Constipation - Symptoms

A patient may be having chronic constipation if they have two or more of the following symptoms persisting for more than months:

• straining to pass stools
• lumpy or hard stools
• a sensation of incomplete evacuation or a feeling of having to pass stools again
• feeling of blockage in the rectum that is not allowing stools to pass out
• passing stools less than three times a week
• needing help to pass stools, example: pressing hands on the abdomen or using a finger to remove stools from the rectum

Types

1. Normal-transit constipation
   • Normal-transit constipation is a part of constipation, present with normal stool movement but with associated abdominal pain and bloating.
   • It is seen in individuals with increased emotional stress, who can easily feel better with laxatives.
2. Slow-transit constipation
   • In order to expel the contents of the colon forward, the intestine undergoes a sequence of synchronised muscular contractions. These coordinated movements pass through the nerves present in the gut wall. Any abnormality or delay in the coordination of a nerve can decrease gut motility, thereby causing constipation.
   • This is generally diagnosed in the early days of life, when the child is born and there is a delay in passing stools. These individuals suffer severe forms of constipation and a lack of control over bowel movements. They are constantly anxious and socially withdrawn, with emotional disturbances.
3. Evacuation disorders
   • Stools are not propelled out after reaching the anus. Patients experience prolonged straining to pass soft stools with heaviness in the anal area and thus need to insert their finger and manually remove the faeces.
   • The exact reason still remains unknown. Those who do not respond easily to medication may require relaxation therapy.

When to seek urgent medical help:

The patient must look for the following associated alarming signs:

• sudden onset of constipation
• fever
• weight loss
• lump upon examining the stomach
• blood in stools