What is Chronic Constipation:

Chronic constipation is described as having fewer or 3 bowel movements in a week. Occasional Constipation is very common and can be treated with the medication. but some people may face chronic constipation that can interfere with their ability to go out with the daily tasks. Chronic constipation may also cause excessive straining and difficult bowel moments.

Symptoms of Chronic Constipation:

Signs or Symptoms are as follows;-
  • Having problems and pain while passing stools
  • lumpy/ hard stools or straining in bowel moments
  • passing fewer than three stools in a week
  • Feeling like blockage in rectum which is preventing stools to come out
  • the feeling you are unable to empty the rectum 
  • Eagerly pressing your stomach or needing help to empty rectum by using finger to remove stool from the rectum

If you are facing such signs with your rectum or abdomen, you must make an appointment with the doctor and share your bowel habits experience to him.

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Causes of Chronic Constipation:

Chronic Constipation occurs when stool moves too slowly to the rectum and gets dry & hard to come out. There can be numerous of reasons or causes responsible for Chronic Constipation which are:-

  1. Blockages:- Blockages in Colon or Rectum may effect the bowel movement and the causes are:-
    • Anal fissure
    • Bowel obstruction
    • Colon cancer
    • Narrowing of the Colon or bowel stricture
    • Other abdominal cancer that presses on the colon
    • Rectal cancer
    • Rectum bulge through the back wall of the vagina 
  2. Neurological problems:- These may affect the nerves of colon and rectum muscles. The causes may include:-
    • Autonomic neuropathy
    • Multiple sclerosis
    • Parkinson's disease
    • Spinal cord injury
    • Stroke
  3. Pelvic Muscle dyssynergia : Problems in pelvis muscle may create hurdle in stool elimination and may cause chronic constipation. These problems may be:-
    • pelvic muscle is unable to relax while bowel movement (anismus)
    • Pelvic muscles are unable to coordinate relaxation & contraction correctly (dyssynergia)
    • Weakened pelvic muscles
  4. Hormonal Imbalance: Hormones play a role in balancing fluids in our body. Some disease may disturb the balance or hormones causing chronic constipation which is:-
    • Diabetes
    • Overactive Parathyroid Gland (hyperparathyroidism)
    • Pregnancy
    • Underactive thyroid (hypothyroidism)

Complications of Chronic Constipation:

  • Hemorrhoids:- Having straining while bowel movement may lead to swelling in your veins and around the anus.
  • Anal Fissure:- Hard and Dry Stool may tear the anal line or may create tiny cut in anal skin
  • Fecal Impaction:- It happens when the hardened stool gets stuck in your intestines and not getting expelled.
  • Rectal Prolapse:- Straining too much during bowel movement may cause a small amount of rectum to stretch from the anus

Diagnosis of Chronic Constipation:

A doctor will perform the general physical examination and digital rectal exam. To have detailed pictures and to analyze the actual causes, following tests are undertaken:-

  1. Blood Tests:- Through this, Doctor will look for low thyroid which is also called hypothyroidism.
  2. Sigmoidoscopy:- In this process, Doctor will insert a lighted and flexible tube into the anus to examine the rectum, sigmoid or lower colon.
  3. Colonoscopy: In this method, Doctor will examine the entire colon with the help of the flexible camera-equipped tube.
  4. Anorectal Manometry:- Doctor will insert a narrow but flexible tube into your anus/ rectum and inflates a small balloon at the tip of the tube. The device is then pulled back through the sphincter muscle. This procedure will allow the doctor to examine the anal sphincter muscle function and to measure the coordination of muscles you use to move your bowels.
  5. Balloon Expulsion Test: It is often used along with anorectal manometry to measure the amount of time it takes to push out the balloon filled with water & places in your rectum. It evaluates anal sphincter muscle speed.
  6. Colonic Transit Study:- In this process, you will swallow. A capsule containing radiopaque marker or wireless recording device. The progress of capsule will be recorded over several days and will be visible on X-Rays. It evaluates how well food moves through the colon.
  7. Scintigraphy: This will help the doctor to look for the signs of intestinal muscle dysfunction and how well food moves to your colon. You may eat radiocarbon- activated food and a special camera will record the progress.
  8. Defecography:- Doctor will insert a soft paste made of barium into your rectum. you will pass the barium as you would pass stool. barium shows X-rays and may reveal the problems with muscle functions and rectum coordination.
  9. MRI Defecography:- In this process, contrast gel is used in place of barium paste. MRI scanner will examine and assess the function of defecation muscles. This'll also diagnose the problem causing constipation such as rectocele or rectal prolapse.

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