On this page, we deal with the most common complications of constipation.
For those of us who have been backed-up on a regular basis, constipation has become an integral part of our life.
After a while, if the episodes are not too acute, we learn to live with it and even ignore it. We may convince ourselves that "everyone is constipated from time to time". We seek reassurance that we are not alone. We don't have the choice anyway, do we? We learn to live with it, or we get depressed over it and even more enslaved to the condition.
First of all, you are right: we created this website because you, we are not alone. As a community, we can share information, comfort each other, and find a way out of this.
Second, we should’nt learn to live with constipation. We should’nt accept it. Because it can cause unpleasant repercussions in the long run. The purpose of this page is to go through those main complications together.
The rest of this website will be dedicated to creating your own remedies, your own toolkit to rid yourself of constipation. But baby steps are required.Knowledge comes first. We are laying the foundations. Later, we will start building the house.
So let's look at the main complications of constipation. This is an introductory article, each complication will be covered in detail in separate pages.
Hemorrhoids are the most common yet one of the most feared complications of constipation.
Hemorrhoids are swollen and inflamed vascular structures of the anus. We are using the term "vascular structures" and not simply "veins" here. As we will see in a separate article, they differ slightly in nature and have a very specific role in the anus function.
Hemorrhoids can be internal to the anus, or external (in which case they can be seen and touched). They can sometimes develop unnoticed. They almost always become painful, swollen, throbbing, irritated, itchy and bleeding.
A 1990 study on the prevalence of hemorrhoids and chronic constipation states that 4.4% of the general population suffers from hemorrhoids(1). Among the constipated population, the percentage is evidently much higher. Such a common complication of constipation indeed deserves its own page on this website.
To find out how to treat this condition, click on the following link :
Fecal impaction (also spelled faecal impaction) is a real problem in constipated children. See "psychological blockage" section below. It is not very common in the young adult sufferer, but increases significantly with age and greatly hinders the quality of life of the older population. If and when it happens to you, you should be prepared to deal with this situation.
Let us not forget one of the key roles of the colon: to dehydrate food residues in order to reclaim precious water and minerals. If this stool matter is not evacuated, it will become drier and drier. At some point, a hard, immovable plug may form in the colon. This is faecal (or fecal) impaction.
As we will see on the page dedicated to fecal impaction, this condition brings its own sets of symptoms, some unexpected (liquid stool evacuation – we will explain why).
Fecal incontinence (also spelled faecal incontinence) is a very embarrassing condition. It is, in my opinion, one of the most humiliating complications of constipation. It happens when we lose the ability to control our bowel muscles. The last part of the colon, the anus in particular, is not tonic enough to keep the stools and gases inside.
This leads to involuntary passage of fecal material. This can range from sporadic leakage of a small amount of feces or gas, to the passage of a complete bowel movement.
The main cause is of course chronic constipation, and the continuous stretching of the anal muscles, leading to a loss of tension and tonicity. We will dedicate a separate page to this trying situation.
Most of the time, rectal bleeding is one of the innocuous complications of constipation. Hard and dry feces have a tendency to cut into our colon and anal mucosa, creating small tears that can bleed on and off. This can be accompanied by throbbing pain (the tear being tender and inflamed).
Rectal bleeding can also hide a more serious condition. Do not worry yourself too much at this stage if you see occasional bleeding on your toilet paper. For us chronically constipated, it is part of our condition. But please do read the page going through constipation and bleeding, just to make sure you have your bases covered.
Complications of constipation can be of a psychological nature. This happens frequently in constipated children. After having gone through several painful bouts, the fear created by the expectation of another painful defecation can create a withholding issue.
The blockage is psychological, as there is nothing physiological preventing the progression of stools within the colon (as opposed to a case of real colon anatomical blockage).
As adults, we can clench out teeth and go through the motions one more time. Not so for children. If they have suffered several times while on the potty, they will want to withhold forever. This, if left untreated, may lead to fecal impaction.
A study done in the 90’s on a group of children presenting difficulty of defecation found a large proportion of faecal impaction(2). The study divided the kids into two groups.
For the first group, including children younger than 36 months:
For the second group, including children older than 36 months :
This condition is so widespread that it is fully addressed on the toddler constipation page.
When a child suffered from constipation and painful defecation for a while, she may develop a condition called encopresis.
Encopresis is the combination of uncontrolled soiling with constipation (sometimes with fecal impaction) and fear of going to the toilet.
To read more about this condition, please go to the encopresis article.
(1) Johanson JF, Sonnenberg A. "The prevalence of hemorrhoids and chronic constipation. An epidemiologic study". Gastroenterology. 1990;98:380–386.
(2) Partin JC, Hamill SK, Fischel JE, Partin JS. "Painful defecation and fecal soiling in children". Pediatrics 1992; 89: 1007-9.