Digestive & Bowel Health

Understanding Constipation

Constipation refers to infrequent or difficult bowel movements, often accompanied by straining, hard stools, or a feeling of incomplete emptying. It is a very common complaint and is usually benign, but persistent or worsening constipation can sometimes signal an underlying condition that needs specialist assessment.

Common Causes of Constipation

Constipation can result from a wide range of factors, including:

  • Low dietary fibre or fluid intake
  • A sedentary lifestyle
  • Certain medications
  • Irritable bowel syndrome or hormonal conditions such as an underactive thyroid
  • Pelvic floor dysfunction, which can make it difficult to fully empty the bowel
  • Painful anorectal conditions such as an anal fissure, which may cause avoidance of bowel movements
  • Less commonly, structural narrowing or growths within the colon

When to See a Specialist

Most cases of constipation improve with simple dietary and lifestyle changes. However, you should seek specialist assessment if constipation:

  • Persists for several weeks despite dietary changes
  • Is accompanied by rectal bleeding or blood in the stool
  • Is associated with unexplained weight loss
  • Represents a new or sudden change in your normal bowel habit, particularly after age 45–50
  • Occurs alongside a family history of colorectal cancer or polyps

These features may warrant further investigation such as a colonoscopy or colorectal cancer screening.

How Dr Chamisa Can Help

Dr Chamisa provides a thorough clinical assessment of chronic constipation in Pretoria, taking a detailed history and examination to help identify contributing factors. Where an anorectal cause is suspected — such as an anal fissure or pelvic floor dysfunction — a pelvic floor assessment may be recommended. Where a colorectal cause needs to be excluded, a colonoscopy can be performed to examine the bowel directly.