Complications Of Constipation - Constipation: Digestive Disorders

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Complications of constipation

Most cases of constipation can be treated successfully, but sometimes constipation leads to physiological complications.

Straining to have a bowel movement can cause hemorrhoids — dilated vascular "cushions" of swollen tissue at the anus or just within the rectum. They can bleed or cause severe discomfort. Anal fissures (tears in the skin around the anus) can occur when hard stool stretches the sphincter muscle; this may cause rectal bleeding.

Treatment of hemorrhoids may include warm "sitz" baths (sitting in warm water in the bathtub for 20 minutes), ice packs, and ointment applied to the affected area. Using stool softeners and fiber supplements is helpful. Band ligation, in which a physician ties tiny rubber bands to the base of internal hemorrhoids to cut off their circulation, may be necessary if there is frequent and excessive bleeding. In some situations, surgery may be needed.

Anal fissures are treated by topical medications such as nitroglycerin or injection of botulinum toxin to relax the sphincter muscle. Occasionally, it may be necessary to stretch the sphincter muscle or surgically remove tissue or skin in the affected area.

Straining can cause a tiny bit of the lining of the intestine to push out from the anus, a condition known as rectal prolapse. Usually, simply stopping the straining will improve the condition. If not, surgery may be necessary to strengthen and tighten the anal sphincter muscle or to repair the prolapsed lining.

Severe constipation may also cause the hard stool to pack the intestine and rectum so tightly that it cannot be expelled, no matter what treatment is tried. Some patients experience diarrhea or incontinence because liquid leaks around the hard stool. This condition, called fecal impaction, usually requires that the stool be softened by an enema. Even then, the doctor may have to remove the impacted stool manually.

Last updated:	August 21, 2007