At one point or another, almost everyone gets constipated. Fortunately, most cases can be resolved with simple changes to diet and exercise. Sometimes, though, constipation can lead to complications.
What is Constipation?
Constipation is a condition in which a person has fewer bowel movements than usual. More specifically, constipation is usually defined as having fewer than three bowel movements per week or having hard, dry and small stools that can be painful or difficult to pass.
Constipation can make people feel bloated and cause abdominal pain. The condition can develop suddenly and last only a short amount of time (acute constipation) or it can last a long time, sometimes for years (chronic constipation).
In any given person, there may be several causes for constipation, including a lack of fiber, not drinking enough fluid, an inactive lifestyle and changes to one's environment. Constipation may also be associated with a more serious condition, such as diabetes, scleroderma (buildup of scar-like tissue in the skin), thyroid disease, multiple sclerosis (MS) or Parkinson's disease.
What are the Complications of Constipation?
In most cases, constipation is acute and not likely to cause serious problems. However, it can still cause complications.
Hemorrhoids
Hemorrhoids are swollen veins in the lower rectum or around the anus. These swollen veins can develop when a person strains to have a bowel movement while constipated. Hemorrhoids may lead to bleeding from the rectum. This rectal bleeding may appear bright red on the stool, on toilet paper or in the towel. Hemorrhoids are typically treated with changes to diet to prevent constipation, warm baths, and special creams or suppositories (medication delivered through the rectum) before bed.
Anal fissures
Anal fissures are small tears in the tissue lining of the anus. These fissures can cause pain, itching and bleeding. Similar to hemorrhoids, anal fissures can be treated with dietary changes to prevent constipation, or with special creams and warm baths.
Rectal prolapse
Rectal prolapse happens when the rectum (the bottom end of colon, right above the anus) becomes stretched out of the anus. As a result, mucus or stool can leak. This issue usually results from straining during bowel movements. In most cases, the only treatment needed for prolapse is eliminating the cause, which might be straining or coughing. If prolapse is severe or continues for a long period of time, surgery may be needed.
Fecal impaction
Fecal impaction happens most often in children and older adults. The conditions occurs when the stool becomes hard and loads the intestine and rectum. The stool becomes so impacted that the colon can't expel the stool. Treatment for impaction usually involves softening the stool with mineral oil taken by mouth or through an enema (through the rectum or colon).
Treatment for Constipation
Treatment options vary depending on the cause, severity and duration of the constipation.
Changes to diet
Fiber-rich food is necessary to normalize and maintain bowel function. Reducing the amount of refined and processed foods, such as processed meats, cheese and ice cream, that you consume each day may also ease constipation. Instead, choose foods with natural fiber. Such foods include vegetables, fruits, beans, cereals and breads. Also drink plenty of water and non-alcoholic liquids.
Exercise and lifestyle changes
Exercise daily. Also, try to have a bowel movement within the same time frame every day. Consider trying 15-45 minutes after breakfast, as eating helps stimulate the colon.
Medication
Ask your pharmacist if your medications can cause constipation. If so, talk to your primary care doctor to see if a change to your medication, or stopping altogether, is right for you.
If diet and lifestyle changes are not enough to ease your constipation, ask your doctor if a laxative medication or enema might work.
Surgery
In severe cases where rectal prolapse causes blockage in the anorectal structure (the structure of anus and rectum), surgery might be needed. Colon muscles can be removed if they no longer work properly.
Biofeedback
This method can be used to retrain the anorectal muscles. It uses certain sensors to project bodily functions onto a video screen where doctors can see if the correct muscles are being used.
