Bloated bellies don’t lie. It’s been a few days since your last bowel movement — and things are starting to feel … well, backed up. Show
It’s normal to be constipated every once in a while, but when is constipation sounding the alarm for a bigger problem? Colorectal surgeon Massarat Zutshi, MD, gives us the 411 on No. 2. Q: What causes constipation?A: Constipation happens when your bowel movements occur less often or cause more strain than usual. Dr. Zutshi says there are three kinds of constipation:
Normal transit and slow transit constipation are both considered motility disturbances. And to understand motility, look no further than the morning commute. Motility is how well the roads — or in this case, the muscles in your gastrointestinal (GI) tract — are moving.
And just like there are many causes for snarled roadways, there are different reasons your inner streets are backing up, such as a lack of: You have less control over these other constipation causes:
Q: So how do I know if I am constipated? What’s normal?A: While the nursery school book “Everyone Poops” still rings true, how often they do so is another story. “There’s no real normal. Men are different from women. Age changes things. Pregnancy changes things,” adds Dr. Zutshi. “As long as you have a bowel movement that occurs regularly — not too few in a week — and has a regular consistency, you’re fine.” But what’s “not too few,” you ask? “Constipation is defined as less than three in a week.” Uh-oh. So now what? Q: How long is too long to be constipated?A: Dr. Zutshi explains: It depends if you’re regularly regular or not. “People who have constipation frequently know what to do when it strikes. They’ll try home remedies during the two or three weeks they don’t have a bowel movement. And then if nothing works, they see a doctor,” says Dr. Zutshi. But if you’re someone who doesn’t usually experience constipation, see a doctor sooner. Dr. Zutshi recommends making an appointment if constipation lasts longer than a week. Q: Is constipation ever an emergency?A: It can be, but most often is not. “It would be an emergency if you hadn’t had a bowel movement for a prolonged time, and you’re also experiencing major bloating or severe abdominal pain,” notes Dr. Zutshi. Slight symptoms will not take you to the emergency room. You should go to the emergency room if your symptoms are severe. Other warning signs to watch for are:
Q: How can I prevent or get rid of constipation?A: Dr. Zutshi emphasizes the big three: Water first. Fiber next. Exercise third.
If you think you’re having issues with constipation, Dr. Zutshi advises you to be proactive. “See a gastroenterologist to figure out if everything is OK. And if you have not had a colonoscopy, and you’re over 50, it’s time to schedule one.” Related Articles
Constipation occurs when bowel movements become less frequent and stools become difficult to pass. It happens most often due to changes in diet or routine, or due to inadequate intake of fiber. You should call your doctor if you have severe pain, blood in your stools, or constipation that lasts longer than three weeks.
Having fewer than three bowel movements a week is, technically, the definition of constipation. However, how often you “go” varies widely from person to person. Some people have bowel movements several times a day while others have them only one to two times a week. Whatever your bowel movement pattern is, it’s unique and normal for you – as long as you don’t stray too far from your pattern. Regardless of your bowel pattern, one fact is certain: the longer you go before you “go,” the more difficult it becomes for stool/poop to pass. Other key features that usually define constipation include:
How common is constipation?You are not alone if you have constipation. Constipation is one of the most frequent gastrointestinal complaints in the United States. At least 2.5 million people see their doctor each year due to constipation. People of all ages can have an occasional bout of constipation. There are also certain people and situations that are more likely to lead to becoming more consistently constipated (“chronic constipation”). These include:
How does constipation happen?Constipation happens because your colon absorbs too much water from waste (stool/poop), which dries out the stool making it hard in consistency and difficult to push out of the body. To back up a bit, as food normally moves through the digestive tract, nutrients are absorbed. The partially digested food (waste) that remains moves from the small intestine to the large intestine, also called the colon. The colon absorbs water from this waste, which creates a solid matter called stool. If you have constipation, food may move too slowly through the digestive tract. This gives the colon more time – too much time – to absorb water from the waste. The stool becomes dry, hard, and difficult to push out. Pathway of food waste through colon, rectum and anus. Can constipation cause internal damage or lead to other health problems?There are a few complications that could happen if you don’t have soft, regular bowel movements. Some complications include:
Does not having regular bowel movements cause toxins to build up in my body and make me sick?Don’t worry, this usually isn’t the case. Although your colon holds on to stool longer when you are constipated and you may feel uncomfortable, the colon is an expandable container for your waste. There is possibly a slight risk of a bacterial infection if waste gets into an existing wound in the colon or rectum.
