Overview

Occasional constipation is quite common. Some individuals experience chronic constipation that interferes with their ability to go about their daily tasks. It may also cause people to strain excessively to have a bowel movement.

Treatment for chronic constipation depends on the underlying cause. However, there are some cases where a cause is never found.

Although constipation is usually not serious, you will feel much better when your body goes back on track.

The frequency of bowel movements varies from person to person. Some individuals have bowel movements three times a day. Others have them just a few times a week.

Going longer than 3 or more days without a bowel movement is tough. After 3 days, your poop gets harder and very difficult to pass.

Symptoms of constipation

The following are the common symptoms of constipation:

• Few bowel movements
• Hard or small stools
• Trouble having a bowel movement
• Belly bloating
• A sense that everything did not come out.
• Feeling as though there is a blockage in your rectum that prevents bowel movement

There could also be the feeling that you need help to empty your bowels, such as using a finger to remove stool from your bottom or pressing your belly.

Causes

The main job of the colon is the absorption of water from residual food that passes through the digestive system. It then creates a stool.

The muscles of the colon eventually propel the waste out through the rectum for elimination. If stool remains in the colon too long, it becomes hard and difficult to pass.

Poor diet is usually the cause of constipation. Adequate water and dietary fiber intake are essential in keeping stools soft.

Fiber-rich foods typically come from plants. Fibers come in soluble and insoluble forms. The soluble fiber dissolves in water and creates a soft, gel-like material as it passes through the digestive system. Insoluble fiber retains most of its structure as it goes through the digestive system. Both types of fiber combine with stool, increasing its size and weight while also softening it. This makes it easier to pass through the rectum.

Several factors such as stress, changes in routine, and conditions that tend to slow the contraction of muscles of the colon or delay the urge to move bowel that may lead to constipation.

Common causes of constipation include:

• Dehydration
• A low-fiber diet, such as diets that are high in meat, cheese or milk
• Lack of exercise
• Travel or other changes in routine
• Delaying the urge to have a bowel movement
• Certain medications, such as diuretics pain medications and high calcium antacids
• Pregnancy

Underlying medical problems

Some underlying medical problems can bring on constipation, such as:

• Certain diseases, such as diabetes, Parkinson’s disease, and stroke
• Overuse or misuse of laxatives
• Problems with the rectum or colon, including irritable bowel syndrome, intestinal obstruction, or diverticulosis
• Hormonal problems, including an underactive thyroid gland.

Signs of constipation

Every person has a different definition of normal bowel movement. Some individuals go three times a day, while others go three times a week.

You may be constipated if you experience the following symptoms:

• Passing dry, hard stools
• Fewer than three bowel movements a week
• A feeling of fullness, even after having a bowel movement
• Straining or pain during bowel movements
• Experiencing a rectal blockage

Diagnosis and Treatment

Many people who are constipated often attempt to self-treat by increasing exercise, changing their diets, or using over-the-counter laxatives.

Laxatives, however, should not be used for more than two weeks without consulting a doctor. Your body can become dependent on them for colon function.

You should talk to your doctor if:

• Your constipation lasted more than three weeks
• You have abdominal pain
• You have blood in your stool
• You are losing weight
• You have sudden changes in your bowel movement

Your doctor will ask you questions about your symptoms, medical history, and any medications or underlying conditions. A physical examination may include a rectal exam and blood tests to check your electrolytes, blood count, and thyroid function.

In severe cases, additional tests may be required to identify the cause of your symptoms. Tests may include the following:

1.  Marker study

Also known as a colorectal transit study, the marker study is used to test the movement of food through your colon. For the test, you will be asked to swallow a pill that contains tiny markets that show up on an X-ray. 

Several abdominal X-rays will be taken over the next few days to let the doctor view how the food is moving through your colon and how well your intestinal muscles are working. During the test, you may also be asked to eat a high-fiber diet.

