Sorting out Chronic Constipation

For those who have felt the effects of constipation for a large part of their lives knowing the type of constipation they have will help find a long-term solution.

There are primary (also called functional constipation) and secondary types of constipation. Primary constipation is due to a problem with the bowel resulting from nerve and muscle dysfunction in the bowel. An example of this is pelvic floor dyssynergia where there , at bowel action time, there is an abnormal increase of pelvic floor muscle activity  rather than the normal decrease necessary for a normal bowel movement. Other types of primary constipation and called normal-transit and slow-transit constipation where nerve and muscle dysfunction causes the changes in the movement of bowel contents.


Secondary constipation results because of something else happening in the body such as constipation dominant Irritable bowel syndrome or hypothyroidism for example. It can also be due to use of medications to treat medical conditions that have a side-effect that alters bowel habits.

Just to make things difficult there is significant overlap between the sub-types so a mixture of solutions may be needed!

Depending on the type there are different treatment options including:

  • Medications to alter bowel nerve and muscle function
  • Increasing fluid intake
  • Increasing dietary fibre to reach fibre target goals
  • Using some non-fermentable commercial fibre supplementation
  • Non-stimulant laxative use – stool softeners and stool lubricants
  • Stimulant laxatives
  • lowering the intake of FODMAP-rich foods in the diet

Making the changes recommended to you by your Gastroenterologist or Accredited Practising Dietitian day in and day out will give long-term improvements to bowel function and improve quality of life.

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