Constipation pain

Constipation is characterized by difficult bowel movement. The stool is usually hard and emptying it is often associated with pain. As it is one of the most common complaints in industrialized countries, constipation is considered a disease of civilization.

It occurs with increasing age, so that about 20-30% of those over 60 are affected. The most common causes of constipation are chronic habitual constipation and irritable bowel syndrome. If pain occurs in the context of constipation, this pain is to be considered a symptom of constipation. Therefore, the treatment of this pain corresponds to the treatment of constipation, which is always dependent on the cause. In most cases of constipation, a change in diet, an abundant fluid intake and a lot of exercise will help to improve.

Origin of pain in constipation

In general, pain during bowel movements is not a rare phenomenon. The most common cause of this pain is chronic constipation. Three quarters of the stool itself consists of water.

Other main constituents are indigestible food remains, intestinal bacteria and exfoliated cells of the mucous membrane lining the intestine. The remaining part of the faeces consists of digestive secretions, bile dyes and salts. Normally, the stool is of soft to medium-hard consistency.

However, if one suffers from constipation, the stool is usually very hard and dry. As a result, the forward movement of the stool is considerably more difficult. The affected person feels the need to empty his or her bowels.

However, this is only possible under strong and frequent pressing. There is often a feeling of incomplete defecation afterwards. The pressing may cause small tears in the mucous membrane of the anus and the intestine, so-called anal fissures. This can cause additional pain for the affected person. Pain caused by anal fissures is usually of a burning or stinging character and also occurs during defecation.

Causes of constipation

There are numerous causes that can lead to constipation. The most common form of constipation is chronic habitual constipation, an intestinal dysfunction that affects about 10% of people in industrialized countries. The exact mechanism of origin is not yet fully understood.

It has been proven that a low-fiber diet and a too low fluid intake as well as lack of exercise can lead to intestinal inertia. A further proven cause is the suppression of the so-called defecation stimulus, the reflex responsible for defecation. If, for example, one is afraid of defecation because one fears pain, the stool is withdrawn, so to speak.

This means that this defecation stimulus is no longer triggered and constipation develops. Suppression of the defecation stimulus as the cause of constipation is particularly common among children. The second most common cause of constipation is irritable bowel syndrome, which is also a functional disorder of the bowel.

Irritable bowel syndrome is characterized by recurrent pain mostly in the lower abdomen. These are often described as pressing, pulling, stabbing or cramping. Other typical symptoms are flatulence, a feeling of fullness, constipation or diarrhoea.

Also typical is the frequent feeling of urge to defecate with the subsequent feeling of incomplete evacuation. The consistency of the stool can be hard or soft. The causes of irritable bowel syndrome are unclear.

It is suspected that there is an interplay between predisposition, intestinal infections and psyche. The intestine is closely related to the psyche, so that stress, depression or excitement can have a negative influence on the symptoms. Another cause of constipation can be a temporary constipation due to infections or a change in diet.

Many medications can cause constipation, such as opiates (strong painkillers). Too low a potassium level in the blood can also lead to constipation, which can also be caused by taking certain medications. It is always important to distinguish between the presence of intestinal diseases.

For example, the bowel can be partially constricted and thus clogged by a tumor, a foreign body or infections, but also by chronic inflammatory bowel diseases. Since the movements of the intestine are controlled by nerves, various nervous disorders can also cause constipation. These include diabetes mellitus with associated diseases of the autonomic nerves, Parkinson’s disease and multiple sclerosis.Changes in hormone balance can also contribute to the development of constipation: for example, hypothyroidism, diabetes and even pregnancy can lead to constipation.