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Constipation

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Condition

Constipation

Definition

Constipation is a problem passing stool. Stool may be too hard or dry to pass. It is a common health problem.

Causes

Constipation may be caused by:

  • Not drinking enough fluids
  • Using laxatives too much
  • Lack of activity
  • Being on bed rest
  • Some medicines, such as:
    • Pain relievers
    • Opioids
    • Antacids that have aluminum in them
    • Antidepressant and antipsychotic medicines
    • Medicines for epilepsy and Parkinson disease
    • Antiseizure medicines
    • Iron supplements
    • Calcium channel blockers
  • Often delaying the need to pass stool
  • Pregnancy
  • Diabetes
  • Spasm of the anal sphincter due to painful anal fissures or hemorrhoids
  • An underactive thyroid
  • Irritable bowel syndrome
  • Neurological diseases such as:
  • Intestinal disorders, including:
    • Scarring
    • Tumors
    • Cancer
    • Inflammation
  • Travel due to schedule changes, stress, and poor diet

Risk Factors

This problem is more common in older adults.

Other things that may raise the risk are:

  • An inactive lifestyle
  • Lengthy bed rest due to surgery or an accident
  • A diet that is high in fat and sugar and low in fiber

Symptoms

Problems may be:

  • Problems passing stool, despite straining
  • Belly pain
  • A feeling of fullness in the belly
  • Rectal pain and pressure
  • Passing stool that is hard, dry, and small
  • Feeling of incomplete emptying after a bowel movement

Diagnosis

The doctor will ask about symptoms, health history, and bowel habits. A physical exam will be done. The doctor may insert a gloved finger into the rectum to check it. This is called a digital rectal exam.

Blood tests may be done.

Images may be taken of the colon. This can be done with:

Barium Enema.

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Radiology colonhttp://services.epnet.com/getimage.aspx?imageiid=74107410si55551812.jpgsi55551812.jpgNULLjpgsi55551812.jpgNULL\\hgfiler01a\intellect\images\si55551812.jpgNULL11NULL2008-11-072533907410_11936Copyright © Nucleus Medical Media, Inc.

Treatment

The goal of treatment is to promote bowel movements. Any health issues that may be causing constipations will be treated.

Other treatment options are:

  • Diet changes, such as drinking plenty of water and eating foods that are high in fiber
  • Lifestyle changes, such as working out regularly
  • Stopping or changing medicines that are causing symptoms
  • Over the counter and prescription medicines to promote bowel movements, such as:
    • Stool softeners
    • Laxatives
    • Glycerine suppositories
  • Retraining the bowels to have regular movements at the same time each day
  • Biofeedback to learn how to control the muscles that are needed to pass stool

People with severe symptoms may need surgery.

Prevention

The risk of constipation can be lowered by:

  • Eating a healthful, balanced diet that is high in fiber
  • Working out often
  • Drinking plenty of water
  • Passing stool as soon as the urge is felt
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References

  • Camilleri, M., Kerstens, R., et al. A placebo-controlled trial of prucalopride for severe chronic constipation. New England Journal of Medicine, 2008; 358 (22): 2344-2354.
  • Constipation. National Digestive Diseases Information Clearinghouse website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/constipation.
  • Constipation in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-adults.
  • Constipation in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/constipation-in-children.
  • Paquette, I.M., Varma, M., et al. The American Society of Colon and Rectal Surgeons' Clinical Practice Guideline for the Evaluation and Management of Constipation. Diseases of the Colon & Rectum, 2016; 59 (6): 479-492.

Contributors

  • James P. Cornell, MD
Last Updated:
2023-08-01

(C) Copyright 2023 EBSCO Information Services

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.