What Are the Different Types of Constipation? Causes and Treatments

Constipation is a common digestive complaint that affects people of all ages. It can significantly impact quality of life, causing discomfort, bloating, and difficulty with daily functioning. Constipation may be due to a variety of reasons—ranging from poor dietary habits and lack of physical activity to underlying medical conditions or medication side effects.    

 Depending on the type of constipation, treatment plans may differ and often include lifestyle changes like increasing fiber intake and staying hydrated.

Understanding the different types of constipation is key to addressing the problem effectively. Let’s explore these types and their specific causes, symptoms, and treatments.

Types of Constipation

The two main types of constipation include: primary (also known as functional) and secondary. The symptoms and treatments can vary depending on the type.

Below are the different types of constipation:

1) Primary Constipation

Primary or functional constipation is a common digestive problem characterised by infrequent or difficult bowel movements that are not caused  by any  underlying medical conditions. Various factors, including poor diet, inadequate fluid intake, lack of exercise, and certain medications, can cause primary constipation. It’s further classified into 3 subtypes:

a) Normal transit constipation

• The most common form of constipation.
• Bowel movement frequency and stool consistency are generally normal.
• Individuals may still feel bloated, have difficulty with evacuation, or complain of abdominal discomfort.
• Symptoms often overlap with Irritable Bowel Syndrome (IBS).

Read more: Best Home Remedies to Get Rid of Bloating

b) Slow transit constipation

• Slow transit constipation is a rare form of constipation, mainly seen in middle-aged women.
• People suffering from this  type of constipation do not experience peristalsis, which is an inability to experience normal stimulation of the bowels after eating.
• Due to lack of peristalsis, the food moves more slower than usual in the digestive tract, and the time taken for the  stools to pass through the colon is much longer.
• Bowel movements are infrequent, and stools remain in the colon for longer periods.

c) Outlet constipation

• Outlet constipation occurs when there is damage to the muscles or nerves of the pelvic floor.
• The person experiences difficulty in passing the stools.
• Symptoms of outlet constipation include straining during bowel movements, delay in bowel movements due to pain, and feeling the need of using  hands to assist the bowel movements.
• A specific form, called dyssynergic defecation, occurs when the anal muscles fail to relax properly during a bowel movement.

Treatment for Primary Constipation

Treatment for normal and slow constipation includes

• Increasing your consumption of fibre-rich foods like whole grains, fruits, and vegetables
• Increasing water intake.
• Doing  regular yoga & exercise
• Use of laxatives (medicines used to relieve constipation)

Treatment of outlet constipation

• Pelvic floor muscle training involves exercises that help strengthen the pelvic muscles, relax them, and improve bowel movements.
• Biofeedback therapy: A probe is inserted into the anal sphincter (group of muscles at the end of the rectum) by a trained therapist, and visual or verbal feedback is given to the person to use the pelvic floor muscles and anal sphincter during bowel movements, which help the person  improve the coordination by restraining the pelvic floor muscles.
• Adjunctive Therapies: Therapies like laxatives and enemas are given for the treatment of outlet constipation.
• Surgery: In severe cases of outlet constipation, surgery is performed  for the muscles around the anal sphincter.

2) Secondary Constipation

Secondary constipation is another type of constipation that occurs as a side effect of taking medications or due to an underlying medical condition. 

Causes of secondary constipation

The common Causes of secondary constipation are:

• Neurological disorders such as spinal cord injury, Parkinson’s disease
• Endocrine or metabolic disorders such as diabetes mellitus, hypothyroidism, and pregnancy
• Organic causes, such as colorectal cancer
• Medicines, such as tricyclic antidepressants, opiates, or iron preparations
• Diet or lifestyle, such as low fibre diet, inactive lifestyle, dehydration

Treatment of Secondary Constipation

Read more: Role of probiotics and prebiotics for gut health

Effective management focuses on identifying and addressing the root cause: 

• Hydration: Ensure you drink enough water, as dehydration can contribute to constipation. Have at least eight glasses of water per day.
• Fibre: Increase your fibre intake by eating more fruits, vegetables, and whole grains. It will add bulk to your stool and help it move quickly through your intestines.
• Exercise: Regular physical activity can help stimulate your digestive system and alleviate constipation. Work out at least 30 minutes a day to avoid constipation.
• Avoid processed foods: Processed foods are often low in fibre and can contribute to constipation. 
• Add magnesium to your diet: Magnesium is a mineral that helps regulate bowel function. You can get more magnesium by eating foods like spinach, almonds, and black beans or taking a magnesium supplement.
• Probiotics: Beneficial bacteria called probiotics live in your gut. Consuming probiotics through foods like yoghurt or a probiotic supplement may help improve gut health and alleviate constipation.

