Constipation: a common but undertreated condition

Constipation is one of the most common ailments troubling patients of all ages, male and female alike. Unfortunately, I find that constipation is also one of the most undertreated conditions when I see patients in my office. Many people tend to ignore constipation and simply “live with it”. By the time a patient with chronic constipation ends up in a proctologist’s office, he or she is often suffering from one of many other secondary problems that may have been avoided or at least minimized if the constipation had been addressed at an earlier stage.

Constipation is a symptom, with a different meaning for different patients. The typical features of constipation are infrequent and firm bowel movements, or bowel movements that are difficult to pass and require straining or manual evacuation. One of the most common phrases that I say to patients on a regular basis is: “It’s not normal to strain to pass a bowel movement.”

Constipation is often multifactorial, and patients may have one or more contributing factors that need to be identified and addressed in their own way. I find that a detailed history can often find the heart of the problem before I even examine the patient or order advanced testing. There are several types of constipation, each of which is best treated in its own way, and experienced eyes and ears can tease out the problem. There are also diagnostic tests that can help clarify the nature of a patient’s constipation and how best to treat it. These diagnostics include colonoscopy, specialized x-rays, anorectal physiology testing and MRI defecography.

The importance of recognizing and treating constipation early is highlighted by the many acute and chronic problems that are the direct result of constipation. Hemorrhoids and anal fissures are the two most common conditions that I encounter in the office. These problems often resolve simply with appropriate diagnosis and management of constipation. The longer the symptoms have been present, the harder it can be to alleviate hemorrhoids and anal fissures.

Further down the road, the all too frequent problems of pelvic floor dysfunction and its many relatives are often rooted in years and years of irregular bowel movements and chronic straining. Patients can develop difficulty evacuating stool and debilitating chronic pain due to weakness and dysfunction of their pelvic floor muscles. As the problem progresses, one may acquire more advanced conditions such as rectal prolapse and rectocele, as well as fecal incontinence.

Most people treat constipation as a normal part of their everyday life and do not seek help. They are often unaware of the short and long-term ramifications of chronic constipation. However, you should not ignore this problem, as constipation can be miserable in and of itself, and seeking help can correct it as well as any secondary problem you have developed. With the right care provider who truly understands the problem and takes the time to listen, you can experience not only relief in the short term, but also prevent future problems that are often more difficult to treat.

Dr. Kristin Vercillo is a board-certified colon and rectal surgeon with Advocate Condell Medical Center and Surgeons of Lake County.  A specialist in proctology, minimally invasive colon surgery, and anorectal surgery, Dr. Vercillo sees patients in Libertyville.  To learn more about Dr. Vercillo or schedule an appointment call (847) 816-7495.

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