Chronic Constipation (April, 2012)

Recognizing Constipation

Constipation is a disorder that is frequently seen in many people. Individuals with developmental disabilities often have problems with chronic constipation. This may be due to medication side effects, or neuromuscular problems related to the person's disability. Chronic constipation must be addressed in all individuals. This can often be a silent problem, especially for individuals who are independent in toileting activities. Without treatment, chronic constipation can lead to bowel obstruction, bowel perforation and death. Due to the often silent nature of this problem, staff must actively address this issue with individuals.

Individuals who have been recognized to have chronic constipation should have bowel tracking logs for staff to document bowel movements. Recognition of worsening constipation is key in order to treat the problem and maintain the health of the individual. Those individuals not known to suffer from chronic constipation should be periodically assessed to assure that they are not developing problems with constipation.

Signs of Constipation

  • include small infrequent bowel movements
  • hemorrhoids due to straining with bowel movements
  • increased abdominal girth
  • abdominal pain

Conservative Treatment Measures

Conservative measures to address constipation include increasing physical activity and ensuring adequate fluid and fiber intake. Physicians can work with individuals who do not respond to these methods to find the most appropriate regimen to maintain regular bowel movements. Staff play an important role in the recognition and treatment of individuals suffering from chronic constipation to prevent complications from developing.

When to Seek Medical Care

Sometimes an individual with severe constipation will have what is called "overflow diarrhea." This is when an individual has a large firm stool within the rectum that they are unable to pass, yet liquid stool in small amounts may pass around this. This can often be missed and confused with an episode of diarrhea. If an individual with chronic constipation develops overflow diarrhea, decreased appetite, nausea, vomiting or moderate abdominal pain, they should be evaluated promptly by a physician. These are all signs that may indicate further complications from chronic constipation.