Constipation is something most people deal with at some point, but for many, it evolves into a persistent challenge that affects their quality of life.

You might find yourself stuck in a cycle of discomfort, trying various remedies, yet still feeling frustrated and defeated.

When does this common issue transform into chronic constipation?

And more importantly, when should you consider reaching out to a healthcare professional for help?

Understanding these questions is vital for maintaining your digestive health.

In this blog, Mykare Health will dive into the nuances of chronic constipation—exploring its causes, symptoms, and the signs that indicate it’s time to seek medical advice.

Understanding Constipation

Constipation is typically defined as having fewer than three bowel movements per week or experiencing difficulty during bowel movements, characterised by hard or lumpy stools. The symptoms can vary but often include

• Straining during bowel movements

• A feeling of incomplete evacuation

• Abdominal discomfort or bloating

Types of Constipation

• Acute Constipation: This type is usually short-lived and can be triggered by various factors such as diet changes, dehydration, or stress.

• Chronic Constipation: When constipation lasts for three months or longer, it is classified as chronic. This condition often requires a more thorough investigation and management.

What Causes Chronic Constipation?

Chronic constipation can arise from a variety of factors, often interlinked. Understanding these causes is crucial for effective management.

Dietary Factors

A diet low in fibre can significantly contribute to constipation. Fibre is essential for adding bulk to the stool and promoting regular bowel movements. Foods rich in fibre include

• Fruits and vegetables

• Whole grains

• Legumes

Inadequate fluid intake can also exacerbate the issue, as water helps soften stools, making them easier to pass.

Lifestyle Factors

• Sedentary Lifestyle: Lack of physical activity can slow down the digestive process.

• Ignoring Urges: Suppressing the urge to have a bowel movement can lead to constipation over time.

• Stress and Anxiety: Mental health plays a significant role in digestive health; stress can disrupt normal bowel function.

Medical Conditions

Certain medical conditions can lead to chronic constipation, including

• Irritable Bowel Syndrome (IBS): IBS can cause various gastrointestinal symptoms, including constipation.

• Hypothyroidism: An underactive thyroid can slow down bodily functions, including digestion.

• Diabetes: High blood sugar levels can damage nerves, affecting bowel function.

• Neurological Disorders: Conditions like Parkinson’s disease and multiple sclerosis can impair bowel movements.

Medications

Several medications can contribute to constipation as a side effect, including

• Pain medications (especially opioids)

• Antacids containing aluminium

• Certain antidepressants

• Iron supplements

When Does Constipation Become Chronic?

While everyone experiences occasional constipation, it becomes a concern when it is frequent and persistent. Chronic constipation is typically diagnosed when symptoms last for three months or more and may include

• Having fewer than three bowel movements per week

• Difficulty passing stools

• A sensation of blockage or obstruction in the rectum

If you notice that your bowel habits have changed and you’re experiencing these symptoms consistently, it’s time to evaluate your situation more closely.

When Should You See a Doctor?

Persistent Symptoms

If you’ve been experiencing constipation for several weeks without any relief from home remedies or dietary changes, it’s essential to consult a healthcare professional. Chronic symptoms may indicate an underlying condition that requires further investigation.

Accompanying Symptoms

Seek medical attention if your constipation is accompanied by any of the following symptoms

• Severe abdominal pain

• Blood in your stool

• Unexplained weight loss

• Changes in your bowel habits (e.g., diarrhea alternating with constipation)

• Fever or other systemic symptoms

These signs may indicate a more serious condition that requires immediate medical evaluation.

Age and Family History

If you are over 50 years old or have a family history of gastrointestinal disorders, it’s prudent to discuss your symptoms with a doctor. Age can increase the risk of colorectal issues, including cancer.

What to Expect During Your Doctor's Visit?

When you decide to see a doctor about chronic constipation, they will typically follow a series of steps to evaluate your condition.

Medical History Review

The doctor will begin by taking a comprehensive medical history, including

• Duration and frequency of your constipation

• Dietary habits

• Medications you are currently taking

• Any accompanying symptoms

Physical Examination

A physical examination may be conducted to assess your overall health and look for any abnormalities that could contribute to your symptoms. This may include a rectal examination to check for blockages or issues with the rectal muscles.

Diagnostic Tests

Depending on your symptoms and medical history, the doctor may recommend further tests, including

• Blood Tests: To check for conditions like thyroid dysfunction or diabetes.

• Imaging Studies: Such as X-rays or CT scans, to examine the digestive tract.

• Colonoscopy: A procedure that allows direct visualisation of the colon and rectum, especially if there are concerns about cancer or other serious conditions.

Treatment Options for Chronic Constipation

Once a diagnosis is made, the treatment for chronic constipation will depend on the underlying cause. Here are some common approaches:

Dietary Modifications

• Increase Fibre Intake: Aim for at least 25-30 grams of fiber daily. Consider incorporating more fruits, vegetables, and whole grains into your diet.

• Stay Hydrated: Drink plenty of water throughout the day to help soften stools.

Lifestyle Changes

• Regular Exercise: Engage in physical activity, as even walking can promote bowel regularity.

• Establish a Routine: Try to set aside time each day for bowel movements, allowing your body to develop a regular pattern.

Over-the-Counter Treatments

Several over-the-counter laxatives may provide temporary relief, including

• Bulk-forming Agents: Such as psyllium husk, which increases stool bulk.

• Osmotic Laxatives: Such as polyethylene glycol, which draws water into the intestines.

• Stimulant Laxatives: Such as bisacodyl, which stimulates bowel contractions.

Prescription Medications

If over-the-counter options are ineffective, your doctor may prescribe medications specifically designed to treat chronic constipation, including

• Lubiprostone: Increases fluid secretion in the intestines.

• Linaclotide: Increases intestinal fluid secretion and promotes bowel movements.

Behavioural Therapies

In some cases, cognitive-behavioural therapy (CBT) may be recommended to address any underlying anxiety or stress contributing to bowel issues.

Prevention Tips for Chronic Constipation

Preventing chronic constipation is often easier than treating it once it becomes an issue. Here are some strategies to maintain regular bowel movements

Maintain a High-Fiber Diet

Include a variety of high-fibre foods in your daily meals, and consider gradually increasing your fibre intake to avoid gastrointestinal discomfort.

Stay Active

Aim for at least 150 minutes of moderate exercise each week. This can include walking, swimming, or other physical activities that you enjoy.

Listen to Your Body

Don’t ignore the urge to have a bowel movement. Responding to your body’s signals can prevent constipation from becoming a chronic issue.

Stay Hydrated

Ensure you drink enough water daily. The general recommendation is about 8-10 cups, but individual needs may vary based on activity level and climate.