Difficulty in evacuating feces is a rather common disorder, it can be episodic or represent a permanent condition. Professor Silvio Danese, Head of the Centre for Intestinal Chronic Diseases in Humanitas, spoke of acute and chronic constipation and the causes responsible for these two forms in an interview with Corriere della Sera; prof. Danese also provided some advice to try to counter constipation.

The simple fact of not evacuating every day does not mean suffering from constipation, as long as this happens effortlessly and with soft stools “, prof. Danese points out. Generally speaking, constipation is defined as the presence of less than three evacuations per week, usually associated with stress during defecation, hard stools or an incomplete feeling of evacuation.


Causes of acute constipation

A distinction must be made between acute and chronic constipation. A sudden change in intestinal regularity can more easily address a cause, e.g. the initiation of therapy with medications that can aid the problem, such as antidepressants, antihypertensives or iron supplements. Moreover, a sudden constipation with less frequency could be the result of a structural change in the intestine as a result of stenosis, i.e. a post-inflammatory narrowing, which can even lead to occlusion,” explains Professor Danese.


Causes of chronic constipation

Conversely, the identification of the possible causes in the chronic form is more articulated and only a careful analysis of the patient’s history can put you on the right track. In some cases, chronic constipation is associated with reduced colon motility or dysfunction of pelvic floor muscles involved in evacuating feces. Other times at the base of everything there are misguided eating habits, in particular reduced fiber consumption. Fibers, especially insoluble ones, determine the normal intestinal peristaltic conditions, thus favoring the progression of the fecal mass and its subsequent expulsion.

Chronic constipation can also be a consequence of ill-considered use of laxatives, numerous diseases associated with slowing down gastrointestinal motility (hypothyroidism, Parkinson’s disease, systemic lupus erythematosus), as well as tumors of the colon and other abdominal organs that mechanically compress the intestine,” continues prof. Danish.


Advice against constipation

It is advisable to change eating habits, increasing the introduction of fiber into the diet by up to 20-35 grams per day. Drinking a lot is just as important: fluids help to soften the feces and thus facilitate their evacuation. When these measures are not sufficient, mass-forming laxatives such as psyllium or methylcellulose may be used. Other laxatives, which may provide benefit are those of the osmotic type, such as preparations based on polyethylene glycol. A number of new medicines have also recently been put on the market, such as lymphalopride and prucalopride, but they must be taken under strict medical supervision. The former acts by promoting the secretion of water and chlorine ions inside the colon, the latter stimulates intestinal peristalsis, when it is absent or insufficient,” concludes Professor Danese.