When you have chronic (long-lasting) constipation, you need to find out what’s causing it.
It could be a medical condition or even medications that you take that are backing you up. But it could also be that your body’s waste disposal system isn’t working as it should. This is called functional or primary constipation. It’s constipation not caused by something else, and it’s more common in young children and older adults.
Types of Functional Constipation
There are 3 different types:
Normal transit constipation: This is the most common. When you have this, muscles in your colon squeeze and relax the way they should: not too fast and not too slow. Your waste moves at the right speed. Still, your stool may be hard and difficult to pass. You may have belly pain or bloating, too.
It usually gets better by eating more fiber-rich foods or by using a certain kind of laxative.
Slow transit constipation: This means your colon isn’t moving waste fast enough. Doctors don’t know exactly why this happens. But it could be because your nerves aren’t signaling your colon muscles to move the way they should.
Signs of this kind of constipation include:
- Not feeling the urge to go to the bathroom
- Pooping less than once a week
- Passing dry, hard stools
- A bloated or painful belly
This type is more common in young women. Doctors aren’t sure why.
Laxatives and fiber may not work for this type, but behavioral training (biofeedback) may help.
Defecation disorders: It takes coordinated muscle movements in your pelvic floor to move stool out of your body. These muscles, including your anal sphincter, need to relax at the right time for you to poop comfortably. If you have this type of constipation, you may feel the urge to go but have a hard time doing it. It may be painful.
You may have this problem if you:
- Spend a lot of time on the toilet straining and pushing to move your bowels
- Use your fingers to get stool out or use enemas frequently
- Laxatives or fiber supplements don’t relieve your constipation
People with this type often have hemorrhoids, cracks around the anus called fissures, and hard, impacted stools. These problems need treatment because they can make it even more difficult and painful to go.
It’s not clear what brings this kind of constipation on, but it’s often treated with behavioral and relaxation training.
You may need special tests to figure out what type of functional constipation you have. They may seem awkward and embarrassing, but medical staff do them all the time and they’re over pretty quickly. They’ll tell your doctor what he needs to know so he can best treat you.