Frequently asked questions about constipation

Constipation is one of the most common chronic digestive disorders, and one of the most common reasons for consultation, both in primary care and gastroenterology. In fact, approximately one in five people reports symptoms compatible with constipation during their lives. It may affect people of any age and tends to be more common in women, until 65-70 years, when it affects both sexes equally. In most cases, constipation is occasional, and even in chronic cases it is rarely associated with complications.  

Constipation is not only defined by the number of bowel movements. Some people who come to us with constipation have a bowel movement at least once a day, while others go to the toilet every two or three days and have no issues at all.  

Constipation is the subjective manifestation of a state of discomfort: in some patients it mainly manifests in difficulty evacuating the faeces, which requires assistance with the hand or the use of suppositories. In others, it is a case of low frequency of bowel movements, while others have daily frequency, but the faeces have a very hard consistency and it is difficult or even painful to expel. If a patient repeatedly has one or many of these symptoms over time, they are advised to consult a doctor to receive a diagnosis and the most suitable treatment.  

It is important to drink a lot of water; do regular exercise (walking, running); eat a diet rich in fruit, vegetables and grains that provide fibre; maintain a consistent routine when it comes to going to the bathroom; take your time when going to the bathroom and avoid using laxatives without a prescription.  

It has not been shown that constipation leads to any kind of bowel cancer. However, in rare cases it is possible that this type of cancer manifests as the sudden onset of constipation. For this reason, if this change in intestinal rhythm appears suddenly and lasts for several weeks in a person over 50 years of age, or if it is associated with other clinical signs such as blood in the faeces, iron-deficiency anaemia, weight loss or the appearance of a mass in the rectum or abdomen, you should consult a doctor to exclude the possibility that the constipation is a consequence of colon or rectal cancer.  

Constipation normally follows a mild course, although it can be very uncomfortable, and some people with serious constipation may develop complications. These often include haemorrhoids and anal fissures. Haemorrhoids appear due to excessive force during defecation, which causes the veins in the anus to dilate. It may also cause them to be inflamed, causing pain, itching and bleeding. Anal fissures are wounds that are caused to the anus due to passing hard faeces, and are also normally associated with excessive straining. This is why preventing constipation is part of the treatment plan for patients with haemorrhoid symptoms such as pain or secondary bleeding as well as anal fissure. There may be other complications such as the appearance of enterocele or rectocele (herniation with descent of the intestine or rectum towards the vagina), intestinal obstruction due to faecaloma (impacted hard faeces in the rectum or colon), intestinal volvulus (when the intestine is twisted around itself). These are very infrequent, and when they do occur, they tend to affect elderly people with associated diseases.