Definition of Constipation


Constipation is not a disease but a symptom of many diseases. It is basically described as less frequent bowel movements that result in hard, dry stools with painful defecation. When a person defecates less than three times a week and this condition persists for several weeks, it is termed as Constipation. Occasional Constipation is very common. Chronic Constipation is usually due to some serious underlying cause and requires the treatment of that cause. Person may feel straining on the abdomen and unable to perform the daily work comfortably in case of Chronic Constipation.

Cause of Constipation

Colon plays role in absorbing the water and salts from the digested food propelling it towards the rectum as a waste material. If waste material stays too long in the colon, it becomes hard and dry and there is difficulty in its passage to the rectum. Following are the causes which affects the passage and digestive tract in Constipation :

Blockade of colon and rectum : If there is any block in the passage, waste material cannot be propelled forward. Common causes include:

  • Anal fissure
  • Obstruction in bowel
  • Colon cancer
  • Bowel stricture
  • Rectal cancer
  • Rectocele
  • Any abdominal mass that presses the bowel

Involvement of nervous system around colon and rectum : If the nerves acting upon the muscles of the colon and rectum are damaged, Chronic Constipation occurs. Causes include :

  • Stroke
  • Spinal cord injury
  • Parkinson’s disease
  • Autonomic neuropathy
  • Multiple sclerosis

Role of muscles involved in defecation : Pelvic muscles are involved in the bowel movement. If they are affected by any cause, Chronic Constipation occurs. Causes include :

  • Progressive weakness of pelvic muscles
  • Inability to relax the pelvic muscles during defecation to allow the bowel movement. It is termed as Anismus.
  • If there is no coordination between relaxation and contraction of pelvic muscles. It is termed as Dyssynergia.

Hormones affecting digestive tract : Balance of fluids depends upon the secretion of hormones. The main causes of imbalances in hormones are :

  • Overactivity of parathyroid gland
  • Underactivity of thyroid gland
  • Pregnancy
  • Diabetes

Some other causes :

  • Dehydration
  • Low fiber diet
  • Lack of exercise
  • Side effects of various medicines
  • Travelling or change in routine


Signs and Symptoms of Constipation


  • Passing less than three stools in a whole week
  • Passing lumpy, hard, dry stools
  • Feeling that you cannot empty the rectum completely
  • Pressing your abdomen with hands during defecation
  • Straining or pain during bowel movements
  • Feeling there is a blockade in the rectum


Risk Factors for Constipation

Factors which increase the risk of Constipation includes :

  • Old age
  • People confined to bed as in trauma, stroke or spinal cord injury
  • Dehydration
  • Taking sedatives, narcotics or medicines to lower blood pressure
  • Low fiber diet
  • Little or no physical activity

Diagnosis of Constipaiton


Tests and procedures used to diagnose Constipation include :

  • Marker study or colorectal study in which there is examination of how your food passes through colon or rectum which are shown on X Ray
  • Anorectal manometry in which there is examination of anal sphincter muscle function
  • Examination of colon with the help of a barium enema Xray
  • Examination of the colon with colonoscopy


Prevention from Constipation

Constipation is prevented with intake of plenty of water, diet rich in fibers, daily walk and exercise. Also do not ignore the urge of defecation.


Treatment of Constipation

Treatment plan includes the following methods :

  • Change in lifestyle and dietary habits
  • Use of laxatives
  • Training of pelvic muscles
  • Surgery, if there is any obstruction or stricture in the colon or rectum