Constipation is a decrease in the frequency of bowel movements or facing difficulty in or pain in passing stool. In most cases, it occurs due to the excess absorption of water from the food by the colon. The slower the food moves through the digestive tract more water the colon absorbs from it. The stool that forms is hard and dry. This makes emptying of the bowel more painful.
Different Types of Constipation & Their Causes and Treatments
The types of constipation are as follows:
- Primary or functional constipation
- Secondary constipation
- Iatrogenic constipation
- Traveler’s constipation
It is important to understand the different types of constipation as knowing about the underlying cause can be helpful in treating it effectively. Identifying the cause can guide how it can be treated. Different types of constipation respond differently to treatments. Knowing the types helps in tailoring the treatment according to the type. While learning about the type, individuals who are at risk of hemorrhoids, fissures, and fecal impaction (complications of constipation) can be identified and can be treated accordingly.
Primary constipation is a type of constipation with no underlying cause or medical condition. It is also sometimes referred to as functional or idiopathic constipation.(1)
Primary constipation is of several types:
- Slow-Transit Constipation: This occurs when there is a delay in the movement of the stool through the colon. It occurs as people do not experience normal bowel stimulation called peristalsis. The food, therefore, takes longer than usual to move through the colon. It causes infrequent bowel movements or difficulty in passing stool. It is mostly seen affecting females in their middle age.(2)
- Pelvic Floor Dysfunction Constipation: This type of constipation occurs when the pelvic floor muscles which have the role of controlling the bowel movement do not work properly. This can make it difficult to pass stool. It can also occur due to damage to the pelvic muscles.
Damage to the pelvic floor muscle can occur due to several reasons such as in giving birth to a child.
The symptoms presented by a person with pelvic floor dysfunction constipation include:
- Straining to empty bowel
- Needing hands to assist bowel movement
- Delaying bowel movement due to pain
- Normal-Transit Constipation: In this type, the stool passes through the colon at a normal rate but the person may still experience difficulty in passing stool. The person may experience abdominal pain and bloating. Normal transit constipation is mostly due to low fiber intake, a sedentary lifestyle and dehydration.
Primary constipation can be identified through medical evaluation that includes taking the complete medical history of a person, performing a physical examination, and carrying out diagnostic tests such as colonoscopy and transit study.
The treatment for primary constipation may include the following:
- Increasing fiber and fluid intake
- Regulating bowel habits
- Therapies depending on the specific type of constipation
Secondary constipation is a type of constipation that occurs due to an underlying cause. It can be due to a medical condition, medication, or other reasons.
The causes of secondary constipation include:
- Medications: Certain medications including opioids, pain medications, calcium channel blockers, and anticholinergic drugs can have constipation as a side effect.
- Neurological Conditions: A few conditions affecting the nervous system such as Parkinson’s disease or multiple sclerosis may affect the normal functioning of the muscle involved in bowel movement.
- Hormonal Imbalance: Changes in the hormone levels seen during a few conditions such as endocrine disorders including hypothyroidism may cause constipation. Diabetes may also lead to constipation.
- Anatomical Abnormalities: Abnormalities in the structure of the colon such as the occurrence of stricture or tumor may obstruct the normal flow of stool thereby causing difficult stool as it is thought to cause damage to the enteric nerves altering the intestinal muscle contractility and function.
- Irritable Bowel Syndrome: Irritable bowel syndrome is a common bowel condition that is characterized by pain in the abdomen and changes in bowel habits including diarrhea and constipation.
- Inflammatory Bowel Disease: Inflammatory bowel disease includes Crohn’s disease and ulcerative colitis that may lead to inflammation of the digestive tract causing constipation and other digestive symptoms.
- Lifestyle Disorders: These include dietary choices in an individual, lack of exercise, and inadequate fluid intake that may contribute to constipation.
Treating secondary constipation involves treating the underlying cause. Addressing underlying causes and altering the medication may help alleviate constipation in many. Some may need laxatives, fiber supplements, and enemas to manage the symptoms of constipation.
It is important to go through a medical evaluation to diagnose the cause and treat it.
Iatrogenic constipation is a type of constipation that occurs due to medication or medical procedures.
- Medications: The medications can cause constipation as a side effect. These include opioids, anticholinergic medication, and iron supplements.
- Medical Procedure: Procedures involving anesthesia or surgery can lead to constipation.
Iatrogenic constipation can be managed by various means. The patients are advised to drink plenty of water, eat high-fiber foods, and do regular physical activity. The doctors also adjust the medication dosage or switch to alternative options that are less likely to cause constipation. In severe cases, laxatives or bowel-stimulating medications are given to manage symptoms.
Traveler constipation or travel-induced constipation occurs when people travel. It occurs due to changes in the routine, dietary habits, and physical activity while traveling.
The several causes of traveler constipation include:
- Dehydration if the water intake decreases while traveling
- Changes in dietary habit
- Lack of physical activity
- Stress and anxiety due to stress
Some people avoid using public restrooms which may also contribute to constipation.
To prevent traveler’s constipation, it is important to drink plenty of fluids to maintain hydration and eat a high-fiber diet including fruits, vegetables, and whole grains that may promote regular bowel movement. It is also important to exercise regularly or be physically active anyways to keep the bowel moving. Taking restroom breaks while traveling can also be helpful. If all these measures do not help then medications are given to alleviate symptoms.
Importance of Seeking Medical Advice for Chronic and Severe Constipation
Seeking medical advice is important for chronic and severe constipation, due to the following reasons:
- Chronic and severe constipation can have several causes ranging from dietary and lifestyle factors to more serious medical conditions. Seeking medical advice can be helpful in easing the condition and getting an accurate diagnosis.
- There are several complications that can result from chronic constipation including fecal impaction, rectal prolapse, and hemorrhoids. Seeking medical advice can help in preventing these complications.
- The quality of life is affected due to chronic constipation. Early medical advice can help in identifying the cause and treating it at the earliest, thereby, improving the quality of life.
Early medical advice can help prevent complications, detect any serious condition, provide personalized treatment, and improve the quality of life. If constipation persists and causes concerning symptoms, a healthcare professional should be consulted.
Constipation is not having regular bowel movements or having painful or difficult bowels.
Primary constipation occurs due to functional problems in the colon or rectum. It can be acute or long-term. It can be treated by keeping the body hydrated, eating fiber-rich foods, and increasing physical activity.
Secondary constipation occurs due to the underlying cause and can be treated by treating the cause.
Iatrogenic constipation occurs due to the use of certain medications or a medical procedure. It can be managed by adjusting the dosage of the medicine, giving an alternative, or with the help of laxatives.
Traveler’s constipation occurs while traveling. It can occur due to various factors including changes in diet, routine, and daily physical activity. Introducing high-fiber foods and increasing hydration can be helpful in managing constipation while traveling. Laxatives can also be used to manage the symptoms.
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