Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. If there is a severe constipation not relieved by traditional laxatives available at your pharmacy and there is severe pain it could be a case of Intestinal Obstruction. This is more likely if gas build up is present and there is significant swelling of your abdomen. It could be due to multiple causes for example- a herniated bowel loop (intestine is pushed through the abdominal wall and become constricted). If there severe pain, it could be due to cutting off of blood supply due to the strangulation of bowel loop (emergency scenario- immediately report to your nearest hospital if severe abdominal pain or fever). Chronic constipation could also be due to Inflammatory Bowel Disease, as well as due to hypothyroidism (if you started noticing any weight gain, a throat swelling, lethargy, avoiding cold temperatures, dryness of skin). It could also be due to diabetes (get your blood sugars tested as part of routine evaluation should be done as well). My recommendation is to go consult a gastroenterologist who will evaluate your condition possibly with the help of an endoscopy or an ultrasound. I hope I have answered your query. Let me know if you have any further questions. Regards, Dr. Ankit Gopinath