Problems with passing stool are called constipation. This condition is often diagnosed when you pass stool fewer than 3 times per week. It is a common condition that usually occurs due to a lack of dietary fiber, fluids, and physical exercise. Sometimes, certain medicines and health conditions can also cause constipation.
Commonly, treatment involves dietary changes, regular physical exercise, and over-the-counter (OTC) medicines. Sometimes, people get rid of constipation by changing the medicines they take or other treatments recommended by their doctor.
In some cases, people may develop long-term (chronic) constipation. To get rid of chronic constipation, you may need treatments for the underlying condition that causes or worsens it.
Symptoms
Those who suffer from constipation may experience the following symptoms:
- Dry, lumpy, or hard stools
- Less than 3 stools per week
- Pain or straining when passing stools
- A feeling that not all stool has passed or the rectum is blocked
- Sometimes, you may need to use a finger to pass stool
Usually, people with chronic constipation have at least 2 of the previous symptoms that last for 3 months or longer.
Immediately visit a doctor if any of the previous symptoms occur. For example:
- The symptoms last more than 3 weeks, or they interfere with your daily activities
- Bleeding from the rectum
- Bloody or black stools
- Persistent stomach pain
- Unusual weight loss
Causes
Generally, bowel movement patterns are different among people. Most commonly, the typical range is 3 times per day to 3 times per week. Thus, it is very important to know what range is normal for you.
Most people experience constipation when the stool passes too slowly through the large intestine (colon), which makes it absorb too much water. As a result, the stool becomes dry and challenging to pass. Check below some causes of constipation:
Lifestyle Causes
- Not drinking enough fluids
- Low fibers
- Regularly exercise
- Not using the toilet when there is an urge to pass stool
Medicines
This condition may occur as an adverse reaction to certain medicines (such as opioid pain relievers). However, medicines used for the following diseases may also cause constipation. These include:
- Hypertension (high blood pressure)
- Seizures
- Mental disorders (such as depression)
- Nervous system conditions
- Allergies
Pelvic Floor Muscle Problems
In normal circumstances, the pelvic muscles hold the organs at the bottom of the torso. When stool passes from the rectum, these muscles are relaxed. However, if you experience problems with coordination or weakness of any of the pelvic muscles, you may develop chronic constipation.
Colon or Rectum Blockages
Changes or damage to the colon or rectum tissue may block the stool. Furthermore, people with colon or rectum tumors may also experience blockages that lead to constipation.
Other Causes
A lot of conditions and factors may negatively affect the muscles, hormones, and nerves involved in passing stool. Check below some things that are linked with chronic constipation:
- Irritable bowel syndrome (IBS)
- Diabetes
- Multiple sclerosis
- Nerve damage or dysfunction
- Thyroid diseases (such as hyperthyroidism or an overactive thyroid gland)
- Parkinson’s disease
- Pregnancy
In some cases, healthcare professionals cannot identify the exact cause of constipation.
Risk Factors
Healthcare providers identified some factors that may increase your risk of developing constipation. Check below some examples:
- Age – Older people are more prone to develop this condition.
- Sex – Women develop constipation more frequently than men.
- Little or lack of physical activity
- Mental health problems (such as eating disorders, depression, and others)
Complications
People with a chronic form of this condition may experience some complications, especially if they do not get treatment. For example:
- Anal fissures
- Hemorrhoids (it occurs when the tissues around the anus is swollen)
- Fecal impaction (this complication happens when hard stools go backward in the colon)
- Rectal prolapse (in such cases, the rectum tissue goes out of the anal opening)
How to Prevent Constipation?
Check below some tips that may help prevent or reduce the risk of constipation:
- Regular schedule for passing stool
- You should not ignore the urge to pass stool
- Drink plenty of fluids
- Regularly perform physical exercises
- Adopt a healthy diet that includes more fresh fruits, vegetables, whole grains, and beans. Limit processed foods, dairy, and meats.
Diagnosis
Healthcare professionals usually perform a physical examination and may ask some questions about your medical history and symptoms. During a physical examination, they will press on the abdomen to heck for pain, irregular lumps, or tenderness, look at the anus tissue, and may use a gloved finger to check for rectum diseases. In some cases, to confirm the condition, physicians may perform some tests. For example:
- Laboratory tests – These include blood and urine tests to check for underlying conditions.
- Endoscopy – It involves a small tube with a lighted camera on the end that allows your doctor to see inside the colon. Doctors may also perform a colonoscopy and sigmoidoscopy.
