| Risk Factors
Constipation is infrequent and/or uncomfortable bowel movements. Stool is often hard and dry. This is a very common gastrointestinal complaint.
Constipation has many causes, including:
- Not enough fluid intake
- Overuse of laxative medicines
- Too little exercise
- Bed rest
Certain medicines, including:
- Pain relievers
- Aluminum-containing antacids
- Antidepressant and antipsychotic medicines
- Antispasmodic medicines
- Iron supplements
- Calcium channel blockers
- Frequently delaying the need to have a bowel movement
Spasm of the anal sphincter; due to painful
- Underactive thyroid
- Irritable bowel syndrome
(periods of constipation may alternate with episodes of
Neurological diseases such as:
- Systemic lupus erythematosus
Intestinal disorders, including:
- Travel (due to schedule changes, stress, and poor diet)
Risk factors include:
- Advancing age
- Sedentary lifestyle
- Prolonged bed rest due to surgery or an accident
- Diet that is high in fat and sugar and low in fiber
- Abdominal pain
- Sensation of abdominal fullness
- Rectal pain and pressure
- Difficulty passing stool, despite straining
- Hard, dry, small stool
- Black stool
- "Rabbit pellet" appearance to stool
- Sensation of retained stool after defecating
Call your doctor if you:
- Are constipated and never had this condition before
- 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 medicine is causing constipation
- Are losing weight
Changes in bowel habits, such as constipation, may indicate a more serious condition. Your doctor may order tests to rule out other conditions. Tests may include:
- Physical exam
- Blood tests
- Digital rectal exam—examination of the rectum with the doctor's gloved, lubricated finger inserted into your rectum
x-ray—a test that uses radiation to take a picture of structures inside the abdomen
- Barium enema—injection of fluid into the rectum that makes your colon light up on an x-ray
- Flexible sigmoidoscopy—a thin, lighted tube with a camera inserted into the rectum to examine the rectum and the lower colon
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Treatment may include:
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 stools a day. Others have one stool every several days.
Eat a healthy, balanced diet that is
high in fiber
(such as unprocessed bran, whole-wheat grains, fresh fruit, and cereals). Eating prunes every day may also improve bowel movements.
- Limit your intake of processed and fatty foods.
- Exercise regularly.
- Drink at least eight, 8-ounce glasses of water each day.
Regularly using laxatives or enemas can be habit forming. Your bowels can become accustomed to these products and require them in order 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 medicines include:
- Polyethylene glycol 3350
(GlycoLax, MiraLax)—a type of laxative
- Psyllium—a bulk laxative
- Docusate—a stool softener
- Lactulose—a type of laxative
(Amitiza)—a medicine that increases fluid in stool
- Botulism injections—may be used to treat certain types of constipation
Set aside the same time each day to move your bowels. Typically, this works best after breakfast and coffee. 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.
works by attaching sensors to the body. These sensors give you information about your muscles. By working with a therapist, you learn how to control certain muscles that can help you to move your bowels.
Work with your doctor to treat other conditions that may be causing your constipation.
If you are taking medicine that causes constipation, talk to your doctor to find out if you can take another drug.
If you are taking opioids to relieve pain, you may have constipation. A medicine called
(Relistor) may help to reduce this side effect.
If you have severe, chronic constipation, your doctor may recommend surgery.
If you are diagnosed with constipation, follow your doctor's
To reduce your chance of getting constipation:
- Eat a healthy, balanced diet that is high in fiber.
- Exercise regularly.
- Drink at least eight, 8-ounce glasses 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.
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Last reviewed October 2012 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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