The passage of very small amounts of hard, dry bowel movements, usually fewer than three times a week is referred to as constipation. It is very difficult and painful to have a bowel movement in people who are constipated.
Some of the symptoms of constipation include lower abdominal pain and discomfort, rectal bleeding, hard stools caused by anal fissures, and a sense of incomplete evacuation after a bowel movement. It can be chronic, sometimes severe, and has a significant, debilitating effect on the quality of life.
In elderly patients, constipation is a significant health-care problem and in the majority of cases, chronic constipation is aggravating, but not life-threatening.
The normal range of passing the stools is from three times daily to three times a week.
What are the Different Types of Constipation?
There are mainly three types of constipation:
Normal Transit Constipation
Normal transit constipation is one of the most common types of constipation. In this type, colon muscles squeeze and relax neither too fast nor too slow. The waste moves with the right speed. Still, the consistency of stools can be hard and difficult to pass.
Normal transit constipation has also been associated with increased psychosocial stress. It gets better by eating more fiber-rich foods or by using a certain type of laxative.
The symptoms of normal transit constipation are generally associated with abdominal discomfort, pain and bloating.
Slow Transit Constipation
Slow transit constipation is characterized by the reduced mortality of large intestine that is because of abnormalities of the enteric nerves. In this type of constipation, the passage of waste moves slowly which leads to various chronic problems such as uncontrollable soiling.
The treatment option includes electrical stimulation, laxatives, and surgery.
Symptoms of Slow Transit Constipation
- Bowel movement less than once a week
- Passing hard and dry stools
- Pain and bloating
- Poor appetite
In this type of constipation, patients face difficulty in expelling stools from the rectum. This may be due to impaired rectal contraction, anal contraction, or inadequate anal relaxation.
The difficulty in passing stools can also be due to the problem with the nerves of the pelvic floor. The lack of coordination of the muscles that are involved in defecation may be the most common cause, but a high proportion of patients also show impaired rectal sensation.
Symptoms of Dyssynergic Constipation
- Very hard stools
- Excessive straining
- Less than three bowel movements per week
- Digital evacuation
- The feeling of incomplete evacuation
Difference Between Painless and Painful Constipation
Constipation can be painless or painful. The painless or mild pain constipation is also called functional constipation and is defined by the presence of bowel symptoms such as excessive straining to defecate.
Painful or moderate to severe abdominal pain constipation is referred to as constipation-predominant IBS and defecation disorder and is characterized by severe abdominal pain associated with bowel disturbances and the relief of pain is with defecation.
As compared to painless constipation patients, painful constipation patients had more prominent bowel symptoms and were more likely to have upper gastrointestinal symptoms including:
- Anorectal symptoms
- Sexual symptoms
- Slower rectosigmoid transit
The symptoms of painful constipation can partly reflect the increased perception of visceral sensations such as wall tension.
When can Constipation Lead to an Emergency Situation?
Constipation is generally a short-term problem that can be resolved with self-care, but sometimes it leads to emergency medical treatment such as in the following situations:
- When stools become hardened and lodged in the rectum. These severe complications can lead to bleeding.
- The bowel obstruction occurs when the small or large intestine becomes partially or fully blocked which cause stretching of the intestines which can lead to severe abdominal pain, rupture, and bleeding.
- Unbearable abdominal pain which can also be due to another disease such as appendicitis or bowel obstruction.
- The presence of blood in the stool can also be a cause of rectal bleeding which includes fissures, hemorrhoids, rectal ulcers, and rectal inflammation.
- When constipation lasted for a longer duration for more than three weeks.