Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing it to become hard and dry. Chronic constipation has many causes:
Blockages in the colon or rectum
Blockages in the colon or rectum may slow or stop stool movement. Causes include:
- Anal fissure
- Bowel obstruction
- Colon Cancer
- Narrowing of the colon (bowel stricture)
- Other abdominal cancer that presses on the colon
- Rectal cancer
Problems with the nerves around the colon and rectum
Neurological problems can affect the nerves that cause muscles in the colon and rectum to contract and move stool through the intestines. Causes include:
- Autonomic neuropathy
- Multiple sclerosis
- Parkinson’s disease
- Spinal cord injury
Difficulty with the muscles involved in elimination
Problems with the pelvic muscles involved in having a bowel movement may cause chronic constipation. These problems may include::
- Inability to relax the pelvic muscles to allow for a bowel movement (anismus)
- Pelvic muscles don’t coordinate relaxation and contraction correctly (dyssynergia)
- Weakend pelvic muscles
Conditions that affect hormones in the body
Hormones help balance fluids in your body. Diseases and conditions that upset the balance of hormones may lead to constipation, including:
- Overactive parathyriod gland (hyperparathyroidism)
- Underactive thyroid (hypothyroidism)
Treatments and Drugs
Treatment for chronic constipation usually begins with diet and lifestyle changes meant to increase the speed at which stool moves through your intestines. If those changes don’t help, your doctor may recommend medications or surgery.
Diet and lifestyle changes
Your doctor may recommend the following changes to relieve your constipation:
- Increase your fiber intake. Adding fiber to your diet increases the weight of your stool and speeds its passage through your intestines. Slowly begin to eat more fresh fruits and vegetables each day. Choose whole-grain breads and cereals. Your doctor may recommend a specific number of grams of fiber to consume each day. In general, aim for 14 grams of fiber for every 1,000 calories in your daily diet. A sudden increase in the amount of fiber you eat can cause bloating and gas, so start slowly and work your way up to your goal over a few weeks.
- Exercise most days of the week. Physical activity increases muscle activity in your intestines. Try to fit in exercise most days of the week.
- Don’t ignore the urge to have a bowel movement. Take your time in the bathroom, allowing yourself enough time to have a bowel movement without distractions and without feeling rushed.
- Fiber supplements. Fiber supplements add bulk to your stool. Common ingredients include methylcellulose, psyllium, calcium polycarbophil and guar gum. Brand names include FiberCon, Metamucil, Konsyl and Citrucel.