Understanding Causes of Chronic Constipation

Factors Contributing to Constipation

Chronic constipation varies among individuals. Some experience infrequent bowel movements, others struggle with straining, while some feel there are still stool remnants needing evacuation. Classic criteria define it as fewer than three bowel movements weekly. Often, symptoms overlap. Medical professionals describe it as a combination of:

• Excessive straining
• Incomplete evacuation sensations
• Hard stools
• Difficulty passing stool
• Reduced frequency needing pelvic support or digital assistance

Key Causes of Chronic Constipation

Water is vital for multiple body functions, aiding waste elimination via lungs, kidneys, skin, and digestive system. Inadequate hydration can lead to constipation. Likewise, diets low in fiber slow stool transit. The gut relies on peristalsis—rhythmic contractions—to propel contents. Nervous system issues, such as nerve degeneration from diabetes, multiple sclerosis, Parkinson’s disease, or spinal injuries, can impair stool movement. Weak pelvic muscles and conditions like hypothyroidism, diabetes, or hyperparathyroidism also contribute. Medications, obstructions like tumors, strictures, or conditions such as hemorrhoids or fissures further cause chronic constipation.

Diagnosis involves thorough history-taking, physical and digital rectal exams, blood tests for systemic issues, and endoscopic evaluations like sigmoidoscopy or colonoscopy. Specialized tests, including anorectal manometry, balloon expulsion, colonic transit studies, and imaging techniques like defecography or MRI, assess muscle coordination, sphincter function, and transit time. Identifying underlying causes allows targeted treatment; sometimes, no specific reason is found. Lifestyle modifications—adequate water, high-fiber foods, regular bowel habits, reducing processed foods, increasing activity, and medication review—can help. Persistent symptoms should prompt medical consultation to exclude serious conditions.