Constipation is a problem passing stool. Stool may be too hard or dry to pass. It is a common health problem.
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
- 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
- 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:
- Travel due to schedule changes, stress, and poor diet
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
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
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:
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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
- 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.
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
- 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.
- James P. Cornell, MD
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