- Imaging tests – For example CT (computerized tomography) scans, MRI (magnetic resonance imaging) scans, X-ray scans, and others. Usually, imaging tests are used to get detailed images of the colon. It may help find the exact location of the blockages.
- Stool movement tests – Physicians often use one of the following tests to check how the stool moves through the colon. One of these tests is called a colorectal transit study, and it involves the following procedures. The first is to administer a pill with a radioactive material and then perform an X-ray to see how far the pill moves through the colon. The second study involves eating a meal with radioactive substances that are tracked with a special technology through the colon.
Rectum and Anus Tests
In some cases, doctors may perform additional tests to determine how well the rectum and anus works. For example:
- Anorectal manometry – This test involves a narrow and flexible tube that is inserted into the anus and rectum. Thereafter a balloon-like device is inflated to measure the muscle coordination used to pass the stool.
- Balloon expulsion test – It is also used to check how well the muscles work or are controlled.
Treatment
In most cases, constipation treatment starts with dietary and lifestyle changes that help to increase the speed of the stool that moves through the large intestine. Doctors may also recommend some medicines to prevent complications and ease the symptoms.
Lifestyle and Dietary Changes
Check some changes usually recommended by doctors for people with constipation:
- Adopt a high-fiber diet – It may help the stool hold fluids. Fruits, vegetables, beans, whole-grain bread, cereal, and rice are the some examples of high-fiber foods. According to the Dietary Guidelines for Americans, the recommended amount of fiber that should be taken daily varies between 25 to 34 grams.
- Drink plenty of fluids to prevent dehydration. It also helps prevent bloating, gas, and maintains soft stools.
- Regularly exercise because it helps improve the movement of the stool through the large intestine (colon).
- You should not ignore the urge to pass stool because it also contributes to this condition.
In addition, one common treatment for constipation is prunes (also called dried plums).
Laxatives
These are specific medicines that help move stool through the colon. However, laxatives work differently. Check below some over-the-counter medications:
- Fiber supplements – These supplements help keep fluid in the stool, which helps maintain the stool softer and easier to pass. Doctors usually recommend Psyllium, Calcium polycarbophil, and Methylcellulose.
- Osmotics – These laxatives are used to help the stool move through the large intestine. In most cases, healthcare professionals recommend oral magnesium hydroxide, magnesium citrate, lactulose, and polyethylene glycol.
- Stimulants – These laxatives are used to tighten the intestine walls that helps force the stool movement. Commonly, doctors recommend Bisacodyl or Sennosides.
- Lubricants – These contain mineral oil that helps the stool move through the large intestine more easily.
- Stool softeners – The following nonprescription laxatives are used to allow more fluid to be drawn in the stool. Usually, physicians recommend Docusate sodium or Docusate calcium.
Suppositories and Enemas
The process, when the fluid is gently pumped into the rectum to help pass stool, is called an enema. Physicians usually recommend an enema when other treatments do not work or the stool blocks the rectum. The fluid used to pass stool can be tap water, mineral oil, or tap water with mild soap.
A small-shaped object placed in the rectum to deliver the medicine is called a suppository. Commonly, suppositories contain one of the following laxative types. For example, osmotic, stimulant, or lubricant.
Prescription Medications
The following medicines are used when previous treatments do not work. For example:
- Lubiprostone
- Linaclotide
- Plecanatide
- Prucalopride
When the constipation is caused by an opioid pain medication, you may need additional medicines to block the opioid effects on stool movement. For example:
- Naloxegol
- Naldemedine
- Methylnaltrexone
Surgery
In severe cases, people may need surgery to fix damage or other abnormalities in the nerves or tissue of the large intestine or rectum. Healthcare providers usually recommend surgery when other treatments do not work.
Frequently Asked Questions
How to trigger a bowel movement?
There are multiple ways to encourage a bowel movement such as a high-fiber diet, drinking plenty of liquids, regularly exercise, over-the-counter (OTC) medicines (including laxatives) and others.
What does severe constipation feel like?
Usually, people with severe constipation experience persistent bloating and abdominal (belly) pain. Previous feelings occur along with difficulty passing hard stools, a sense of incomplete evacuation. If you notice any of the symptoms listed above, do not hesitate to see a doctor.
What are the possible complications of constipation?
People with frequent constipation may experience some complications. Check below the most common of them:
- Hemorrhoids
- Urinary retention
- Stercoral perforation
- Fecal incontinence
- Pelvic floor damage
- Anal fissures
- Poor quality of life
This article does not contain all possible complications of this condition. Ask your healthcare provider if you have any other questions.
