The symptom “ constipation ” is a problem many people consider minor because they think taking laxatives will resolve it. However, regular use of laxatives not only fails to cure constipation but may also lead to other serious illnesses. Therefore, it is better to seek proper treatment for chronic constipation before more severe conditions develop.
Many people believe normal bowel movements happen daily, but in reality, each person's body differs, so frequency varies. As long as bowel movements are comfortable, without excessive straining, and stools are soft and well-formed, infrequent bowel movements are not necessarily abnormal.
Normally, people have bowel movements at least three times per week. If fewer than three times per week or experiencing difficulty such as hard stools, excessive straining, feeling incomplete evacuation, needing to use a finger to help, or using enemas, it may indicate 'chronic constipation.'
Medically, the Rome IV criteria diagnose chronic constipation when symptoms persist for at least six months and interfere with daily life. At least two of the following six symptoms must be present:
1. Straining more than usual to pass stool
2. Passing hard stools
3. Feeling of incomplete evacuation
4. Feeling of blockage in the rectum
5. Using fingers to aid defecation
6. Having fewer than three bowel movements per week
Therefore, if you have two or more of these symptoms consistently, it may signal chronic constipation and you should see a doctor for diagnosis.
Chronic constipation can cause stress, loss of appetite, fatigue, headaches, back pain, abdominal cramping, or worsen acid reflux and heartburn. Frequent straining may harm patients with heart disease, hemorrhoids, or hernias. Importantly, constipation can also be a warning sign of colon cancer.
Constipation might indicate colon cancer, especially if accompanied by other warning signs. Patients should see a doctor promptly for appropriate diagnosis and treatment. Watch for these warning signs:
Initial treatment involves the doctor taking a history, examining symptoms, conducting a general physical exam, and a rectal exam to identify treatable causes such as stopping medications causing constipation or treating hypothyroidism with thyroid hormone replacement.
If no clear cause is found, doctors recommend lifestyle changes including eating fiber-rich foods, drinking plenty of water, regular exercise, and establishing healthy bowel habits. Initially, laxatives may be prescribed, then gradually reduced and stopped as symptoms improve.
Importantly, patients should not regularly self-medicate with laxatives without medical advice, as this may cause the bowel to become dependent on laxatives, worsening constipation and making it harder to cure.
If lifestyle changes and laxatives do not improve symptoms, anatomical abnormalities such as an abnormal angle between the rectum and anus during defecation, rectal prolapse, perineal descent, or physiological dysfunction of the rectal and anal muscles may be present. These can be diagnosed by specialists using specialized tools and treated appropriately, offering a chance for cure.
Information by : Dr. Natthida Sribuathong, Gastroenterologist, Gastrointestinal and Liver Center, Phyathai 2 Hospital