Constipation

Overview

Constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer. Constipation is generally described as having fewer than three bowel movements a week.

Though occasional constipation is very common, some people experience constipation that can interfere with their ability to go about their daily tasks. Constipation may also cause people to strain excessively in order to have a bowel movement. Treatment for chronic constipation depends in part on the underlying cause. However, in some cases, a cause is never found.

Causes

There are many constipation causes like lifestyle choices, medications, medical conditions, and pregnancy. Common lifestyle causes of constipation include:

• Eating foods low in fiber.
• Not drinking enough water (dehydration).
• Not getting enough exercise.
• Changes in your regular routine, such as traveling or eating, or going to bed at different times.
• Eating large amounts of milk or cheese.
• Stress.
• Resisting the urge to have a bowel movement.

Medical and health conditions that can cause constipation include:

• Endocrine problems, like underactive thyroid gland (hypothyroidism), diabetes, uremia, hypercalcemia.
• Colorectal cancer.
• Irritable bowel syndrome (IBS).
• Diverticular disease.
• Outlet dysfunction constipation. (A defect in the coordination of pelvic floor muscles. These muscles support the organs within the pelvis and lower abdomen. They are needed to help release stool.)
• Neurologic disorders including spinal cord injury, multiple sclerosis, Parkinson’s disease, and stroke.
• Lazy bowel syndrome. The colon contracts poorly and retains stool.
• Intestinal obstruction.
• Structural defects in the digestive tract (like fistula, colonic atresia, volvulus, intussusception, imperforate anus, or malrotation.)
• Multiple organ diseases, such as amyloidosis, lupus, and scleroderma.
• Pregnancy

Symptoms

Signs and symptoms of severe constipation include:

• Passing fewer than three stools a week
• Having lumpy or hard stools
• Straining to have bowel movements
• Feeling as though there’s a blockage in your rectum that prevents bowel movements
• Feeling as though you can’t completely empty the stool from your rectum
• Needing help to empty your rectum, such as using your hands to press on your abdomen and using a finger to remove stool from your rectum

This condition may be considered chronic if you’ve experienced two or more of these constipation symptoms for the last three months.

Diagnosis

Talking to your doctor or anyone about your bowel movements (or lack of them) is not the most pleasant of topics. Know that your primary care physician is there for you. Doctors are trained health professionals who have discussed every possible 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.

Treatment

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: Urine and blood 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).

When To See A Doctor

Make an appointment with your doctor if you experience unexplained and persistent changes in your bowel habits.

Summary

Constipation is a condition characterized by infrequent bowel movements or difficulty in passing stools, typically defined as having fewer than three bowel movements per week. While occasional constipation is common, chronic cases can significantly affect daily life and may cause excessive straining during bowel movements. It can be attributed to various factors including lifestyle choices, medications, medical conditions, and pregnancy.

Lifestyle Causes: Common contributors include a diet low in fiber, inadequate water intake, insufficient exercise, changes in routine, excessive dairy consumption, stress, and ignoring the urge to defecate. Studies show that about 30% of people experience constipation due to dietary factors alone.

Medical Conditions: Conditions contributing to constipation include endocrine disorders, such as hypothyroidism and diabetes, colorectal cancer, irritable bowel syndrome (IBS), diverticular disease, outlet dysfunction constipation, neurologic disorders like Parkinson’s disease, lazy bowel syndrome, intestinal obstruction, and structural defects in the digestive tract. Approximately 10-15% of the population suffers from chronic constipation, with a significant number linked to these underlying health issues.

Pregnancy: Pregnant women are at increased risk due to hormonal changes and pressure on the intestines.

Symptoms of severe constipation include passing fewer than three stools per week, hard or lumpy stools, straining during bowel movements, a sensation of rectal blockage, and a feeling of incomplete bowel evacuation. Chronic constipation is often diagnosed if symptoms persist for at least three months.

Diagnosis involves a detailed medical history, lifestyle assessment, and tests such as lab tests to check for underlying conditions, imaging tests like CT or MRI, colonoscopy or sigmoidoscopy for internal examination, and colorectal transit studies or other bowel function tests.

Treatment varies based on the underlying cause and may include lifestyle changes, medications, or procedures.

-Disclaimer-

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about constipation or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.