Chronic Constipation: Causes and Solutions for Relief

Inability to have regular bowel movements for an extended period?

I have not had normal bowel movements since I was in sixth grade; it takes me two to three weeks to have a bowel movement.
When I feel the urge to defecate, I experience abdominal pain for about half an hour before I can go.
Initially, my stools are solid, but they eventually become watery.
I spend a long time in the bathroom, and although I don't eat the most vegetables and water, I definitely consume a significant amount.
Therefore, I don't think it's an issue with my vegetable and water intake.
I have seen a doctor who used a stethoscope and said my bowel motility is normal, but the medications prescribed were all laxatives, and no explanation was given regarding my condition.
I would like to know what the problem might be and what I should do.
Thank you!

Wu, 10~19 year old female. Ask Date: 2015/12/21

Dr. Cai Jinji reply Gastroenterology and Hepatology

It is recommended to visit the hospital for a stool examination, and if necessary, a colonoscopy may be arranged to rule out any gynecological issues.

Reply Date: 2015/12/21

More Info

Chronic constipation is a common gastrointestinal issue that can significantly impact a person's quality of life. It is characterized by infrequent bowel movements, difficulty passing stools, and often associated discomfort. Your experience of having bowel movements only every two to three weeks, accompanied by abdominal pain and changes in stool consistency, suggests a more complex underlying issue that warrants further exploration.

Causes of Chronic Constipation
1. Dietary Factors: While you mentioned that you consume a reasonable amount of water and vegetables, it’s essential to consider the overall balance of your diet. A diet low in fiber can lead to constipation. Fiber is crucial for adding bulk to the stool and promoting regular bowel movements. Foods high in fiber include whole grains, fruits, vegetables, and legumes.

2. Physical Activity: A sedentary lifestyle can contribute to constipation. Regular physical activity helps stimulate intestinal function and can promote more regular bowel movements.

3. Medications: Certain medications can cause constipation as a side effect. These include some pain medications, antidepressants, and medications for high blood pressure. If you are taking any medications, it’s worth discussing with your healthcare provider.

4. Underlying Medical Conditions: Conditions such as hypothyroidism, diabetes, irritable bowel syndrome (IBS), and neurological disorders can affect bowel function. Even if your doctor has indicated that your bowel sounds are normal, it may be beneficial to explore these possibilities further.

5. Psychological Factors: Stress, anxiety, and depression can also play a role in bowel habits. The gut-brain connection is well-documented, and emotional well-being can significantly impact gastrointestinal function.

Solutions for Relief
1. Dietary Adjustments: Increasing your fiber intake gradually can help. Aim for a mix of soluble and insoluble fiber. Soluble fiber (found in oats, beans, and fruits) helps to soften the stool, while insoluble fiber (found in whole grains and vegetables) adds bulk. Additionally, consider keeping a food diary to identify any potential triggers or patterns related to your diet.

2. Hydration: Ensure you are drinking enough fluids, as dehydration can exacerbate constipation. While you mentioned you drink water, consider increasing your intake further, especially if you increase your fiber consumption.

3. Regular Exercise: Incorporating regular physical activity into your routine can help stimulate bowel movements. Aim for at least 30 minutes of moderate exercise most days of the week.

4. Establish a Routine: Try to set aside time each day for bowel movements, especially after meals when the gastrocolic reflex is strongest. Creating a routine can help train your body to have more regular bowel movements.

5. Medications: While laxatives can provide temporary relief, they should not be relied upon long-term without medical supervision. Discuss with your healthcare provider about other options, such as fiber supplements or medications that promote bowel motility.

6. Consult a Specialist: If your symptoms persist despite making these changes, consider seeking a gastroenterologist's opinion. They can perform further evaluations, such as imaging studies or motility tests, to determine if there is an underlying condition that needs to be addressed.

7. Mindfulness and Stress Management: If you suspect that stress or anxiety may be contributing to your constipation, consider techniques such as mindfulness, yoga, or therapy to help manage these feelings.

Conclusion
Chronic constipation can be a complex issue with multiple contributing factors. It’s essential to take a comprehensive approach that includes dietary changes, physical activity, and possibly medical intervention. If you continue to experience difficulties, don’t hesitate to seek further medical advice to explore potential underlying conditions. Remember, you are not alone in this, and with the right strategies, relief is possible.

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