The term constipation may have a different meaning from person to person. The frequency of a bowel movement varies considerably among people, ranging from 1-3 times/day to once in 3 days. Therefore, it is difficult to have a precise definition for constipation that would stand true for all. Thus, constipation is generally described as having fewer than three bowel movements a week. It also means passing stools very infrequently, passing hard stools, or having any kind of difficulty in evacuating the bowel. Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. Typically lasting for more than several weeks, chronic constipation can cause significant pain and discomfort and affect one’s quality of life.

Causes of Constipation

The inner lining of your colon absorbs water from the food passing through your digestive tract. With the required amount absorbed, your colon muscles squeeze rhythmically to expel the residual waste out through the rectum. This residue is stool.

Constipation can be due to

• Poor diet: Adequate dietary fiber and water intake are essential to soften the stool. If your diet lacks these components, stools harden and become difficult to pass.
• Physical inactivity: Physical activity and exercise enable the mobility of your digestive tract. People restricted to a bed or chair or who have a sedentary lifestyle are more prone to developing constipation problems.
• Prescription medicines: Some medications can interfere with your colon’s water absorption, increasing the risk of constipation. These medications include opioid pain relievers, anticonvulsants, diuretics, calcium channel blockers, and antacids containing calcium or aluminum. Overuse of laxatives can also harden stools and cause constipation.
• Underlying medical conditions: If the stool remains in the colon for a long duration, it can harden and turn problematic. Medical conditions such as intestinal obstruction, irritable bowel syndrome, and diverticulosis can restrict bowel movements, causing constipation. Conditions such as stroke and Parkinson’s disease can impact the mobility and muscle coordination of the colon.
• Habitual changes: A change in routine during travel or stress can influence your bowel movements. Also, ignoring the urge to defecate can result in stool drying and hardening. It can put you at risk of faecal impaction.

Symptoms of Constipation

Signs of constipation include:

• Bowel movements are less than three a week
• Passing hard and dry stool
• Having to strain to pass stool
• Painful bowel movements
• Abdominal pain and cramping
• Feeling bloated
• Inability to empty your bowel

How is Constipation Diagnosed?

Often, Constipation corrects itself. If you have a chronic Constipation problem that does not subside with simple remedies, you should consult your doctor. Your doctor will take a detailed medical history, including your diet, lifestyle habits, and bowel movement history. A physical exam includes lab tests and a rectal exam to check for signs of infection, inflammation, or cancer. Depending on the severity and the duration of your symptoms, your doctor will order other tests and procedures.

• Anorectal manometry: In anorectal manometry, the doctor will place and inflate a balloon inside your colon. The test measures the muscle strength of your anal sphincter. It checks the contractility of the sphincter.
• Barium enema X-ray: A barium enema involves inserting liquid dye into your rectum. The barium highlights the inner lining of your colon and rectum on an X-ray. It enables the doctor to detect any abnormalities causing constipation problems.
• Colonoscopy: Your doctor will insert a thin, flexible tube fitted with a camera into your colon. A colonoscopy will allow your doctor to view the area better.