Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.
Constipation is generally described as having fewer than three bowel movements a week.
Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. Chronic constipation may also cause people to strain excessively in order to have a bowel movement.
Treatment for chronic constipation depends in part on the underlying cause. However, in some cases, a cause is never found.
Signs and symptoms of chronic constipation include:
- 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
Constipation may be considered chronic if you’ve experienced two or more of these symptoms for the last three months.
When to see a doctor
Make an appointment with your doctor if you experience unexplained and persistent changes in your bowel habits.
Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract or cannot be eliminated effectively from the rectum, which may cause the stool to become hard and dry. Chronic constipation has many possible causes.
Blockages in the colon or rectum
Blockages in the colon or rectum may slow or stop stool movement. Causes include:
- Tiny tears in the skin around the anus (anal fissure)
- A blockage in the intestines (bowel obstruction)
- Colon cancer
- Narrowing of the colon (bowel stricture)
- Other abdominal cancer that presses on the colon
- Rectal cancer
- Rectum bulge through the back wall of the vagina (rectocele)
Problems with the nerves around the colon and rectum
Neurological problems can affect the nerves that cause muscles in the colon and rectum to contract and move stool through the intestines. Causes include:
- Damage to the nerves that control bodily functions (autonomic neuropathy)
- Multiple sclerosis
- Parkinson’s disease
- Spinal cord injury
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:
- The inability to relax the pelvic muscles to allow for a bowel movement (anismus)
- Pelvic muscles that don’t coordinate relaxation and contraction correctly (dyssynergia)
- Weakened pelvic muscles
Conditions that affect hormones in the body
Hormones help balance fluids in your body. Diseases and conditions that upset the balance of hormones may lead to constipation, including:
- Overactive parathyroid gland (hyperparathyroidism)
- Underactive thyroid (hypothyroidism)
Factors that may increase your risk of chronic constipation include:
- Being an older adult
- Being a woman
- Being dehydrated
- Eating a diet that’s low in fiber
- Getting little or no physical activity
- Taking certain medications, including sedatives, opioid pain medications, some antidepressants or medications to lower blood pressure
- Having a mental health condition such as depression or an eating disorder
Complications of chronic constipation include:
- Swollen veins in your anus (hemorrhoids). Straining to have a bowel movement may cause swelling in the veins in and around your anus.
- Torn skin in your anus (anal fissure). A large or hard stool can cause tiny tears in the anus.
- Stool that can’t be expelled (fecal impaction). Chronic constipation may cause an accumulation of hardened stool that gets stuck in your intestines.
- Intestine that protrudes from the anus (rectal prolapse). Straining to have a bowel movement can cause a small amount of the rectum to stretch and protrude from the anus.
The following can help you avoid developing chronic constipation.
- Include plenty of high-fiber foods in your diet, including beans, vegetables, fruits, whole grain cereals and bran.
- Eat fewer foods with low amounts of fiber such as processed foods, and dairy and meat products.
- Drink plenty of fluids.
- Stay as active as possible and try to get regular exercise.
- Try to manage stress.
- Don’t ignore the urge to pass stool.
- Try to create a regular schedule for bowel movements, especially after a meal.
- Make sure children who begin to eat solid foods get plenty of fiber in their diets.
Home remedies for constipation
There are many natural ways to help relieve constipation. People can do these in the comfort of their own homes, and most of them are supported by science.
Here are 13 natural home remedies to relieve constipation.
You might not feel like taking a trip to the gym when you’re backed up, but exercise may provide the relief you need. Going for a walk or run, for example, can help stimulate the muscles in your intestines and colon. Any physical movement helps the bowels move things through.
To help prevent and relieve constipation, make exercise a regular part of your routine. Aim for at least 150 minutes of moderate aerobic activity per week. That’s equivalent to 30 minutes of aerobic exercise per day, five days a week. If that seems like too much for you, set a smaller goal to start. Try to get some physical activity every day to stay regular.
2. Drink more water
Being dehydrated regularly can make a person constipated. To prevent this, it is important to drink enough water and stay hydrated .
When a person is constipated, they might find relief from drinking some carbonated (sparkling) water. This can help them rehydrate and get things moving again.
Some studies have found sparkling water to be more effective than tap water at relieving constipation. This includes in people with indigestion, or dyspepsia, and people with chronic idiopathic constipation .
However, drinking carbonated drinks such as sugary soda is not a good idea, as these beverages can have harmful health effects and may make constipation worse .
Some people with irritable bowel syndrome (IBS) find that carbonated drinks worsen their symptoms, so these individuals may wish to avoid sparkling water and other carbonated drinks.
Bottom line: Dehydration can cause constipation, so be sure to drink enough water. Sparkling water may be even more effective at relieving constipation.
3. Eat enough dietary fiber
Getting enough fiber in your diet is crucial. There are two main types of fiber: soluble fiber soaks up water, which helps keep your stool soft; insoluble fiber adds bulk to your stool, which helps it move through your digestive system faster.
To help treat mild cases of constipation, try eating easy-to-digest foods that are high in fiber, such as berries, bananas, prunes, or avocado. To prevent future problems, include plenty of fiber-rich foods in your diet, including vegetables, fruits, and whole grains. You may also benefit from a daily fiber supplement, such as psyllium husk (Metamucil).
5. Consider taking magnesium supplements
Getting enough magnesium in your diet might also help relieve constipation. Oral magnesium supplements function as osmotic laxatives. That means they pull water into your digestive system, which helps soften your stool.
You can purchase magnesium capsules at health food stores and pharmacies. You can also get magnesium from food sources. Talk to your doctor before talking magnesium if you have a history of kidney problems. Conveniently, most foods that are high in magnesium are also high in fiber. For example, whole grains and dark leafy greens are good sources of both.
6. Reach for coconut oil
According to Dr. Arielle Miller Levitan, an Illinois-based internal medicine specialist, eating a tablespoon or two of coconut oil each day might help lubricate your intestines. In turn, this may help prevent constipation. Ask your doctor if this remedy might work for you.
If the idea of swallowing a spoonful of coconut oil doesn’t appeal to you, there are other ways to add it to your diet. For example, you could mix it into your morning coffee or blend it with vinegar for a simple salad dressing.
7. Eat prunes
People often tout prunes and prune juice as nature’s remedy for constipation — and for good reason. Prunes may be the most accessible natural solution available.
In addition to fiber, prunes contain sorbitol. This is a sugar alcohol that has a laxative effect .
Some studies have shown that prunes may be more effective than fibers such as psyllium .
The effective dosage may be around 50 g, or seven medium prunes, twice per day .
However, people with IBS may want to avoid prunes, because sugar alcohols are high FODMAP foods.