Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer.
Constipation is generally described as having fewer than three bowel movements a week.
Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. Chronic constipation may also cause excessive straining to have a bowel movement and other signs and symptoms.
Treatment for chronic constipation depends on the underlying cause. Though, in some cases, a cause for chronic constipation is never found.
Causes- Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing it to become hard and dry. Chronic constipation has many causes:
Blockages in the colon or rectum
Blockages in the colon or rectum may slow or stop stool movement. Causes include:
·         Anal fissure
·         Bowel obstruction
·         Colon cancer
·         Narrowing of the colon (bowel stricture)
·         Other abdominal cancer that presses on the colon
·         Rectal cancer
·         Rectocele
Problems with the nerves around the colon and rectum
Neurological problems can affect the nerves that cause muscles in the colon and rectum to contract and move stool through the intestines. Causes include:
·         Autonomic neuropathy
·         Multiple sclerosis
·         Parkinson's disease
·         Spinal cord injury
·         Stroke
Difficulty with the muscles involved in elimination
Problems with the pelvic muscles involved in having a bowel movement may cause chronic constipation. These problems may include:
·         Inability to relax the pelvic muscles to allow for a bowel movement (anismus)
·         Pelvic muscles don't coordinate relaxation and contraction correctly (dyssynergia)
·         Weakened pelvic muscles
Conditions that affect hormones in the body
Hormones help balance fluids in your body. Diseases and conditions that upset the balance of hormones may lead to constipation, including:
·         Diabetes
·         Overactive parathyroid gland (hyperparathyroidism)
·         Pregnancy
·         Underactive thyroid (hypothyroidism)
Symptoms-- Signs and symptoms of chronic constipation include:
·         Passing fewer than three stools a week
·         Having lumpy or hard stools
·         Straining to have bowel movements
·         Feeling as though there's a blockage in your rectum that prevents bowel movements
·         Feeling as though you can't completely empty the stool from your rectum
·         Needing help to empty your rectum, such as using your hands to press on your abdomen and using a finger to remove stool from your rectum
Constipation may be considered chronic if you've experienced two or more of these symptoms for the last three months.
ALUMINA 30—Alumina is an effective remedy for constipation when there is absence of urge  for stool. The person needing Alumina has no desire to pass stool for days together until a  large accumulation collects in the intestine. The intestines are highly sluggish and inactive. Stool whether hard, dry or soft needs much straining for it to find its way out. In constipation of bottle fed babies and infants  Alumina, a best choice of medication.

NUX VOMICA 30—Nux vomica is one of the top medicines for constipation when frequent , ineffectual urging to stool is present.   In every attempt, the stool passed is scanty and there is a feeling of incomplete evacuation. Shortly after passing the stool, the urge gets renewed.  In Cases of constipation from abuse of laxatives  Nux Vomica to be extremely useful. It can also be used in cases where piles develop in association with constipation. Nux Vomica is highly suitable to persons with constipation who have sedentary habits and are not in a habit of regular exercise.

BRYONIA ALBA 30-Bryonia is very effective for constipation  when stool is highly dry, large and excessively hard. Bryonia Alba is mainly indicated for all the conditions where mucous membranes are dry to the utmost degree. Along with constipation, abdomen may appear distended and sore to touch. An increased thirst for large quantities of water with dry mouth and lips may accompany. Along with constipation gastric headache of bursting nature may also appear .

OPIUM 200- Opium is best suited for those cases of constipation where stool is passed as round, hard, black balls like sheep dung. Stool gets retained in intestines for long without having any desire for defecation. Abdomen seems hard and bloated with constipation. Opium is also highly ranked homeopathic remedy for constipation which occurs after the abuse of enemas

SILICEA 200-Silicea is another effective remedy  in constipation with painful constriction of anal sphincter. Stool is passed down the rectum with great straining efforts but due to spasmodic constriction of anal sphincter it recedes back . Stool slips back into the rectum after being partly expelled as anus closes upon passing stool. Rectum is also very weak and seems paralyzed. Stool remains in the rectum for a long time. Obstructed flatus is present along with constipation and the abdomen feels tight, bloated, hard and distended.  Silicea offers great help in females who suffer from constipation before and during menses.

 CASCARA SAGRADA Q- It is a specific remedy for constipation. Chronic indigestion . Constipation with piles.It is an intestinal tonic and helps remove dyspepsia.

CALCAREA CARB. 30- Calcarea carb is a prominent remedy for constipation in children. For it to be indicated the first part of stool is hard followed by soft stool ,which too, is passed with great difficulty. Aversion to milk is often present in children needing Calcarea carb. They may also show  desire for indigestible things like chalk, lime and pencil .

SANICULA 30- Sanicula is indicated when a child passes variable stool with different character. Sometimes stool is large and painful, while at other times stool crumbles at verge of anus and at times stool recedes after being partly expelled. In addition to this many a times stool is passed in small, hard balls and even needs to be mechanical removed.

CHAMOMILLA 30- Chamomilla is a much needed remedy for constipation in children who are irritable, headstrong and obstinate to the utmost degree.

MAGNESIA MUR. 30-Magnesia mur. is effective for constipation of infants during dentition. Passes only a small quantity of stool like sheep’s dung.

SEPIA 30-Sepia is an effective remedy for constipation in pregnancy.  Sepia provides much help when stool is very hard and the need arises for it to be mechanically removed. Constant bearing down in uterus often accompanies constipation for women needing Sepia.

CAUSTICUM 30—Causticum is another remedy for constipation with piles.  Causticum when large piles are present and they obstructs the passage of stool through rectum.

HYDRASTIS CAN. Q-Hydrastis considered a specific remedy for constipation. Stools are felt in small intestine but do not come down to the large intestines and anus. Constipation with sinking feeling in the stomach and dull headache. Enemas and glycerine plugs are useless and do not relieve constipation in this case.

 COLLINSONIA CAN. 30-Collinsonia is effective for constipation during pregnancy. Collinsonia can be used for obstinate constipation- hard, dry, knotty stool -with piles.

NITRIC ACID 30-Nitric acid is indicated when anal fissure occurs with constipated bowels. It is accompanied with much burning and pain . There is bleeding from rectum

NATRUM MURIATICUM 30-Natrum mur. is used when fissures are present along with constipation.Natrum Mur is used when smarting, tearing and stitching pain at anus is present in the fissure due to constipation. There is unsatisfactory stool. The nature of the stool is like sheep dung.

PHOSPHORUS 30-Phosphorus another effective remedy for constipation . Stool is long and dry like that of a dog. There is bright red blood passes along with stool.

PODOPHYLLYUM PEL. 30- Podophyllum is very effective for constipation in children. It is prescribed when constipation alternates with diarrhoea and colic is present.

PLUMBUM METALLICUM 30-Plumbum met . is effective for traveller’s constipation who are often change food, water and places.

SULPHUR 200-Sulphur is prescribed when constipation occurs on account of fear of passing the stool because stool is hard, knotty and difficulty to expel, they cause pain in the anus while passing.

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