Chronic Constipation | Digestive Health | Loyola Medicine

Chronic Constipation

Overview and Facts about Chronic Constipation

Chronic constipation results when you have irregular bowel movements or difficulty passing stool that lasts for at least several weeks. It often occurs when stool lingers in your digestive tract, moving slower than normal, leading to stool that is hard, dry, and difficult to pass. If you have bowel movements fewer than three times a week, you may have chronic constipation, especially if it begins to interfere with your daily tasks. Constipation can result from various things, including medication, lifestyle habits, and underlying diseases or conditions.

Symptoms and Signs of Chronic Constipation

The most common signs and symptoms of chronic constipation include:

  • Straining to pass stool
  • Feeling the urge to go but not being able to
  • Having fewer than three stools a week
  • Passing stool that is hard or lumpy
  • Feeling like your bowels aren’t completely empty
  • Needing help to empty your bowels

If you have two or more of these symptoms for at least three months, your doctor may diagnose you with chronic constipation.

Causes and Risk Factors of Chronic Constipation

Chronic constipation can result from a range of causes, including:

  • Stroke
  • Difficulty relaxing pelvic muscles
  • Weakened pelvic muscles
  • Diabetes
  • Thyroid issues
  • Pregnancy
  • Dehydration​

Certain medications, including opiates, sedatives, and some antidepressants, can increase your risk for chronic constipation. Other risk factors include eating a low-fiber diet and getting little or no physical activity. If you have an eating disorder or depression, you may have a higher risk of chronic constipation.

Tests and Diagnosis of Chronic Constipation

Your doctor may recommend a variety of tests and procedures to rule out certain conditions and confirm the root cause of your constipation, including:

  • Blood tests
  • Rectum and lower colon exam (sigmoidoscopy)
  • Rectum and full colon exam (colonoscopy)
  • Anal sphincter muscle function evaluation (anorectal manometry)
  • Anal sphincter muscle speed evaluation (balloon expulsion test)
  • Colonic transit study, where the doctor watches how food moves through your colon
  • X-ray of the rectum during defecation
  • MRI defecography, where contrast gel is inserted into the rectum and the MRI scans as you pass the gel

Treatment and Care for Chronic Constipation

While treating the underlying cause of your chronic constipation is the ultimate goal, managing your symptoms often starts with diet and lifestyle changes that encourage your stool to move through your system faster. Your doctor may recommend an increase in fiber intake, including eating more fresh fruits and vegetables, whole-grain breads and cereals, and even taking a fiber supplement if necessary. Your doctor may suggest increasing your physical activity to exercising most days of the week. You should never ignore the urge to have a bowel movement. If lifestyle changes aren’t enough to improve your regularity, your doctor may prescribe you a laxative or stool softener. If your chronic constipation is caused by a blockage, anal fissure, or stricture, surgery may be necessary to improve your condition.