What Are the Long-Term Complications of Chronic Constipation? Why Treatment Matters

When you’re constipated, you may find yourself straining to pass stool. Straining during bowel movements can cause the veins in your anus and lower rectum to swell. These swollen veins are known as hemorrhoids or piles.

Hemorrhoids can cause:

• irritation or itching around your anus
• discomfort or pain around your anus
• swelling around your anus
• bleeding during bowel movements

To help stop hemorrhoids from developing or getting worse:

• treat chronic constipation early
• try to avoid straining during bowel movements
• avoid sitting for long periods of time on the toilet, which can put pressure on the veins around your anus

To manage the symptoms of hemorrhoids, it may help to:

• apply an over-the-counter hemorrhoid cream, ointment, or pad
• use an over-the-counter hemorrhoid suppository
• take an oral pain reliever
• soak in a warm bath, several times per day

If you develop signs or symptoms of hemorrhoids that don’t get better within a week, make an appointment with your doctor. In some cases, they might use a non-surgical or surgical procedure to shrink or remove the hemorrhoids.

An anal fissure is a small tear in the tissue that lines your anus. This tissue can tear when you pass hard stool or strain to have a bowel movement, both of which are common in people with constipation.

Potential signs and symptoms of an anal fissure include:

• a visible tear around your anus
• a bump or skin tag near the tear
• pain during or after a bowel movement
• bright red blood on your toilet paper or stool after a bowel movement

To prevent and treat anal fissures, it’s important to treat chronic constipation and try to avoid straining during bowel movements. Soaking in a warm bath several times a day may also help promote healing and soothe symptoms of an anal fissure.

In some cases, your doctor might recommend additional treatment, such as:

• topical treatment with nitroglycerin (Rectiv)
• topical treatment with anesthetic creams, such as lidocaine hydrochloride (Xylocaine)
• injections of botulinum toxin type A (Botox), to help relax your anal sphincter
• oral or topical treatment with blood pressure medications, to help relax your sphincter

If you develop a chronic anal fissure that doesn’t respond to other treatments, your doctor might recommend surgery.

Over time, it’s possible for chronic constipation to cause rectal prolapse. Rectal prolapse happens when a part of the large intestine known as the rectum falls from its normal position. If this happens, part of the rectum might slip out of the anus.

Potential signs and symptoms of rectal prolapse include:

• a sensation of fullness in your bowels
• a feeling that you can’t empty your bowels completely
• itching, irritation, or pain around your anus
• leakage of feces, mucus, or blood from your anus
• visible red tissue protruding from your anus

If you develop signs or symptoms of rectal prolapse, make an appointment with your doctor.

In mild cases of rectal prolapse, your doctor might recommend changes to your diet, Kegel exercises, or other home treatments. But in many cases, surgery is needed to treat this condition.

Chronic constipation can also lead to fecal impaction. This happens when a hard mass of stool gets stuck in your colon. It’s also known as an impacted bowel or impacted feces.

Potential signs and symptoms of fecal impaction include:

• discomfort, cramping, or pain in your abdomen, especially after eating
• abdominal bloating or swelling
• difficulty passing stool or gas
• the passage of liquid stool
• loss of appetite
• nausea
• vomiting
• headache

If you develop signs or symptoms of fecal impaction, make an appointment with your doctor. Depending on your condition, they might recommend one or more of the following treatments:

• an enema to soften stool and promote intestinal contractions
• manual disimpaction, in which your doctor inserts a gloved finger into your rectum to try to remove the hardened stool
• water irrigation, in which your doctor inserts a small hose into your rectum and uses water to flush feces out your intestines

Without treatment, fecal impaction can cause tears in the wall of your colon. This can lead to a potentially life-threatening infection.

To avoid potential complications, it’s important to prevent and treat chronic constipation.

Practicing healthy lifestyle habits may help. For example:

• go to the washroom whenever you feel the urge, rather than waiting
• eat fiber-rich foods, such as fruits, vegetables, beans, nuts, seeds, and whole grains
• stay well-hydrated by drinking at least six to eight cups of water or other fluids every day
• get regular exercise and limit the amount of time you spend on sedentary behaviors
• take steps to reduce emotional stress and practice self-care

In some cases, your doctor might also encourage you to:

• take fiber supplements
• take over-the-counter stool softeners
• use over-the-counter oral laxatives, rectal suppositories, or enemas

Another approach to treating chronic constipation is bowel training. Your doctor may suggest that you:

• try to go to the bathroom at the same time each day, usually 15 to 45 minutes after eating
• try biofeedback therapy to retrain the muscles involved in bowel movements

If lifestyle changes and over-the-counter products aren’t relieving your symptoms, your doctor may recommend a prescription option. Several different types of prescription medications are available to treat chronic constipation.

Sometimes, chronic constipation may be a sign of an underlying medical condition that requires additional treatment. You doctor can help you identify the potential causes of chronic constipation and develop a treatment plan.

If left untreated, chronic constipation can cause complications, some of which may be serious. Fortunately, many treatments are available for chronic constipation.

If you experience signs or symptoms of constipation on an ongoing basis, make an appointment with your doctor. They can help you identify potential causes of the constipation and develop a plan for treating it. They can also help you learn how to prevent and treat potential complications.