Medically reviewed by the clinical team at Consultants in Gastroenterology
Almost everyone deals with constipation from time to time. A change in routine, a few days of low fiber, less water than usual, or travel can slow things down for a day or two. That kind of constipation usually resolves on its own.
Chronic constipation is different. When infrequent, hard, or difficult-to-pass stools become a regular part of your life rather than an occasional inconvenience, it is worth finding out why.
If you have been dealing with constipation for three months or longer, or if you rely on laxatives just to have a bowel movement, it is time to schedule an appointment. This is not something you need to manage on your own indefinitely.
What Counts as Chronic Constipation?
Occasional constipation is common and typically clears up with a diet change, more water, or a short course of an over-the-counter remedy.
Chronic constipation is generally defined as experiencing two or more of the following, for at least three months:
- Fewer than three bowel movements per week
- Straining during more than a quarter of bowel movements
- Hard or lumpy stools
- A sense of incomplete emptying
- A sense of blockage in the rectum
- Needing to use your hand to help pass a stool
If any of this sounds familiar and it has been going on for months rather than days, it is time for an evaluation rather than another trip down the laxative aisle.
Common Causes of Chronic Constipation
Chronic constipation has several possible underlying causes, and the right treatment depends on which one applies to you.
- Functional constipation is the most common diagnosis we make. There is no structural problem and no underlying disease. The colon simply moves stool more slowly than it should, often related to diet, hydration, activity level, or delaying the urge to go.
- Irritable bowel syndrome with constipation (IBS-C) involves constipation along with abdominal pain or bloating that improves after a bowel movement. It is a functional condition, but it responds well to a targeted treatment plan.
- Pelvic floor dysfunction, sometimes called dyssynergic defecation, occurs when the muscles involved in having a bowel movement do not coordinate properly. Patients often describe straining, a feeling of blockage, or needing to change position to pass stool, even when the stool itself is not particularly hard.
- Medication-induced constipation is common and frequently overlooked. Opioid pain medications, certain antidepressants, iron supplements, calcium channel blockers, and some antacids can all slow the digestive tract.
- Hypothyroidism can slow down digestion along with many other body functions. A simple blood test can rule this in or out.
- Neurological conditions, including Parkinson’s disease and diabetes-related nerve changes, can affect the nerves and muscles that move stool through the colon.
- Structural issues, such as a stricture, rectocele, or in rarer cases a colon tumor, can physically obstruct normal bowel movements. This is why new constipation, especially after age 45 or 50, should always be evaluated rather than assumed to be routine.
Symptoms That Should Prompt a Call to Our Office
You should contact us for an evaluation if you are experiencing any of the following:
- Constipation lasting three months or longer
- Needing laxatives regularly just to have a bowel movement
- Straining, incomplete emptying, or a sense of blockage
- New constipation that started after age 45, without a clear cause
- Constipation alternating with episodes of diarrhea
- Blood in the stool or on toilet paper
- Unintentional weight loss
- Abdominal pain or bloating alongside constipation
- A family history of colorectal cancer or inflammatory bowel disease
When Is It a Medical Emergency?
Please seek immediate care if you have severe abdominal pain, significant abdominal swelling, vomiting, or an inability to pass stool or gas at all. These can be signs of a bowel obstruction, which requires prompt attention.
What We Will Look For
When you come in for an evaluation, we will start with a detailed history of your symptoms, diet, medications, and family background, along with a physical exam. From there, depending on what we find, we may recommend blood work to check thyroid function, a colonoscopy to rule out structural causes, or specialized testing such as anorectal manometry or a colonic transit study to see how well the muscles and nerves involved in digestion are working.
Our goal is not simply to help you have a bowel movement today. Our goal is to understand why your digestive system has slowed down and to build a plan that keeps it working the way it should.
A Word About Waiting
Many patients tell us they assumed chronic constipation was just something to live with, especially as they got older, or that it was not worth mentioning to a doctor.
Chronic constipation is a medical symptom, not a personal failing. It can usually be treated effectively once we understand the underlying cause. Left unaddressed, it can also lead to complications like hemorrhoids, anal fissures, or, in some cases, mask a more serious condition that deserves earlier attention.
You do not have to keep managing this alone, and there is likely more we can do than another change in diet or a different over-the-counter product.
Schedule With Consultants in Gastroenterology
If chronic constipation has become a regular part of your life, it does not have to stay that way. Our doctors at both Columbia, SC, locations are ready to listen, evaluate, and build a care plan tailored to your needs, whether you are dealing with new symptoms or have been struggling with this for years.
Your quality of life matters. Reach out to us today, and let us help you get back to feeling like yourself.
To schedule an appointment with one of our gastroenterologists, call our office or request a visit online. We look forward to taking good care of you.