An estimated 14% of people experiences chronic constipation. Women, older people, and those with lower socioeconomic status are at higher risk.
Chronic Idiopathic Constipation Symptoms
The primary symptoms of CIC include:
Infrequent bowel movements Straining Hard or lumpy stools Feeling of incomplete evacuation Feeling that something is blocking the stool from coming out Need to use fingers to get stool to pass (digital evacuation and vaginal splinting)
Many people who have chronic idiopathic constipation also report experiencing the following symptoms in addition to the above:
Abdominal pain or discomfort Bloating Gas pain
Diagnosis
If you have chronic constipation, your healthcare provider will work to rule out identifiable causes before deeming your case idiopathic.
They’ll most likely do a physical exam and run some bloodwork. They may also order other diagnostic tests depending on your symptoms and medical history.
FGDs are diagnosed according to the Rome IV criteria, which refer to the disorder as functional constipation. For a diagnosis of functional constipation, your diagnostic workup must not show any sign of abnormality.
These criteria attempt to quantify chronic idiopathic constipation symptoms, stating that there needs to be:
Fewer than three bowel movements per weekOther symptoms occurring at least 25% of the timeRare loose stools (unless you’ve used a laxative)
CIC vs. Irritable Bowel Syndrome
Constipation-predominant irritable bowel syndrome (IBS-C) shares many of the same symptoms as chronic idiopathic constipation. By definition, though, CIC is only diagnosed if the criteria for IBS has not been met.
The main difference between the two disorders is that the diagnostic criteria for IBS-C require that there be the experience of chronic pain associated with bowel movements. With that said, many healthcare providers will tell their patients that they have IBS if they are experiencing chronic constipation without an identifiable cause, regardless of whether pain accompanies bowel movements.
Some researchers believe the two disorders are not very distinct from each other and may just be different points on a spectrum. Many people diagnosed with chronic idiopathic constipation do have abdominal pain and discomfort, and many people switch from one diagnosis to the other over time.
One important distinction may be related to treatment, as people with IBS-C appear more likely to respond to treatments that are effective for pain relief, while those with CIC appear to respond better to treatments that target muscle function in the large intestine.
Treatment
There’s no one specific treatment for CIC, but you and your healthcare provider have a variety of treatment options to choose from, including:
Dietary fiberMedications, including laxativesBiofeedback
Dietary Fiber
Your healthcare provider may recommend that you increase your intake of dietary fiber, as fiber can help to soften stools and make them easier to pass.
You can increase your intake of dietary fiber through the foods you eat or with a fiber supplement.
Too much fiber too soon could lead to symptoms of gas and bloating, but you can avoid this by increasing intake slowly so your body has time to adjust. You may find soluble fiber easier to tolerate.
Medications
Laxative medications can provide short-term relief of constipation. There are two types:
Osmotic laxatives, which increase fluid levels in the large intestine Stimulant laxatives, which stimulate intestinal movement
Many laxatives are available over the counter. However, there’s little evidence that long-term laxative use is beneficial for CIC.
Prescription medications may provide more relief. Some common ones are:
Amitiza (lubiprostone) Linzess (linaclotide) Motegrity (prucalopride)
Biofeedback
If your healthcare provider has determined that dyssynergic defecation (pelvic floor dysfunction) is playing a role in your chronic idiopathic constipation, they may recommend that you try biofeedback. This method helps train you to tune into your body’s processes in an effort to exert some control over them.
This treatment has been shown to be helpful in improving the coordination of the muscles of the pelvic floor that are involved in the process of having a bowel movement.
A Word From Verywell
Chronic idiopathic constipation may be a diagnosis that, in a way, is a letdown to get. Knowing the exact cause of any symptoms generally gives you a more concrete path toward managing them. Nevertheless, those with CIC can find relief. Speak openly with your healthcare provider about what you are experiencing and seek additional consults if your treatment plan is not as effective as it should be.
