Refractory Chronic idiopathic constipation
Refractory Chronic Idiopathic Constipation (RCIC)
Refractory Chronic Idiopathic Constipation (RCIC) is a long-term subtype of constipation that is persistent and severe. This form of constipation has a prolonged course, and is characterized by the presence of hard, dry stools, and abdominal pain. Symptoms may be exacerbated by diet, lifestyle, stress, and other factors. RCIC is a type of functional gastrointestinal disorder, and can limit an individual’s quality of life.
Causes
The exact cause of RCIC is unknown. Some research suggests structural or neurological abnormalities in the submucosal plexus, myenteric plexus, or pelvic muscles, as potential causes for RCIC. An individual’s diet low in fiber, and a sedentary lifestyle, may worsen symptoms of RCIC. Other contributing factors include metabolic and endocrine disruptions, as well as:
- Smoking
- Use of laxatives
- Less fluid intake
- Prescription medications, such as opioids, antidepressants, and anticonvulsants
- Stress
- Irritable Bowel Syndrome (IBS)
Symptoms
Common symptoms of RCIC include:
- Infrequent and small stools
- Difficulty passing stools (straining)
- Hard, dry stools
- Incomplete evacuation
- Excessive gas
- Abdominal pain
- Nausea
- Bloating
Diagnosis
RCIC is diagnosed through a physical examination and review of the individual’s medical history. The medical provider may use diagnostic tests to help rule out other medical conditions. These include X-rays, lactose breath tests, and stool tests. The medical provider may also use psychological questioning to assess the individual’s state of mind.
Treatment
Treatment of RCIC includes:
- Adopting a healthy lifestyle, such as eating a balanced diet, exercising, and learning how to manage stress.
- Intake of probiotics, laxatives, and fiber supplements
- Prescription medications, such as laxatives, osmotic agents, and opioid receptor antagonists.
- Biofeedback therapy
- Surgery to remove blockages in the intestines.
In some cases, individual may learn techniques to reduce the strain when passing stools. These techniques include relaxation techniques to reduce abdominal discomfort.
Outlook
With proper treatment, many individuals with RCIC experience symptom relief. If symptoms last more than 6 weeks, the individual should see a healthcare provider for evaluation and treatment. In some cases, surgery may be required. Long-term lifestyle changes may also be required to help manage symptoms.
