Constipation – Chronic Condition?

For decades researches have been unable to clearly decipher the question of functional constipation. Chronic complaints by patients of abdominal pain, bloating, and the inability to regularly pass stools have led to multiple studies trying to find common factors among patients suffering with constipation without a clear physical disorder. This article focuses on one such article in the academic journal Gut entitled Severe Chronic Constipation of Young Women: Idiopathic Slow Transit Constipation.

Who has chronic constipation?

Chronic constipation in this study was found when patients came to the hospital complaining of bowel movements once a week or less and often only with the assistance of laxatives. To attempt to eliminate structural bowel problems, researches had patients eat radio-opaque solid markers that could be tracked based on when they exited the system. Patients who passed 16 of the 20 markers within 5 days were eliminating normally whereas the patients who took longer than 5 days but still had normal enemas were considered to have functional constipation (chronic variety.

The characteristics of those with chronic constipation could lead to some interesting insights. Of the 64 patients questioned, 15 had symptoms before 5 years of age and 53 of the 64 had dealt with a lack of relief for constipation by the age of 20. 75% had missed time at work due to their constipation & chronic abdominal swelling and pain was present in more than 80% of the patients. Also of note is that all the patients were women.

How do women with constipation (chronic type) compare to controls?

The important question for those who struggle with issues like the women above is whether there are other identifiable symptoms that are correlated with constipation that could help identify the causes of the problem. Researchers found that dietary intake was not significantly different among the two groups and neither were rates of constipation in the families of the women. Women with constipation (chronic variety) did have significantly higher rates of complaints around having cold hands and of having epilepsy or blackouts. They had also undergone appendicectomy, hysterectomy, and ovarian cystectomy more often than the controls.

Researchers also noted that women with severe constipation used their fingers more often to help the sphincter relax. It is suggested that this may be because these women had trouble letting a muscle called the “puborectalis” relax, making it difficult to pass stools – something that manual pressure with the fingers might help alleviate.

Conclusions

This study was done in 1986, but its ambiguity about the causes of constipation are as relevant today as they were then. These women could find no constipation relief with traditional bulk or osmotic laxatives, though perhaps our better understanding about prebiotics, probiotics, and the role of the parasympathetic nervous system could provide help where these women were unable to find it.