What Is Constipation?

Constipation is a condition of having fewer than three bowel movements a week. Chronic constipation is defined as irregular bowel movements or difficult passage of stools lasting for several weeks or longer. Though occasional constipation is a common problem, some people can also experience chronic constipation that can interfere with their ability to perform daily tasks. It may also cause people to strain excessively.

What Causes Constipation?

Constipation most commonly happens when waste or stool moves too slowly through the digestive tract or cannot be appropriately eliminated from the rectum, causing the stool to become hard and dry. Constipation has many possible causes.

Common Causes:

Dehydration.
Lack of fiber intake.
Pregnancy.
Less physical activity.
Side effects of some medications.
Side effects of some food.
Being bedridden for a long time.
Improper sleep.
Late-night hangouts.
Mismanaged lifestyle.
Piles and anal fissures.

Uncommon Causes:

Diverticular disease.
Related Topics
How can anal fissure be treated?
Why am I having hard stools with ulcer inside my anus?
Does constipation cause burning sensation in anus?
Colon cancer.
Irritable bowel syndrome.
Intestinal obstruction.
Underactive thyroid (hypothyroidism).
Overactive parathyroid gland (hyperparathyroidism).

What Are the Signs and Symptoms of Constipation?

The common signs and symptoms of constipation include:

Having fewer than three stools a week.
Having dry, hard, or lumpy stools.
A feeling of partially emptying the stool from the rectum.
Straining excessively to have bowel movements.
Feeling as if there is a rectum blockage preventing bowel movements.
Feeling bloated and nauseous.
Painful defecation (passage of stool).
Burning during, before, and after passing stools.
Bright red bleeding due to straining and piles.
Having stomach ache or cramps.
Piles due to hard stools.
Fissures due to hard stools.
Pruritus ani (itching in the anus).

How Is Constipation Diagnosed?

In addition to a general physical examination and a digital rectal examination, healthcare providers may recommend the following diagnostic tests and procedures to diagnose constipation and try to find the root cause:

Blood Tests: The doctor may recommend blood tests to check for systemic conditions such as hypothyroidism or high calcium levels.

X-Ray: An X-ray can help the doctor determine whether the intestines are blocked and whether the stool is present throughout the colon.

Other Imaging Tests: Computed tomography (CT) and magnetic resonance imaging (MRI) may be ordered to detect other problems causing constipation.

Colonoscopy: This diagnostic test allows the health care professional to examine the entire colon with a flexible, camera-equipped tube.

Colorectal Transit Studies: These tests involve swallowing a capsule containing either a radiopaque marker or a wireless recording device and then tracking the amount of time and how well the substance moves through the colon.

Defecography: In this procedure, the doctor inserts a soft paste made of barium into the rectum. The barium appears on X-rays and may show a prolapse or muscle function and coordination problems.

Balloon Expulsion Test: This test is often used in conjugation with anorectal manometry. It measures the time it takes for an individual to push out a balloon that has been filled with water and placed in the rectum.

How Is Constipation Treated?

Treatment for constipation typically begins with diet and lifestyle modifications to increase the speed at which stool moves through the intestines. The doctor may recommend medications or surgery if lifestyle and dietary changes fail to help.

Diet and Lifestyle Changes:

One can manage most cases of mild to moderate constipation at home. Some self-care tips to help relieve constipation include:

Drink plenty of water a day. Avoid drinking caffeine-containing beverages and alcohol, which can cause dehydration.
Increase the fiber intake. Add fruits, vegetables, whole-grain bread, and cereals to the diet.
Avoid eating high-fat foods like meat, eggs, and cheese.
Maintain a food diary and rule out foods that cause constipation.
Exercise regularly as physical activity increases muscle activity in the intestines.
Do not hold the stool for a long time. Instead, take time in the bathroom, allowing enough time to have a bowel movement without distractions and without feeling rushed.

Laxatives:

Several laxatives are available, and each laxative works differently to make it easier to have a bowel movement. The following are over-the-counter laxatives:

Fiber supplements like psyllium, calcium polycarbophil, and methylcellulose make the stools bulky, softer, and easier to pass.
Stimulants including Bisacodyl and Sennosides cause the intestines to contract.
Osmotic laxatives help move stool through the colon by increasing fluid secretion from the intestines and helping stimulate bowel movements. Examples of osmotic laxatives include Oral magnesium hydroxide, Magnesium citrate, Lactulose, and Polyethylene glycol.
Lubricants like mineral oil allow stool to move through the colon more quickly.
Stool softeners, such as Docusate sodium and Docusate calcium, help moisten the stool by removing water from the intestines.
Tap water enemas aid in softening stool and produce a bowel movement. Glycerin or Bisacodyl suppositories are also helpful in moving stool out of the body by providing lubrication and stimulation.

Prescription Medications:

If over-the-counter medications do not help treat constipation, the doctor may recommend the following prescription medications:

Medications like Lubiprostone, Linaclotide, and Plecanatide, work by drawing water into the intestines and speeding up the movement of stool.
Prucalopride helps move stool through the colon.
If opioid pain medications cause constipation, peripherally acting mu-opioid receptor antagonists (PAMORAs), such as Naloxegol and Methylnaltrexone, reverse the opioid effects on the intestine to keep the bowel moving.

Surgery:

Surgery is rarely needed to treat constipation. However, the doctor may recommend surgery if a structural problem in the colon causes constipation. Examples include blockage in the colon, a narrowing in a portion of the intestine, a tear in the anus, or the collapse of part of the rectum into the vagina.

How Is Constipation Prevented?

Prevention tips may include:

Eat a well-balanced diet, including plenty of high-fiber foods, such as beans, vegetables, fruits, whole grain cereals, and bran.
Drink plenty of fluids. Drink at least eight glasses of water a day.
Avoid a sedentary lifestyle and try to get regular exercise.
Try to manage stress.
Avoid liquids containing caffeine, such as coffee and soft drinks, which can cause dehydration.
Move the bowels when feeling the urge.
Ensure children who begin to eat solid foods get plenty of fiber in their diets.

Conclusion:

Constipation is a condition of fewer than three bowel movements a week, usually due to changes in diet or routine or inadequate fiber intake. See a doctor if a person notices a difference in the bowel pattern or interferes with their ability to perform daily tasks.