Constipation is characterized by infrequent bowel movements, often resulting in hard, dry stools. It’s typically defined as having fewer than three bowel movements per week. Various factors including diet, medications, pregnancy, or routine changes can contribute to its development.
Constipation is a common digestive issue in the United States, affecting about 16% of adults. This prevalence increases significantly among individuals aged 60 and older. Continue reading to learn about constipation symptoms, causes, and treatment options.
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Symptoms | Causes | Relief and treatment | Prevention | Diagnosis | Takeaway
Constipation Symptoms
Bowel habits vary among individuals – some may have movements three times daily while others three times weekly. However, these symptoms may indicate constipation:
- Fewer than three bowel movements weekly
- Hard, lumpy, or dry stools
- Straining or pain during bowel movements
- Feeling of incomplete evacuation
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends medical consultation if symptoms persist or you experience:
- Rectal bleeding
- Blood in stool
- Persistent abdominal pain
- Lower back pain
- Trapped gas sensation
- Vomiting
- Fever
- Unexplained weight loss
- Sudden bowel habit changes
Medical professionals may conduct tests to rule out serious conditions like colorectal cancer or irritable bowel syndrome (IBS).
Constipation Causes
The colon absorbs water from food waste as it moves through the digestive system, forming stool. Colon muscles then propel this waste for elimination. When stool remains too long in the colon, it hardens and becomes difficult to pass.
Poor dietary habits frequently cause constipation. Adequate fiber and water intake are essential for maintaining soft stools.
Fiber-rich plant foods promote regularity. Fiber comes in soluble (dissolves in water, forming gel) and insoluble (maintains structure) forms. Both types add bulk and soften stool for easier passage.
Other contributing factors include stress, routine changes, and conditions affecting colon muscle contractions or delaying defecation urges.
Common causes include:
- Low-fiber diets high in meat, dairy, or cheese
- Dehydration
- Inactivity
- Ignoring bowel urges
- Travel or routine changes
- Certain medications (some antacids, pain relievers, diuretics, Parkinson’s treatments)
- Pregnancy
- Aging (affects about one-third of people over 60)
Underlying health conditions may also cause constipation:
- Conditions like stroke, Parkinson’s disease, and diabetes
- Colon/rectal issues (intestinal obstruction, IBS, diverticulosis)
- Laxative overuse/misuse
- Hormonal imbalances (underactive thyroid)
Relief and treatment
Dietary changes and increased activity are the simplest ways to treat and prevent constipation. Consider these approaches:
- Drink 1.5-2 quarts of water daily
- Limit alcohol and caffeine (can cause dehydration)
- Eat fiber-rich foods (fruits, vegetables, whole grains, beans, prunes, bran cereal)
- Reduce low-fiber foods (meat, dairy, cheese, processed foods)
- Aim for 150 minutes weekly of moderate exercise (30 minutes daily, 5x/week)
- Respond promptly to bowel urges
- Consider bowel training (establishing post-breakfast bathroom routine)
- Use footstool to elevate knees during bowel movements
- Allow adequate bathroom time and relax muscles
- Use laxatives sparingly (can cause dependence)
- Discuss constipating medications with your doctor
Over-the-counter Medications
If lifestyle changes don’t help, doctors may recommend:
- Fiber supplements
- Osmotic agents (Milk of Magnesia)
- Stool softeners
- Lubricants (mineral oil)
- Stimulants
Prescription Drugs
For chronic constipation, doctors may prescribe:
- Lubiprostone (increases intestinal fluid)
- Linaclotide or plecanatide (for chronic constipation/IBS)
- Prucalopride (promotes colon movement)
Doctors may also recommend stopping constipating medications.
Other Options
Additional approaches include:
- Biofeedback therapy
- Enemas
- Manual fecal removal
- Surgery for blockages
- Chronic condition management
How to prevent constipation
While occasional constipation is common, preventive measures can maintain regularity and digestive health:
- High-Fiber Diet: Gradually increase fiber intake from fruits, vegetables, whole grains, legumes, nuts, and seeds.
- Stay Hydrated: Drink at least eight glasses of water daily, limiting dehydrating beverages.
- Regular Exercise: Aim for 30 minutes of moderate activity most days.
- Bathroom Routine: Establish consistent bowel movement times.
- Proper Toilet Habits: Relax, don’t strain, use footstool if needed.
- Limit Processed Foods: Reduce refined sugars and processed carbs.
- Stress Management: Practice relaxation techniques.
- Respond to Urges: Don’t delay bowel movements.
- Consider Probiotics: May help regulate digestion.
- Medical Consultation: For persistent issues despite lifestyle changes.
Consistent implementation of these measures can reduce constipation risk and improve digestive health.
How is constipation diagnosed?
For persistent constipation, medical evaluation typically involves:
- Medical History: Symptom review, medications, and health conditions.
- Physical Exam: Including rectal examination.
- Blood Tests: To check blood counts, electrolytes, and thyroid function.
Additional Tests:
Depending on findings, doctors may recommend:
- Marker Study: Tracks food movement through colon using X-ray visible markers.
- Anorectal Manometry: Assesses anal sphincter muscle function.
- Barium Enema: Uses contrast dye to visualize colon/rectum.
- Colonoscopy: Direct colon examination with a camera-equipped tube.
These tests help identify underlying causes for targeted treatment.
Takeaway
Key points about constipation:
- Symptom Awareness: Recognize signs like infrequent movements, hard stools, and abdominal discomfort.
- Cause Identification: Understand contributing factors including diet, hydration, activity, and medications.
- Effective Relief: Implement dietary changes, exercise, and proper bathroom habits.
- Professional Consultation: Seek medical advice for persistent or concerning symptoms.
- Prevention Focus: Maintain fiber-rich diet, hydration, activity, and stress management.
Proactive management and medical guidance when needed can effectively address constipation and promote digestive health.
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Symptoms | Causes | Relief and treatment | Prevention | Diagnosis | Takeaway