There are many causes of constipation – lifestyle choices, medications, medical conditions, and pregnancy. Common lifestyle causes of constipation include:
Medications that can cause constipation include:
Many drugs can cause constipation. Ask your doctor or pharmacist if you have any questions or concerns. Medical and health conditions that can cause constipation include:
What are the symptoms of constipation?Symptoms of constipation include:
Talking to your doctor – or anyone – about your bowel movements (or lack of them) is not the most pleasant of topics. Know that your doctor is there for you. Doctors are trained health professionals who have discussed just about every health topic you can think of with their patients. Your doctor will first ask you questions about your medical history, bowel movements, and your lifestyle and routines. Medical history These questions may include:
Bowel movement history These questions may include:
Lifestyle habits and routines
Your doctor will also perform a physical exam, which includes a check of your vital signs (temperature, pulse, blood pressure). He or she will use a stethoscope to listen to the sounds in your abdomen. Your abdomen will also be touched to check for pain, tenderness, swelling, and lumps. Be aware that your doctor will also perform a rectal exam. This is a finger exam of the inside of your rectum. It’s a quick check for any masses or problems that can be felt by finger. What lab tests and other medical tests may be done to find the cause of my constipation?Your doctor can order no tests or many types of tests and procedures. The decision of which ones your doctor might order for you depends on your symptoms, medical history, and overall health. Lab tests: Blood and urine tests reveal signs of hypothyroidism, anemia, and diabetes. A stool sample checks for signs of infection, inflammation, and cancer. Imaging tests: Computed tomography (CT), magnetic resonance imaging (MRI) or lower gastrointestinal tract series may be ordered to identify other problems that could be causing your constipation. Colonoscopy: A colonoscopy or sigmoidoscopy– an internal view of your colon with a scope – may be performed. During this procedure, a small sample of tissue (biopsy) may be taken to test for cancer or other problems and any found polyps will be removed. Colorectal transit studies: These tests involve consuming a small dose of a radioactive substance, either in pill form or in a meal, and then tracking both the amount of time and how the substance moves through your intestines. Other bowel function tests: Your doctor may order tests that check how well your anus and rectum hold and release stool. These tests include a certain type of x-ray (defecography), done to rule out causes of outlet dysfunction constipation, and the insertion of a small balloon into the rectum (balloon expulsion test and anorectal manometry).
Self-care Most cases of mild to moderate constipation can be managed by you at home. Self-care starts by taking an inventory of what you eat and drink and then making changes. Some recommendations to help relieve your constipation include:
Medication/supplement review In addition to self-care methods, your doctor will review your medications and supplements (if you take any). Some of these products can cause constipation. If they do, your doctor may change the dose, switch to another drug and/or ask that you stop taking the supplement. Never stop taking your medications or supplements before talking with your doctor first. Prescription medications A few prescription drugs are available to treat constipation. These include lubiprostone (Amitiza®), prucalopride (Prudac®, Motegrity®), plecanatide (Trulance®), lactulose (Cephulac®, Kristalose®) and linaclotide (Linzess®). Your doctor will pick the drug that might work best for you based on the results of your tests. Surgery Surgery is rarely needed to treat constipation. Your doctor may, however, recommend surgery if constipation is caused by a structural problem in the colon. Examples of these problems include a blockage in the colon (intestinal obstruction), a narrowing in a portion of the intestine (intestinal stricture), tear in the anus (anal fissure) or the collapse of part of the rectum into the vagina (rectal prolapse). Some causes of outlet dysfunction constipation may be treated with surgery. This is best discussed after testing. You may also need surgery if cancer was found in your colon, rectum or anus.
Use the same home-based methods you used to treat constipation to prevent it from becoming a chronic problem:
Call your healthcare provider if:
Remember, talk openly and honestly with your doctor about your bowel movements and any questions or concerns you may have. Pooping is something we all should be doing. Constipation may be a temporary situation, a long-term problem or a sign of a more serious condition. Be safe. See your doctor, especially if you’ve noticed a change in your bowel pattern or if your life is being ruled by your bowels.
Last reviewed by a Cleveland Clinic medical professional on 11/07/2019. References
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy |