Constipation has many causes, including:
- Not enough fluid intake
- Overuse of laxative medications
- Too little exercise
- Lengthy bed rest
Certain medications, including:
- Pain relievers
- Aluminum-containing antacids
- Antidepressant and antipsychotic medications
- Medications for epilepsy and Parkinson's disease
- Antispasmodic medications
- Iron supplements
- Calcium channel blockers
- Frequently delaying the need to have a bowel movement
- Spasm of the anal sphincter; due to painful anal fissures or hemorrhoids
- Underactive thyroid
- Irritable bowel syndrome —periods of constipation may alternate with episodes of diarrhea
Neurological diseases such as:
- Parkinson's disease
- Multiple sclerosis
- Spinal cord injuries or tumors
Intestinal disorders, including:
- Travel due to schedule changes, stress, and poor diet
- Abdominal pain
- Sensation of abdominal fullness
- Rectal pain and pressure
- Difficulty passing stool, despite straining
- Hard, dry, small stool
- Feeling of incomplete emptying after a bowel movement
When Should I Call My Doctor?
Call your doctor if you:
- Have constipation that lasts longer than 2-3 weeks
- Have a painful or swollen abdomen
- Have nausea or vomiting
- Have signs of an infection, such as fever or chills
- Have pain or burning in anal area with or without bowel movement
- Have blood in your stool or black stool
- Think that your prescription medication is causing constipation
- Are losing weight
You will be asked about your symptoms and medical history. A physical exam will be done. It may include a digital rectal exam of the rectum with the doctor's gloved, lubricated finger inserted into your rectum.
Your bodily fluids may be tested. This can be done with blood tests.
Your bodily structures may need to be viewed. This can be done with:
- Abdominal x-ray
- Barium enema
- Flexible sigmoidoscopy or colonoscopy
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Treatment may include:
Understanding Normal Bowel Movements
Talk to your doctor about what is a normal frequency of bowel movements for you. The range of normal is quite broad. Some people have several per day, while others may have less over a period of days
Making Lifestyle Changes
- Eat a healthy, balanced diet that is high in fiber and includes foods such as unprocessed bran, whole-wheat grains, fresh fruit, and cereals. Eating prunes may also improve bowel movements.
- Limit your intake of processed and fatty foods.
- Exercise regularly .
- Drink plenty of water each day.
Taking Laxatives, Stool Softeners, or Glycerin Suppositories
Regularly using laxatives or enemas can be habit forming. Your bowels can become used to these products and require them to produce a stool. Stool softeners, though, are not habit-forming. Ask your doctor about how often and for how long to use these products.
Examples of medications include:
- Polyethylene glycol 3350
- Botulism injections
Retraining Your Bowels
Set aside the same time each day to move your bowels. Typically, this works best first thing in the morning. Sit on the toilet for 15-20 minutes. Over time, your body will learn to have regular bowel movements at the same time each day.
Biofeedback may be effective in certain conditions. By working with a therapist, you learn how to control certain muscles that can help you to move your bowels.
Treating Underlying Conditions
Work with your doctor to treat other conditions that may be causing your constipation.
If you are taking medication that causes constipation, talk to your doctor to find out if you can take a different medication.
If you are taking opioids to relieve pain, you may have constipation. A medication called methylnaltrexone may help to reduce this side effect.
If you have severe, chronic constipation, your doctor may recommend surgery.
To reduce your chance of getting constipation:
- Eat a healthy, balanced diet that is high in fiber.
- Exercise regularly.
- Drink plenty of water a day.
- In an effort to train your bowels, schedule a time daily to sit on the toilet just after a meal.
- Do not rush yourself when using the bathroom.
- If you feel the urge to move your bowels, do not ignore this feeling. Go to the bathroom right away.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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American Gastroenterological Association http://www.gastro.org
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov
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