Chronic Constipation: Causes, Treatments, and When to Seek Help

Constipation

Hello, I am 16 years old and have been suffering from constipation for about 5 to 6 years since I can remember.
Initially, I didn't pay much attention to it, but over the past year, I started traditional Chinese medicine treatment.
It worked for the first one to two months, but the dosage kept increasing, and eventually, it stopped being effective.
I have tried 3 to 4 different medications and have also started drinking 2000 cc of water, eating a large plate of boiled vegetables, sweet potatoes, and fruits.
I haven't even been passing gas.
It feels like my intestines are inactive.
My body seems to have slight swelling, and about every 8 to 9 days, I experience severe abdominal cramps before having a bowel movement.
I go to the bathroom 6 to 7 times a day, and it's really uncomfortable.
Is my situation just simple constipation? What treatments should I consider? How long would the treatment last? Which department should I visit at the hospital? Thank you for your response; I really appreciate it.

wu wu, 10~19 year old female. Ask Date: 2004/03/18

Dr. Chen Qingbin reply Internal Medicine

Your condition does not seem to be a simple case of constipation; it is best to visit a hospital and consult a gastroenterologist for examination and treatment.

Reply Date: 2004/03/18

More Info

Chronic constipation is a common issue that can significantly impact one's quality of life, especially for a young individual like yourself. Understanding the causes, treatments, and when to seek help is crucial for managing this condition effectively.

Causes of Chronic Constipation
Chronic constipation can arise from various factors, including:
1. Dietary Habits: A diet low in fiber can lead to constipation. While you mentioned consuming vegetables, fruits, and whole grains, it's essential to ensure you're getting enough fiber daily (around 25-30 grams for adolescents).

2. Fluid Intake: Adequate hydration is vital for digestive health. You mentioned drinking 2000cc of water, which is generally good, but individual needs can vary.

3. Physical Activity: A sedentary lifestyle can contribute to constipation. Regular exercise helps stimulate bowel movements.

4. Medications: Some medications, including certain pain relievers, antidepressants, and iron supplements, can cause constipation as a side effect.

5. Psychological Factors: Stress, anxiety, and depression can also affect bowel habits.

6. Underlying Health Conditions: Conditions such as hypothyroidism, diabetes, or gastrointestinal disorders (like irritable bowel syndrome) can lead to chronic constipation.

Treatments for Chronic Constipation
Given your experience with traditional Chinese medicine and dietary changes, here are some additional treatment options you might consider:
1. Over-the-Counter Laxatives: If dietary changes and hydration are not effective, you may need to try over-the-counter laxatives. Options include osmotic laxatives (like polyethylene glycol) and stimulant laxatives (like bisacodyl). However, these should be used under the guidance of a healthcare provider to avoid dependency.

2. Prescription Medications: If over-the-counter options are ineffective, a doctor may prescribe medications specifically designed for chronic constipation, such as lubiprostone or linaclotide.

3. Behavioral Modifications: Establishing a regular bowel routine can help. This includes setting aside time each day to sit on the toilet, even if you don’t feel the urge to go.

4. Biofeedback Therapy: If there are issues with how your body coordinates the muscles involved in bowel movements, biofeedback therapy can help retrain these muscles.

5. Dietary Adjustments: Continue to focus on a high-fiber diet, but also consider keeping a food diary to identify any potential food intolerances or triggers.

When to Seek Help
It's essential to seek medical attention if:
- You experience severe abdominal pain or bloating.

- You notice blood in your stool or have a change in bowel habits that lasts more than a few weeks.

- You have unexplained weight loss.

- You experience persistent nausea or vomiting.

Which Specialist to See
For chronic constipation, you should consider visiting a gastroenterologist. This specialist focuses on digestive system disorders and can provide a comprehensive evaluation and treatment plan tailored to your needs.

Conclusion
Chronic constipation can be a complex issue, and it’s commendable that you are seeking help. Given your symptoms, including abdominal pain and infrequent bowel movements, it’s crucial to consult a healthcare professional who can provide a thorough assessment and appropriate treatment options. Remember, managing chronic constipation often requires a multifaceted approach, including dietary changes, lifestyle modifications, and possibly medication. Don't hesitate to reach out for help; you deserve to feel comfortable and healthy.

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