, serotonin 5-hydroxytryptamine 4 receptors to aid stool movement through the colon, etc.

# Training pelvic muscles: A therapist will work with you with devices to teach you how to relax and tighten your pelvic muscles at the opportune moment to help pass stool easier. This is biofeedback training.

# Surgery: If your chronic constipation is triggered by obstruction, rectocele or stricture and you have exhausted other modes of treatment, surgery could be an option the doctor would suggest. Such a procedure usually involves surgical removal of a part of the colon for those who have abnormally slow movement of stool through the colon.

While constipation is a common occurrence that most people suffer from at some point of their lives, it is likely to worsen with age. If the problem persists and makes normal life difficult, it is important to talk to a doctor about it. At Medica Ranchi, our Constipation Clinic offers comprehensive services is understanding and managing the condition, along with diagnosis and treatment for any underlying medical condition.

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