Chronic Idiopathic Constipation | Definition, Symptoms and Treatment Options

It is estimated that up to 35 million US adults may suffer from chronic idiopathic constipation, ranging in severity from mild to severe, with approximately 40% of all sufferers currently taking some form of medication. Chronic idiopathic is much more prevalent in adults over the age of 35, with that age group making up 84% of patients. Caucasians seem to be by far the most affected race with 82% and women are slightly more affected than men at 56% but this is possibly due to less men reporting the condition. 

Constipation is defined as a motility issue, where patients have infrequent bowel movements or stools that are hard to excrete. Normal motility is different from person to person and is defined as being between three times a day to once every three days, so for this reason you will need to compare your recent bowel movements to your standard movement to diagnose constipation. The other symptoms that may present commonly with constipation is bloating, cramps, belly pain and a feeling that the bowels have not been fully emptied.

There are several complications that may arise from prolonged or severe constipation these include anal fissures, hemorrhoids and stool impaction.
 

Chronic constipation is diagnosed when these symptoms of constipation have occurred for a long period of time. The condition is described as ‘idiopathic’ when there is no known underlying condition or reason for the constipation to be chronically occurring. This chronic and idiopathic nature can have many negative influences on the patient's life that reach further than the symptoms and pain associated with constipation.

Symptoms of Chronic Idiopathic Constipation

• Belly pain
• Difficulty passing stools
• Hard fecal matter
• Straining when passing stools
• Flatulence
• Bloating
• Cramping
• Problems with social life
• Needing to miss many days of employment
• Depression
• Poor quality of life
• Inability to vigorously exercise
• Overall health decline

Cause of Chronic Idiopathic Constipation

As the name suggests in ‘Idiopathic’, the underlying cause is often unknown and the chronic constipation seems to arise spontaneously from an obscure or unknown reasons. 

The factors that influence and worsen the constipation are consistent with all constipation. Factors such as dehydration or inadequate amount of liquid and fibre intake as well as any slowing of motility (the movement of food through the alimentary canal from the mouth to the anus). Slowing of motility along the intestine has two key issues. Firstly the slower fecal matter travels along the small and large intestine, the more water will be removed from the fecal matter, resulting in hard and dry stool which are harder to defecate. Secondly the slow motility means that fecal matter will be ready to expel from the body much less frequently, causing a build up of fecal matter in the intestine resulting in potential fecal impaction and worsening of constipation symptoms.

Red Flag Warnings of Chronic Idiopathic Constipation

If you experience any of the below symptoms while experiencing chronic constipation you should contact your doctor as soon as possible;

• Unexplained weight loss.
• Blood in your stools.
• Fever.
• Family history of bowel cancer.
• Family history of IBD (Inflammatory Bowel Disease) including UC (Ulcerative Colitis) and Crohn’s disease.
• Prolonged constipation unresponsive to treatment.
• Severe cramping and pain.

Treatment of Chronic Idiopathic Constipation

When deciding upon a treatment plan doctors need to take into account a wide range of information. The severity of the condition, based upon the impact on the patient’s life will decide if treatment is necessary. The initial plan will involve a lifestyle management plan and possible the addition of different types of laxatives in combination. 

If these have been introduced and the patient is still suffering from constipation there are a number of medications that are prescribed, some licensed and other off-license. Some of these medications are listed below;

• Linzess (Linaclotide)
• Resotran (Prucalopride)
• Motegrity (Prucalopride) 

Lifestyle advice for treatment of Chronic Idiopathic Constipation

• Keep a diary of your bowel movements.
• Drink plenty of fluids. Try to consume most of your fluids as water.
• Eat plenty of fibre in the form of fruit and vegetables.
• Exercise regularly.
• Eat a healthy balanced diet.