You may have constipation if you have difficulty having a bowel movement or don't go regularly. This happens when stool moves slowly through your digestive system, causing it to become hard and dry.
Bowel movement frequency varies from person to person. Constipation is usually defined as going fewer than three times a week or having hard stools. This can be the result of too few fluids in your diet or a lack of fiber.
You can usually relieve constipation by eating a higher fiber diet, drinking extra fluids, being more active, or taking a laxative or stool softener.
Constipation is common – and more common in women and children.
You are at risk for constipation if you:
- Are older
- Aren't active
- Eat a low fiber diet
- Don't drink enough water or other fluids
- Take medications including some blood pressure drugs, narcotics or sedatives
- Are pregnant
- Are confined to your bed
- Are having chemotherapy
- Have a spinal cord injury
- Have a bowel obstruction
- Have an autoimmune disease
- Have colorectal cancer
Symptoms of constipation include:
- Hard stools
- Fewer than three bowel movements a week
- Straining during bowel movements
- Feeling like you haven't emptied your bowels after a bowel movement
- Feeling like something is blocked
Usually, constipation isn't serious. If you can't get relief on your own, have symptoms that happen frequently or are worried about your symptoms, see your doctor.
If you notice blood in your stools, have thin pencil-like stools, have severe abdominal or rectal pain, lose weight without trying, or have constipation and diarrhea alternately, see your doctor. These can be signs of another medical condition.
You have an examination and testing to make sure you don't have an intestinal blockage or another condition that causes constipation. Depending on your doctor's findings, you may have:
- Sigmoidoscopy to examine your lower colon and rectum. Your doctor inserts a flexible tube in your anus and views pictures on a monitor to see inside your digestive system.
- Colonoscopy to examine your colon. Your doctor inserts a flexible tube in your anus and views pictures on a monitor to see inside you.
- X-rays of your ano-rectal area. Your doctor fills your rectum with a paste and takes X-rays as it exits your body. This test measures how well your body is eliminating waste.
- Barium enema X-ray. Your doctor gives you an enema to coat the lining of your bowls with a dye (barium), which helps show your rectum, colon and part of your intestine on X-rays.
- Ano-rectal manometry to check how well your muscles are working to produce bowel movements. Your doctor inserts a flexible tube in your anus for this test.
- Colorectal transit study to check how well food moves through your colon. You swallow a capsule with markers that show up on X-rays taken over a few days as the capsule moves through your digestive system.
Most cases of constipation are relieved without extensive testing.
You usually don't need medical treatment for constipation. Your doctor can recommend steps to take to relieve your discomfort and get your bowels moving, including changing your diet and activity.
Lifestyle changes can include:
- Eating a diet high in fiber (20 to 35 grams of fiber per day) including whole grains, vegetables and fruits
- Avoiding nonfibrous foods such as processed foods, meat and cheese
- Being active to stimulate your bowels
- Drinking plenty of water and other fluids
- Using the bathroom when you feel the urge; don't wait
When lifestyle changes don't help to relieve your constipation, consider over-the-counter products:
- Fiber supplements to add fiber to your system; drink plenty of water with these
- Stimulant laxatives to make your bowels move; don't rely on these for regular bowel movements
- Stool softeners to soften and loosen your stools
- Saline laxatives to draw fluid into your colon and make stool pass more easily
- Lubricants and osmotics to make your stool move more easily
If lifestyle changes and over-the-counter products don't relieve your constipation, your doctor may prescribe a medication that increases the fluid in your stool (chloride channel activator).
Your doctor can perform a manual maneuver to relieve constipation. This involves inserting a finger into your anus and breaking up the stool. This is followed by an enema.
Rarely, you might need surgery to remove part of your colon that is causing constipation.
Our gastroenterology specialists are experienced in treating every colorectal condition, including constipation.
How to Prevent Constipation
- Eat a diet high in fiber including vegetables, fruits, whole grains and beans
- Be active to get your intestines moving
- Avoid foods low in fiber including processed foods, cheese and ice cream
- Drink enough liquids, especially water, and limit caffeine
- Try over-the-counter fiber supplements and drink lots of water with them
- Use the bathroom when you feel the urge
- Avoid regular use of laxatives so that your body doesn't become dependent on them