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Chronic Constipation: Facts vs. Myths

Learn how to relieve chronic constipation.
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Chronic Constipation: More Prevalent Today? continued...

Rao says that constipation is not about frequency (or infrequency) of bowel movements, but rather chronic constipation is a "symptom complex." Rao explains the symptoms of chronic constipation as follows:

  1. Excessive straining
  2. Hard stools
  3. Feeling of incomplete evacuation
  4. Use of digital evacuation such as support of the pelvic floor
  5. A sensation that you cannot go or will not be able to go (because of obstruction)
  6. A decrease in frequency

Chronic constipation may be associated with normal or slow stool transit time, functional defecation disorder (dyssynergic defecation) or a combination of both. With slow-transit constipation, there is a prolonged delay in the transit of stool through the colon. Dyssynergic or outlet obstruction (also called pelvic floor dyssynergia) is characterized by either difficulty or inability to expel the stool. With pelvic floor dysfunction (dyssynergic defecation), the muscles of the lower pelvis that surround the rectum (the pelvic floor muscles) do not work normally. A third type of constipation occurs with irritable bowel syndrome (IBS) where constipation alternates with bouts of diarrhea.

Chronic Constipation: Why Are Baby Boomers at Risk?

If you're a baby boomer born between 1946 and 1964, you may wonder if chronic constipation tends to increase with age. McIlwain tells WebMD that there are several different causes that trigger constipation in aging adults.

"As adults age, we tend to become more sedentary, eat and drink less, and take in much less fiber in our daily diet," says McIlwain, "all of which are habits that aggravate chronic constipation."

Then, according to McIlwain, more problems occur when you are constipated and start depending on laxatives. "Within days, this laxative habit can aggravate the cycle of chronic constipation and the need to take another laxative and then another."

Not only do lifestyle habits put boomers at risk for chronic constipation, but McIlwain says that many over-the-counter and prescription medications commonly taken to treat arthritis, back pain, hypertension, allergies, and even depression can result in chronic constipation.

"When older adults are treated with multiple medications for health problems, chronic constipation can be the result," says McIlwain. "The most common medications that aggravate constipation are narcotic analgesics like codeine and Tylenol (Tylenol #3), oxycodone (Oxycontin), proposyphene and acetaminophen (Darvocet), and hydromophone (Dilaudid), which are sometimes used for severe pain of osteoarthritis, inflammatory arthritis, disc disease, and other problems. Because these stronger pain medications are known to cause chronic constipation, many physicians go ahead and treat the constipation at the same time the pain medications are prescribed -- before chronic constipation develops and becomes severe and unmanageable."

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