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Chronic constipation

Obstipatio chronica · Chronická zácpa

What it is

Slow transit, hard stool or a pelvic floor that will not relax.

Symptoms & signs

  • Fewer than three stools a week
  • straining
  • hard lumpy stool
  • incomplete emptying
  • bloating

🚩 Get help if…

  • call 112 / 911 now Swollen belly, vomiting and no stool or wind
  • see a doctor soon Blood in the stool or black stools
  • see a doctor soon New constipation after 50 or weight loss
  • see a doctor soon Leaking watery stool around a hard blockage

Where it strikes

Medical treatment

  • Osmotic laxative (macrogol)
  • stimulant as rescue
  • linaclotide or prucalopride
  • biofeedback for pelvic floor dyssynergia
  • vibrating capsule (Vibrant) — FDA-cleared 2022 for chronic constipation

Natural & lifestyle

  • Fibre to 25–30 g slowly
  • 2 L fluid
  • kiwifruit or prunes (proven)
  • exercise
  • toilet routine after breakfast
  • footstool for squat posture

Emerging & experimental

  • Sacral neuromodulation

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Magnesium oxide — an effective laxative in trials trials support
  • Probiotics (Bifidobacterium lactis) — faster transit in trials mixed evidence
  • Abdominal massage — small trials help mixed evidence
  • Coffee enemas — popular in detox circles; no evidence, and a risk of burns and salt imbalance anecdotal / traditional

ICD codes