What Is Constipation?
According to the National
Institute of Diabetes and Digestive and Kidney Diseases, constipation is
one of the most common digestive problems in the U.S. More than four million
Americans every year complain of frequent constipation. Frequent constipation
is commonly defined as having bowel movements fewer than three times a week and
with hard, dry stools.
What Causes Constipation?
Your colonâs job is to absorb water
and salt from food as itâs passing through your digestive system. It then
creates stool (waste). The colonâs muscles eventually propel the waste out
through the rectum to be eliminated. If stools remain in the colon too long, it
can become hard and difficult to pass.
Poor diet frequently causes
constipation. Dietary fiber and adequate water intake are necessary to help
keep stools soft. Fiber-rich foods are generally made from plants, and there
are plant components that your body is not able to digest. Fiber comes in
soluble and insoluble forms. The soluble fiber can dissolve 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
Fiber is very helpful in easing
constipation. Both forms of the fiber join with the dry, hard stools, increasing
their weight and size while also softening the stools. This makes it easier for
them to pass through the rectum.
Changes in routine, stress, and
other conditions that slow muscle contractions of the colon or delay your urge
to go may also lead to constipation.
Common Constipation Causes
Some common causes of constipation include:
low-fiber diet (particularly diets high in meat, milk,
lack of exercise
delaying the impulse to have a bowel movement
travel or other changes in routine
certain medications, such as antacids and pain
Underlying Medical Problems That Can Cause Constipation
The following are some underlying
medical problems that can bring about constipation:
certain diseases, such as stroke, Parkinsonâs disease,
diabetes, and lupus
problems with the colon or rectum, including intestinal
obstruction, irritable bowel syndrome, or diverticulosis
overuse or misuse of laxatives (medications to loosen
hormonal problems, including an underactive thyroid
anal fissures (tears) or hemorrhoids
What Are the Symptoms of Constipation?
Every personâs definition of ânormalâ
bowel movements may be different. Some individuals go three times a day, while
others go three times a week. However, you may be constipated if you experience
the following symptoms:
fewer than three bowel movements a week
passing hard, dry stools
straining or pain during bowel movements
a feeling of fullness, even after having a bowel
experiencing a rectal blockage
Who Is At Risk for Constipation?
Eating a poor diet and not
exercising are major risk factors for constipation. However, you may be at
greater risk if you are:
65 or older.
Older adults tend to be less physically active, may have underlying
diseases, and may eat poorer diets that lead to constipation.
confined to bed.
Those who have certain medical conditions, such as spinal cord injuries,
often have difficulty with bowel movements.
a woman or a child.
Women have more frequent episodes of constipation than men, and children
are more often affected than adults.
Hormonal changes and pressure on your intestines from your growing baby
can lead to constipation.
How Is Constipation Diagnosed?
Many people affected by constipation
choose to self-treat by changing their diets, increasing their exercise, or
using over-the-counter laxatives. However, laxatives should not be used for
more than two weeks without consulting a physician because your body can become
dependent on them for colon function.
You should talk to your general or
family practitioner if:
you have had constipation for more than three weeks
you have blood in your stool
you are experiencing pain during bowel movements
you are losing weight
you have sudden changes in your bowel movements
Your doctor will ask questions about
your symptoms, medical history, and any medications or underlying medical
conditions. A physical examination may include a rectal exam and blood tests to
check your thyroid function.
In severe cases, additional tests
may be required to identify the cause of your symptoms. These may include:
an examination of how food is moving through your
colon, called a marker study or colorectal transit study. For this test, you will swallow a pill that contains
tiny markers that will show up on an X-ray. Numerous abdominal X-rays will
be taken over the next few days so the doctor can visualize how the food
is moving through your colon and how well the intestinal muscles are
working. You may also be asked to eat a diet high in fiber during the
an examination of the anal sphincter muscle function,
called anorectal manometry. For
this test, your doctor will insert a thin tube with a balloon-tip into
your anus. When the tube is inside, the doctor will then inflate the
balloon and slowly pull it out. This test allows him or her to measure
your anal sphincterâs muscle strength and see if your muscles are
an examination of the colon with a barium enema X-ray. For this test, you will drink a special liquid the
night before the test to clean out the bowel. The actual test involves the
insertion of a dye called barium into your rectum, using a lubricated
tube. The barium highlights the rectum and colon area, allowing the doctor
to better view them on an X-ray.
an examination of the colon with a colonoscopy. In this test, your doctor will examine your colon using
a tube that is outfitted with a camera and light source (colonoscope). A
sedative and pain medication is often given, so you will likely not even
remember the examination and should feel no pain. To prepare for this test
you will be on a liquid-only diet for one to three days, and you will have
to take a laxative or enema the night before the test to clean out the
How to Treat and Prevent Constipation
Changing your diet and increasing
your physical activity level are the easiest and fastest ways to treat and
prevent constipation. Try the following techniques as well:
Every day, drink 1.5 to 2 quarts of fluids, such as
water or juice, to hydrate the body.
Limit consumption of alcohol and caffeinated drinks,
which cause dehydration.
Add fiber-rich foods to your diet, such as raw fruits
and vegetables, prunes, or bran cereal. Your daily intake of fiber should
be between 20 and 35 grams. If you have IBS-related constipation, eat
fiber that contains psyllium (a soluble fiber) instead of bran in order to
Cut down on low-fiber foods, such as meat, milk,
cheese, and processed foods.
Aim for about 150 minutes of moderate exercise every
week (about 20 minutes a day), such as walking, swimming, or biking.
If you feel the urge to have a bowel movement, donât
delay. The longer you wait, the harder your stool will become.
Add fiber supplements to your diet if needed. Just
remember to drink plenty of fluids because you can aggravate constipation
if you add extra fiber without also adding fluids to your diet.
Use laxatives sparingly. Your doctor may prescribe
laxatives or enemas for a short period of time to help soften your stools.
Never use laxatives for more than two weeks without talking to your doctor
because you can cause your body to become dependent on them for proper
If you still have trouble with
constipation, your doctor may prescribe medications to help. According to the American
College of Gastroenterology, linaclotide (Linzess) and lubiprostone
(Amitiza) are two drugs that are strongly recommended for people who suffer
from IBS-related constipation. These medications work by increasing the secretions
in your intestines, making the stool easier to pass.
Your doctor may also advise that you
stop taking certain medications that may cause constipation. More severe colon
or rectal problems may require manual procedures to clear the colon of impacted
stool, therapy to retrain slow muscles, or surgery to remove the problem part
of your colon.
What Is the Outlook for Constipation?
Most cases of constipation are mild
and are easily treated with changes in diet and exercise. If you are experiencing
chronic constipation, or constipation along with other changes in bowel
movements, itâs important that you talk to your doctor.