Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several days, weeks or longer.

Types of Constipation:

Primary Constipation

  • Slow-transit constipation. In this type of constipation, motility (gut movement) is decreased causing bloating, abdominal pain and hard stool
  • Outlet constipation. In this type of constipation, discoordination of the musculature of the pelvic floor results in either inappropriate anal contraction.
  • Normal-transit constipation. In this type of constipation you may have daily bowel movements but show the following symptoms: hard stools and abdominal bloating and discomfort

Secondary constipation

  • Secondary constipation can be caused by metabolic disturbances like hypothyroidism; neurological problems like Parkinson’s disease, multiple sclerosis, and spinal cord injuries; celiac disease; and diseases of the large intestine such as colon cancer

Signs and symptoms of chronic constipation:

  • Passing fewer than three stools a week
  • Having lumpy or hard stools
  • Straining to have bowel movements
  • Feeling as though there’s a blockage in your rectum that prevents bowel movements
  • Feeling as though you can’t completely empty the stool from your rectum
  • Needing help to empty your rectum, such as using your hands to press on your abdomen and using a finger to remove stool from your rectum or splinting
  • Increased bloating and gas formation

Difficulty with the muscles involved in elimination

Problems with the pelvic muscles involved in having a bowel movement may cause chronic constipation. These problems may include:

  • Inability to relax the pelvic muscles to allow for a bowel movement (anismus)
  • Pelvic muscles don’t coordinate relaxation and contraction correctly (dyssynergia)
  • Weakened pelvic muscles
  • Pudendal nerve involvement causing muscles to act inappropriately

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Reference:Mayo Clinic, Life Ext, Medline