According to gastroenterologists Michael Camilleri and Joseph A. Murray in the 2008 edition of "Harrison's Principles of Internal Medicine," approximately 20 percent of Americans suffer from symptoms of chronic constipation. Constipation that lasts longer than 12 weeks is considered chronic. Doctors add the term idiopathic to describe symptoms unexplained by diseases, disorders or medication side effects. Unfortunately, most constipation falls into this category.
Definition
Although most patients know when they are constipated, doctors prefer to use a definition. According to the National Institutes of Health, doctors define constipation as having a bowel movement fewer than three times per week.
Symptoms
In addition to infrequent bowel movements, many constipated patients also report hard stools, small stools, stools covered with small amounts of blood or dried white mucous, abdominal distention, excessive straining to have a bowel movement or a sense of incomplete defecation. Chronic idiopathic constipation can also lead to other conditions, such as anal fissures, rectal prolapse and hemorrhoids, which cause their own sets of symptoms.
Diagnosis
Chronic idiopathic constipation represents a diagnosis of exclusion. This means that doctors make the diagnosis on the basis of features that are absent, rather than present. A doctor will typically take a thorough history, perform a physical examination and, sometimes, order diagnostic tests such as thyroid hormone levels or x-rays to exclude other possibilities before attributing the patient's symptoms to chronic idiopathic constipation.
Lifestyle Change
Treatment for the symptoms of chronic idiopathic constipation, as with all kinds of constipation, begins with lifestyle change. Patients should gradually increase their intake of dietary fiber by eating more whole grains, legumes, fruits and vegetables. Increasing physical activity and managing stress can also help.
Medications
Some patients require laxatives in order to obtain relief from symptoms. Although most laxatives are available without a prescription, patients with chronic idiopathic constipation should obtain a recommendation from their doctors before using them. In some cases, a doctor will prescribe lubiprostone, a prescription medication that, according to an April 2010 study published in the journal Digestive Diseases and Sciences, often provides sustained relief from the symptoms of chronic idiopathic constipation in as little as 24 hours after the first dose.
References
- "Harrison's Principles of Internal Medicine, 19th ed.;" A.S. Fauci et al. (Eds.); 2008
- National Institutes of Heatlh: Constipation
- "Digestive Diseases and Sciences;" Efficacy and Safety of Lubiprostone in Patients with Chronic Constipation; C.F. Barish, D. Drossman, J.F. Johanson et al.; Apr. 2010
