Types of Constipation

1. Atonic Constipation

Atonic (Gk. atonos = unaccented, without tension) constipation results from reduced muscle tone (tension) of the colon, abdominal wall or pelvic floor. Causes include:

  • Habits, like sedentary life style, irregular meals, low-fiber diet, postponing bowel movement, overuse of laxatives resulting in a lazy colon that does not react to stimuli, like eating and presence of the stool in the rectum. Affected person simply does not feel the urge to defecate even when his colon is full of stool.
  • Loose rectal muscles, mainly in old people
  • Weak pelvic floor muscles, often in women after giving birth
  • Damage of the intestinal nerves in long-term, poorly controlled diabetes or congenital disorders, like Hirschsprung’s disease.

Change of life habits, or surgery (in Hirschsprung’s disease) can help.

2. Spastic Constipation

Spastic constipation results from colonic spasms, triggered by stress, certain foods or medications, and is known as constipation-dominant irritable bowel syndrome (IBS-C). Symptoms include constipation, abdominal cramps, bloating and occasional diarrhea. Low-FODMAP diet, fighting with stress, and changing medications (if possible) may help.

Certain neurological disorders can also cause spastic constipation.

3. Obstructive Constipation

Obstructive constipation results from obstruction of the passage of stool. Causes include cystic fibrosis (in children), tumors, adhesions - scars formed in the abdomen but outside of the intestine (mostly after abdominal surgery), or strictures – scars firmed within the intestine (mostly caused by inflammation, like in Crohn’s disease), or damaged pelvic nerves (injuries, neurological diseases) that prevent relaxation of anal muscles. Surgical treatment is often needed.

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