Constipation is defined as having three or fewer bowel movements per week. When waste moves too slowly through the digestive tract or won’t vacate the rectum, causing it to become dry and hard, constipation can result. When constipation occurs, bowel movements become more difficult and less frequent.
It’s a common condition across all age groups, affecting 16 of 100 adults and one-third of those ages 60 and older.
The causes of constipation are wide ranging. Sometimes it is a side effect of medications, including narcotics and antidepressants. It could be a symptom of a condition, such as pelvic floor dysfunction, pregnancy, or irritable bowel syndrome with constipation. Frequently, constipation is simply the result of lifestyle behaviors that are easy to change.
Occasional constipation is normal, especially among pregnant women and those who have undergone changes in activity (such as travel). When constipation becomes chronic, or lasts a few months, the signs may include:
- Making fewer bowel movements, and then straining to go.
- Hard and/or small stools.
- Feeling as if the bowel won’t fully vacate (incomplete movements).
The general rule of thumb for detecting constipation is going three days or more without a bowel movement. If the constipation is sudden and the patient is unable to even pass gas and experiences pain and cramping, call a doctor. Tests for diagnosing the underlying cause may include:
- Blood, urine, or stool exams – These samples would be analyzed for underlying conditions including infections, inflammation, diabetes, and colorectal cancer.
- Imaging tests– X-rays may be taken to reveal potential blockages and stool throughout the colon.
- Sigmoidoscopy – This test seeks blockages in the last two feet of the colon using a camera-equipped, flexible tube (sigmoidoscope) that is inserted through the anus.
- Colonoscopy– The gastroenterologist examines the entire colon using a tiny camera. Click here for prep instructions.
- Anorectal manometry– Used to measure the anal sphincter muscles, sensation, and neural reflexes that contribute to having a normal bowel movement.
- Colonic transit study – Used to detect slowed emptying of the colon or difficulty at the rectum.
Remedying constipation requires increasing the speed in which waste is digested. Usually, home remedies will do the trick, including:
- Modifying the diet – Fresh vegetables, fruits, and other fiber-rich foods, accompanied by plenty of fluids, make waste heavier and faster-moving.
- Exercising more often – Physical activity strengthens the digestive muscles and should be practiced most days of the week.
- Digestive aids – Fiber supplements, digestive stimulants, stool softeners, and suppositories will soften the stool and/or help the digestive system better contract.
- Don’t ignore the urge – No one should put off the need to go.
In persistent cases of constipation, the doctor may prescribe:
- Medications – Drugs can help draw water into the intestine, move the stool, or reverse the side effects of other medications.
- Biofeedback – This therapy employs a device, inserted into the rectum, that measures how well the patient tightens and relaxes the pelvic muscles, to improve these actions.
- Surgery – Depending on the cause if the constipation, surgery may be required to remove a blockage or part of the colon.
It is important to recognize alarm signs to seek further evaluation by a gastroenterologist. If you note blood in your stools, weight loss, changes in stool caliber, or chronic symptoms, you should make an appointment.