There may be several ramifications or adverse effects related to being constipated especially over a prolonged period of time. If you have, if you can imagine if you have a large rock hard stool resting in your rectum, it may rub against the rectal wall and cause what we term a stercoral ulcer. Okay, this is because the large hard stool has actually scraped away some of the surface lining of the rectum. And that can result in pain upon defecation. it can definitely cause a patient to avoid going to the restroom and so it can make constipation worse, and it can also result in bleeding and anemia if this condition is allowed to persist over time. As far as causing pain, especially rectal pain or lower abdominal pain, yes, this can adversely affect individuals. Let’s say for example, if a patient has coronary artery disease. Okay, quite frequently when patients are admitted to a coronary care unit, they’re actually given stool softeners because you don’t want to have a patient straining when they have a bowel movement. That can put increased stress on the heart. And so, aside from diminution in appetite, fear of evacuation, there are a number of ramifications of side effects, which can be directly attributable to severe constipation.