Medications for Constipation

There are several types of medications to relieve constipation, based on severity and cause: 

• Fibre supplements, such aspsyllium (Metamucil) or methylcellulose (Citrucel), can help increase the water content  in your stool, making it easier to pass.
• Stool softeners: These medications, such as docusate (Colace), increase the water content in your stool, making its consistency softer and easier to pass.
• Lubricant laxatives: Lubricant laxatives, such as mineral oil, coat the stool’s surface and intestinal lining with a lubricating substance, which can help facilitate bowel movements. These laxatives can be helpful for individuals who experience constipation due to dry or hard stools that are difficult to pass. Lubricant laxatives can be taken orally or as an enema and typically take several hours to produce a bowel movement.
• Osmotic laxatives: Osmotic laxatives, such as milk of magnesia, draw water into the colon, softening the stool and increasing bowel frequency. These laxatives contain substances that are not absorbed by the body and remain in the colon, where they help to increase the  water content of   the stool.
• Saline laxatives: These are a type of laxative that works by drawing water into the colon, which softens the stool and promotes bowel movements.
• Prokinetics: These drugs help to stimulate the muscles of the digestive tract and speed up the passage of stool. Examples include metoclopramide and domperidone.
• Surgery: In severe cases of outlet constipation, surgery to remove part of the dysfunctional colon may be necessary.

Also Read: Home Remedies for Constipation

Complications of Untreated Constipation

Untreated constipation can cause various health problems. While occasional constipation is normal, chronic or severe cases can lead to serious issues. Here are some potential complications:

• Faecal impaction: Chronic constipation can cause stool to build up in the rectum, leading to faecal impaction, which can be challenging to treat and may require medical intervention.
• Hemorrhoids: When you strain to pass a bowel, the veins in the rectum and anus can become swollen and painful, resulting in hemorrhoids.
• Anal fissures: Chronic constipation can also lead to small tears in the anus, known as anal fissures, which can cause pain and bleeding.
• Rectal prolapse: Rectal prolapse is a medical condition in which the rectum, the lower part of the large intestine, protrudes through the anus. It can occur when the muscles and ligaments that hold the rectum in place become weakened or damaged, allowing the rectum to push through the anal opening.
• Bladder dysfunction: Constipation can also put pressure on the bladder and disrupt normal urinary function, leading to urinary incontinence or other bladder problems.

Conclusion

While constipation is a common condition, understanding its type and cause is essential for effective treatment. Most cases can be managed with lifestyle changes, including increased fibre intake, better hydration, and regular physical activity. In other cases, medications or medical therapies may be necessary.

If you experience persistent or severe constipation, consult a healthcare provider to develop a personalised treatment plan.

Frequently Asked Questions (FAQs)

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice. Please consult a healthcare provider before beginning any new wellness practice, especially if you have an existing medical condition or are on medication.

References

• Kang, S. J., Cho, Y. S., Lee, T. H., Kim, S.-E., Ryu, H. S., Kim, J.-W., Park, S.-Y., Lee, Y. J., & Shin, J. E. (2021). Medical Management of Constipation in Elderly Patients: Systematic Review. Journal of Neurogastroenterology and Motility, 27(4), 495–512. https://doi.org/10.5056/jnm20210
• Brocade Desktop: irua. (n.d.). Repository.uantwerpen.be. https://repository.uantwerpen.be/desktop/irua
• Araújo, M. M., & Botelho, P. B. (2022). Probiotics, prebiotics, and synbiotics in chronic constipation: Outstanding aspects to be considered for the current evidence. Frontiers in Nutrition, 9. https://doi.org/10.3389/fnut.2022.935830