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Constipation

Medically reviewed by Drugs.com. Last updated on Oct 20, 2023.

Overview

Constipation is a problem with passing stool. Constipation generally means passing fewer than three stools a week or having a difficult time passing stool.

Constipation is fairly common. A lack of dietary fiber, fluids and exercise can cause constipation. But other medical conditions or certain medicines may be the cause.

Constipation is usually treated with changes in diet and exercise or with nonprescription medicines. Constipation may require medicines, changes in medicines or other treatments prescribed by a health care professional.

Long-term constipation, also called chronic constipation, may require treating another disease or condition that can cause or worsen constipation.

Symptoms

Symptoms of constipation include:

Chronic constipation is having two or more of these symptoms for three months or longer.

When to see a doctor

Make an appointment with your health care professional if you have constipation with any of the following conditions:

Causes

Patterns of bowel movements vary from one person to another. The typical range is three times a day to three times a week. So it's important to know what is typical for you.

In general, constipation occurs when stool moves too slowly through the large intestine, also called the colon. If the stool moves slowly, the body absorbs too much water from the stool. The stool can become hard, dry and difficult to pass.

Lifestyle causes

Slow stool movement may happen when a person does not:

Medicines

Constipation may be a side effect of some medicines, particularly opioid pain relievers. Other medicines that may cause constipation include some that treat the following conditions:

Problems with pelvic floor muscles

The muscles that hold up organs at the bottom of the torso are called the pelvic floor muscles. The ability both to relax these muscles and to bear down are necessary to pass stool from the rectum. Problems with weakness or coordination of these muscles can cause chronic constipation.

Blockages in the colon or rectum

Damage or changes to tissues in the colon or rectum can block the passage of stool. Also, tumors in the colon, rectum or nearby tissues can cause a blockage.

Other factors

A number of conditions can affect the work of muscles, nerves or hormones involved in passing stool. Chronic constipation may be linked to any number of things, including:

Sometimes, the cause of chronic constipation can't be found.

Risk factors

Factors that may increase your risk of chronic constipation include:

Complications

Complications of chronic constipation include:

Prevention

The following tips can help you avoid developing constipation.

Diagnosis

In addition to giving you a general physical exam, your health care professional will likely do the following during your appointment:

You'll also be asked questions about your medical history, diet, exercise habits and stools. For some people, the information from this appointment may be enough for a diagnosis and treatment plan.

For other people, one or more additional tests may be needed to help the health care team understand the nature or cause of constipation.

Laboratory tests

Your health care professional may send samples of your blood to a lab to test for diseases or conditions that can cause constipation.

Endoscopy

Your health care professional may order a procedure called an endoscopy. A small tube with a camera is guided into the colon. This can reveal the condition of the colon or the presence of irregular tissues. Before this procedure, you may have a limited diet, use an enema or drink solutions that clean out your colon. There are generally two types of tests:

Imaging tests

Depending on your symptoms, your health care professional may order X-ray imaging. An X-ray can show where stool is present in the colon and if the colon is blocked. Imaging tests, such as a CT scan or MRI, may be needed to diagnose conditions that may be causing constipation.

Tests of stool movement

Your health care professional may order a test that tracks the movement of stool through the colon. This is called a colorectal transit study. Such studies include:

Tests of the rectum and anus

Other tests may be used to measure how well the rectum and anus work and how well a person can pass stool.

Treatment

Treatment for constipation usually begins with diet and lifestyle changes meant to increase the speed at which stool moves through the colon. Also, your health care professional may change the medicines you take if they may be causing or worsening constipation. If those changes don't help, other treatments may be necessary.

Diet and lifestyle changes

Your doctor may recommend the following changes to relieve your constipation:

Prunes, also called dried plums, have long been used to treat or prevent constipation. Prunes are a good source of fiber, but they also have naturally present agents that draw fluids into the colon.

Laxatives

Laxatives are medicines that help move stool through the colon. Each laxative works somewhat differently. The following are available without prescriptions:

Enemas and suppositories

An enema is a fluid gently pumped into the rectum to help pass stool. An enema may be used when other treatments don't work. Your health care professional may use one of these if the rectum is blocked with stool. Some are also available without prescription. The fluid may be:

A suppository is a small tube-shaped object placed in the rectum to deliver a medicine. The suppository melts at body temperature and releases the medicine. Suppositories for constipation may have one of the following:

Prescription medicines

Your health care professional may prescribe other medicines if other treatments don't work. These include:

If constipation is caused by opioid pain medicine, you may take a prescription medicine that blocks the effect of opioids on stool movement through the colon. These include:

Pelvic muscle training

Biofeedback training involves working with a therapist who uses devices to help you learn to relax muscles and coordinate the use of muscles in your pelvis, rectum and anus. These exercises may correct problems with chronic constipation.

Sensors in the rectum and on the skin provide feedback as sound or light on a device as the therapist helps you go through various exercises. These cues help train you to control the muscles needed to pass stool.

Surgery

Surgery may be necessary to correct damage or irregularities in the tissues or nerves of the colon or rectum. Surgery is usually done only when other treatments for chronic constipation haven't worked.

Alternative medicine

Researcher are studying the use of probiotics and acupuncture to treat constipation. Further research is needed to understand these options.

Preparing for an appointment

You'll likely first see your doctor or other general health care professional. You may be referred to a specialist in digestive disorders, called a gastroenterologist.

Because appointments can be brief, and because there's often a lot of information to cover, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor.

What you can do

For constipation, some questions you might want to ask your doctor include:

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you several questions. Your doctor may ask:

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