Community medical question

Medical Case Summary (Chronic Constipation):
Duration:
More than 5 years
Onset:
Symptoms began after sinus surgery (previously normal bowel function)
Main Symptoms:
Bowel movement occurs every 3–5 days
Attempts defecation daily or every other day
Experiences urge to defecate but often unable to pass stool
Requires excessive straining
Prolonged time spent during defecation attempts
Sensation of incomplete evacuation
Stool Characteristics:
Sometimes hard and fragmented
Sometimes normal in consistency but difficult to pass
Response to Treatment:
Significant improvement with laxatives
Defecation becomes easier and requires minimal effort during use
Symptoms recur immediately after discontinuation
Associated Symptoms:
Presence of hemorrhoids (likely secondary to chronic straining)
No significant bloating or flatulence
No weight loss (although baseline weight is relatively low)
Medication History:
Intermittent use of laxatives (irregular)
Occasional use of antihistamines
Important Notes:
No alarm features (e.g., unexplained bleeding or significant weight loss)
Chronic condition with poor response to conventional management