When you’re constipated, your body isn’t able to get rid of waste like it needs to. Having it every once in a while is common, but if you’re dealing with symptoms for more than 3 months, your constipation is chronic. And that raises your chance of having complications.
The problems most often happen in the places where stool leaves your body.
Hemorrhoids
When you’re constipated, you’re more likely to push hard to try to go. That can make the veins around your rectum and anus swell. These swollen veins are called hemorrhoids, or piles. They’re like varicose veins around your anus. They can be external, which means they’re under the skin around the anus, or internal, which means they’re in the lining of your anus or rectum.
Hemorrhoids can itch and be painful. They can cause bleeding when you have a bowel movement. You may see streaks of blood on your toilet paper when you wipe. Sometimes blood can pool inside a hemorrhoid, which can cause a painful, hard lump. You may also get skin tags, blood clots, or infections from your hemorrhoids.
Anal Fissures
Passing hard stools or straining to pass stools can tear the tissue around your anus. These tears are anal fissures. They cause itching, pain, and bleeding. Because the symptoms of anal fissures make going to the bathroom more difficult, they can make constipation worse. This happens often in children who hold in their stool out of fear of the pain.
The tears are usually very small. But sometimes they can grow larger and affect the ring of muscle at the opening of your anus that keeps it closed. This kind of anal fissure is harder to heal. You may need medication or surgery to fix the problem. Once you’ve had an anal fissure, you’re more likely to get another one.
Impaction
When you can’t get stool out of your body, it can start to stick together in your intestines. The hardened mass gets stuck and causes a blockage. The squeezing your colon normally uses to push stool out of your body can’t move it because it’s too large and hard.
It can cause pain and vomiting. You may even have to go to the emergency room for treatment. Children and older adults are more likely to have fecal impaction.
Rectal Prolapse
Your rectum, the final part of your large intestine, ends at your anus. When you’re constantly straining to pass stools, it can stretch and slip outside your body. Sometimes just part of the rectum comes out, but sometimes the whole thing does.
It can be painful and may cause bleeding. It can sometimes be hard to tell if you have rectal prolapse or hemorrhoids, since both cause bulging out of the anus, but they’re two different conditions that need to be treated differently.