2.  Anorectal manometry

It is a test to evaluate anal sphincter muscle function. To carry out this test, your doctor will have to insert a thin tube with a small balloon tip into your anus.

When the thin tube gets inside, the doctor inflates the balloon and carefully pull it out. The test will allow the doctor to measure the strength of your anal sphincter and check if your muscles contract properly.

3.  Barium enema X-ray

It is a type of test used in the examination of the colon. To carry out this test, you will have to drink a special liquid the night before the test to clean out the bowel.

The test involves the insertion of a dye called barium into your rectum, using the lubricated tube. The dye highlights the colon and rectum area, letting the doctor get a better view of them on an X-ray.

4.  Colonoscopy

It is another type of test used by doctors to examine the colon. In this test, the doctor will conduct an examination of your colon using a tube that is outfitted with a light source and a camera.

A sedative and pain medication is often administered, so you will hardly remember the examination and should feel no pain.

To prepare for the test, you will have to be on a liquid- diet for 1 or 3 days, and you may be asked to take an enema or a laxative the night before the test to clean out the bowel.

Treatment and prevention of constipation

Changing to a healthy diet and increasing your physical activity level are the best and fastest ways of treating and preventing constipation. You can try the following:

• Drink 1.5 to 2 quarts of decaffeinated, unsweetened fluids, such as water, to hydrate the body every day.
• Limit your consumption of caffeinated and alcoholic drinks, which cause dehydration.
• Cut down of low-fiber foods, such as milk, meat, cheese, and processed foods.
• Add fiber-rich foods to your diet, such as vegetables and raw fruits, bean, whole grains, prunes, or bran cereal. You should consume daily between 20 and 35 grams of fiber.
• Aim to exercise moderately for about 150 minutes each week, which is about 30 minutes per day for five days a week.
• If you feel the urge to move your bowel, do not delay it. The longer you wait, the harder your stool will become.
• If needed, have fiber supplements added to your diet. Remember to drink plenty of fluids because they help fiber work more efficiently.
• Use laxatives very sparingly. Doctors typically prescribe laxatives or enemas for a short period to help soften your stools. Do not use laxatives for more than 2 weeks without discussing it with your doctor. Your colon function can be dependent on the laxatives.
• Add probiotics to your diet, such as those from yogurt and kefir. Probiotics can be helpful for chronic constipation.

If you still have problems with constipation, your doctor may prescribe medication to help you move your bowels.

Your doctor may also advise you to stop taking certain medications that may cause constipation. 

Risks of Having Constipation

Eating a poor diet and lack of exercise are major risk factors for constipation. You may also be at great risk of constipation if you are:

• Age 65 or older. Older adults are typically physically inactive, have underlying conditions, and eat poorer diets.
• A woman or a child. Women are prone to have frequent episodes of constipation than men. Children are more affected with constipation more than adults.
• Confined to bed. People with certain medical conditions, like spinal cord injuries, often find it difficult to move their bowel.
• Pregnant. Pregnant women have hormonal changes and experience pressure on their intestines from the growing baby, often leading to constipation.

When to Seek Medical Attention

See your doctor immediately if you have sudden constipation with abdominal pain or cramping and you are unable to poop or pass gas at all.

See your doctor if:

• Constipation is a new problem for you and changing your lifestyle has not helped.
• You have blood in your stool.
• You are losing weight even if you are not trying to.
• Your bowel movement comes with severe pain.
• You are constipated for more than two weeks.
• The consistency, size, and shape of your stool have dramatically changed.

Your doctor may order some tests to determine the cause of your constipation, such as:

• Blood tests to check your hormone levels
• Tests that will check the muscles in your anus
• Colonoscopy to find blockages in your colon
• Tests showing the movement of waste through and out of your colon

Table of Medications

• docusate
• Colace
• MiraLAX
• Dulcolax
• Linzess
• polyethylene glycol 3350
• bisacodyl
• Amitiza
• Metamucil
• Milk of Magnesia