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Chronic Constipation


What is chronic constipation?

Chronic constipation can be either infrequent bowel movements or difficulty in passing stools that happens for several weeks or longer at a time.

The people with chronic constipation have hard or formed stools, small stools or a combination of hard, formed and small stools.

Generally, chronic constipation is described as a stool frequency of less than three per week that lasts for several months.

Though constipation is very common among people, some people experience chronic constipation that disturbs their daily living.

Chronic constipation is associated with much straining and other signs and symptoms due to straining.



How does chronic constipation present?

Chronic constipation may present differently in different people. The most common presentations are:

  • Passing lesser than 3 stools in a week.
  • Passing hard stools or lumps
  • Much straining to have bowel movements.
  • Sitting in the toilet for long hours but nothing comes out from the rectum.
  • Unsatisfied feeling even after passing stools. Feeling as if some part of stool is still remaining inside.
  • Needing help to empty the rectum completely like pressing of abdomen or using finger or other aid to remove stools out from the rectum.

A person is believed to have chronic constipation if he/she experiences one or two symptoms out of these.



What causes chronic constipation?

The food passes through the digestive tract after it is being eaten. The nutrients and water are absorbed from the food leaving a hard and dry mass (stools) which leads to constipation.


Chronic constipation has many causes such as:

Blockages in the colon or rectum

  • The stool movement may be blocked or completely stopped due to blockages in the rectum. It can be due to:
  • Bowel obstruction
  • Anal fissure
  • Narrowing of the colon
  • Cancer of the colon
  • Cancer of the rectum
  • Other cancers in the abdomen that presses on the colon
  • Prolapsed of the rectum


Problem with the nerves around the rectum and colon

  • Problems with the nerves around the rectum and colon affect the muscle movements that help in the movement of stools. The stools move slowly or stop moving leading to constipation. The causes include:
  • Autonomic neuropathy
  • Multiple sclerosis
  • Parkinson’s disease
  • Spinal cord injury
  • Stroke


Difficulty with the muscles of defecation

  • Problems with the muscles involved in defecation can lead to constipation. They can be:
  • Inability to relax the pelvic muscles involved in passing the stools
  • Pelvic muscles do not coordinate relaxation and contraction correctly
  • Weakened pelvic muscles


Conditions that affect hormones in the body

  1. When the hormonal balance is disturbed in the body, it can lead to constipation. The conditions include:
  2. Diabetes
  3. Hyperparathyroidism
  4. Hypothyroidism
  5. Pregnancy



What complications can chronic constipation lead to?

Hemorrhoids or swollen anal veins

  • Excessive straining during the passage of stools may lead to swelling of the anal veins.


Anal fissure

  • Large or excessively hard stools can lead to tearing of the skin around the anus.


Sticking of stools in the intestines

  • Excessively dry and hard stools can lead to sticking in the intestines. The stools cannot be completely expelled due to dryness and it gets stuck in the intestines or the rectum.


Rectal prolapse

  • Straining at stools can lead to protrusion of the intestines or rectum out from the anus.



How is chronic constipation diagnosed?


  • To examine the rectum and lower portion of the colon.



  • To examine the entire colon


Anorectal manometry

  • To examine the activity of muscles and sphincters in the rectum.


An X-ray of rectum while defecating

  • A soft barium paste is inserted into the rectum and the patient is told to pass it he passes stools. The barium shows up on X-ray and reveals if there is any prolapsed or problems with muscle activities.



Self Help

  • Regular bowel habits each morning.
  • Do not ignore the urge to pass stools. If the urge is ignored, and the stool remains for a longer time in the rectum, it becomes drier and becomes more difficult to expel out.
  • Increase fluid intake.
  • Increased intake of dietary fibers.



Homeopathic management

Homeopathic treatment for constipation is based on treating the root causes which leads to constipation. Most cases of constipation may be corrected with some lifestyle and food changes but constipation of long duration requires a medical attention.


Homeopathy remedies for constipation:

Nux vomica

  • Unsatisfactory stools.
  • Ineffectual urge for passing stools..
  • Sedentary habits without any outdoor exercises.
  • Abuse of alcohol, smoking, tea, coffee etc.


Bryonia alba

  • No desire to pass stools.
  • Stool is too thick and large, charred black..
  • Dry and hard stools.
  • Long continued burning in the rectum after passing stools.



  • Constipation along with obesity.
  • Large stool.
  • Hard knotty stools mixed with tough slimy mucus.
  • Anal fissures with soreness at the anus.
  • Relief from eating hot foods and drinks.



  • Inactivity of the rectum.
  • Great straining at stools, even while passing soft stools.
  • Indicated in children who are fed artificially.
  • Stool is dry, hard and knotty.
  • Stools resemble that of a sheep.



  • Stool is partly expelled and then recedes back.
  • Feces remain for a long time in the rectum but are not expelled.
  • Great straining but hardly anything is passed.
  • Constipation is aggravated before and during menses in females.


Plumbum met

  • Habitual obstinate constipation.
  • Paresis of intestines..
  • Urging and terrible constriction and spasm of the anus.
  • Violent colic with sensation of abdominal wall being pulled back towards the spine.



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