Chronic Constipation: Causes, Symptoms, and Solutions

Constipation has persisted for one year?

One year ago, I had no such issues and had a habit of having a bowel movement after dinner.
Until one time, I only ate one meal a day for three consecutive days.
After waking up in the morning and spending the night on the computer, I became very anxious and couldn't have a bowel movement.
At that time, I seemed to forcefully try to push out a stool, and since then, I have developed a habit of constipation.
Later, I went to see a doctor, who said I might just not be drinking enough water or eating enough vegetables.
After listening to my bowel sounds, he noted that they were normal since I hadn't eaten breakfast.
He prescribed a mild laxative and advised me to drink more water.
However, until now, there has been no improvement.
I feel like my intestines are different from before; they seem narrower.
I also feel like I have hemorrhoids (a sensation I've had for a long time).
In the past, when my stools were too hard, I would experience pain in my anus, and there would be blood when wiping.
Previously, when I had diarrhea, it felt very quick, like a flood.
But recently, when I have diarrhea, it feels like it is passing through a very narrow passage, like a trickle.
Do I have obsessive-compulsive tendencies regarding my bowel movements? Should I get my rectum checked? Also, after having a bowel movement, I feel like my anus is very tight.
Additionally, I would like to ask about the correct method for cleaning the anus.
I usually insert my finger slightly while wiping, then use body wash to apply to the anus, and I also habitually insert a bit inside before rinsing with water, which slightly opens the anus.
I am unsure if this is the correct method.

patrick, 20~29 year old female. Ask Date: 2010/06/23

Dr. Chen Qifeng reply Gastroenterology and Hepatology

Hello, please visit the Gastroenterology or Colorectal Surgery department for further examination of the colon.
If there are no structural issues, it may be a functional problem.
If it is a functional disorder, then it would only require dietary adjustments and the use of intestinal medications.
Wishing you good health.
Dr.
Chen Chi-Feng, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2010/06/23

More Info

Chronic constipation is a common gastrointestinal issue that can significantly impact an individual's quality of life. Understanding its causes, symptoms, and potential solutions is essential for effective management.

Causes of Chronic Constipation
Chronic constipation can arise from various factors, including:
1. Dietary Habits: A diet low in fiber, which is found in fruits, vegetables, and whole grains, can lead to hard stools and difficulty in bowel movements. Insufficient fluid intake can also exacerbate this condition.

2. Lifestyle Factors: Sedentary lifestyles, lack of physical activity, and irregular eating habits can contribute to constipation. Stress and anxiety can also affect bowel function.

3. Medications: Certain medications, including pain relievers (especially opioids), antacids containing aluminum, and some antidepressants, can lead to constipation as a side effect.

4. Medical Conditions: Conditions such as hypothyroidism, diabetes, irritable bowel syndrome (IBS), and neurological disorders can affect bowel motility and lead to constipation.

5. Pelvic Floor Dysfunction: Issues with the muscles involved in bowel movements can result in difficulty passing stools. This can be due to a lack of coordination or weakness in the pelvic floor muscles.

Symptoms of Chronic Constipation
Symptoms may vary from person to person but commonly include:
- Infrequent bowel movements (fewer than three times a week)
- Difficulty passing stools or straining during bowel movements
- Hard or lumpy stools
- A sensation of incomplete evacuation after a bowel movement
- Abdominal discomfort or bloating
- Rectal bleeding or pain, which may indicate the presence of hemorrhoids or anal fissures

Solutions and Management Strategies
1. Dietary Changes: Increasing fiber intake is crucial. Aim for at least 25-30 grams of fiber daily through fruits, vegetables, whole grains, and legumes. Additionally, ensure adequate hydration by drinking plenty of water throughout the day.

2. Regular Physical Activity: Engaging in regular exercise can help stimulate bowel function. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Establishing a Routine: Try to set a regular time each day for bowel movements, ideally after meals when the digestive system is most active. This can help train your body to have more regular bowel movements.

4. Over-the-Counter Remedies: If dietary changes and lifestyle modifications are insufficient, over-the-counter laxatives may be helpful. However, these should be used sparingly and under the guidance of a healthcare provider to avoid dependency.

5. Medical Evaluation: If symptoms persist despite lifestyle changes, it may be necessary to consult a gastroenterologist. They can perform tests to evaluate for underlying conditions, such as structural abnormalities or motility disorders.

6. Pelvic Floor Therapy: If pelvic floor dysfunction is suspected, working with a physical therapist specializing in pelvic health can be beneficial. They can provide exercises and techniques to improve muscle coordination and strength.

Addressing Concerns About Anal Health
Regarding your concerns about hemorrhoids and anal health, it is essential to maintain proper hygiene without causing irritation. Here are some tips:
- Gentle Cleaning: After a bowel movement, clean the anal area gently with water. Avoid using harsh soaps or excessive scrubbing, which can irritate the skin.

- Avoid Inserting Objects: Avoid inserting fingers or objects into the rectum for cleaning, as this can lead to injury or infection.

- Use Moist Wipes: Consider using unscented moist wipes designed for sensitive skin if toilet paper causes irritation.

- Warm Baths: Soaking in a warm bath can help soothe discomfort and promote relaxation of the anal area.

Conclusion
Chronic constipation can be a challenging condition, but with appropriate dietary changes, lifestyle modifications, and medical support, it can often be managed effectively. If you continue to experience symptoms or have concerns about your anal health, seeking a thorough evaluation from a healthcare professional is advisable. They can provide personalized recommendations and ensure that any underlying issues are addressed.

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