Constipation

What is constipation?

Generally speaking, a person is constipated when they have three or fewer bowel movements within a week or have difficulty in passing stools.

Occasional constipation can happen to anyone, and results from everyday occurrences such as air travel, dehydration, or a diet low in roughage. Chronic constipation (constipation lasting longer than a week or so) or recurrent constipation can interfere with your daily life; in some cases it may also lead to complications, or indicate a serious underlying illness.

What are the symptoms of constipation?

Symptoms of constipation include:

• • Fewer than three bowel movements in a week
  • Hard stools
  • Straining or paining during bowel movements
  • Bloating and abdominal distension
  • A feeling that you have not completely evacuated the rectum

What causes constipation?

Constipation arise from multiple digestive tract issues, or from behavioral or dietary changes. Common causes include:

• • A diet insufficient in fiber or water
  • Lack of physical activity
  • Common prescription or over the counter medications such as painkillers, antidepressants, and iron supplements
  • Irritable bowel syndrome
  • Pregnancy
  • Problems with the nerves and/or muscles in your digestive tract or pelvis
  • Structural colon disease like diverticular disease
  • Colon or anal cancer
  • Neurological conditions like Parkinson’s disease or multiple sclerosis (MS)
  • An underactive thyroid (hypothyroidism) or diabetes mellitus
  • Anal pathology such as hemorrhoids, inflammation, strictures, or fissure

Constipation: Questions to Consider

• • Have you moved your bowels fewer than three times in the past week?
    Are your stools hard?
  • Do you have to strain to move your bowels?
  • Do you feel like there’s something blocking your rectum?
  • Do you feel as if you can’t fully empty your rectum of stool?
  • Do you need help to empty your rectum, such as by pressing on your abdomen or elsewhere?

How is constipation treated?

You can successfully manage occasional, mild constipation by eating more fiber, staying hydrated, and if necessary using over the counter stool softeners, or occasional laxatives.

If your constipation is chronic, recurrent, or severe, or associated with bleeding or significant pain, you should see a gastroenterologist. The gastroenterologist will evaluate your symptoms carefully during an initial consultation, and will then proceed with diagnostic testing (if needed) and treatment. The goal of treatment is to achieve reliable bowel movements and relief of constipation related discomfort.

Depending on the particular cause, we treat constipation with a combination of diet and lifestyle measures, over the counter or prescription medications, and very occasionally with or endoscopic surgical interventions. Physical therapy to retrain and strengthen the muscles of the pelvis helps restore healthy function in many patients.

Things to take note of before your doctor visit:

• Frequency of bowel movements
• Consistency of bowel movements
• Evacuation difficulty, if any, and what type of stool this occurs with
• Abdominal sensations that accompany having or not having bowel movements