Constipation occurs when bowel movements become infrequent and passing stools is difficult. This is often caused by a poor diet, dietary changes, a shift in routine, or a lack of fiber. Long-term constipation can lead to abdominal pain and dry stools. If you experience severe constipation, stomach pain, blood in your stool, unexplained weight loss, or constipation lasting more than three weeks, it is important to contact a healthcare provider. These symptoms might indicate an underlying condition affecting your bowel muscles and preventing regular bowel movements.
What is Constipation?
Technically, constipation is defined as having fewer than three bowel movements per week. However, bowel habits vary widely; some people go several times a day, while others may go just once or twice a week. What's normal for you depends on your unique pattern, as long as it doesn’t deviate significantly.
Regardless of your typical bowel habits, constipation generally means:
- Dry, hard stools
- Painful bowel movements
- Difficulty passing stools
- Feeling like you haven’t completely emptied your bowels
How Common is Constipation?
Constipation is a common issue in the U.S., with over 2.5 million visits to healthcare providers each year for this problem.
Symptoms and Causes of Constipation
How Does Constipation Happen?
Constipation happens when the colon absorbs too much water from the waste, drying it out and making it hard to pass. Normally, as food moves through your digestive system, nutrients are absorbed, and the leftover waste becomes stool. The colon absorbs water to solidify this waste. When food moves too slowly through the digestive tract, the colon absorbs too much water, resulting in dry, hard stools.
Causes of Constipation
Constipation can stem from various factors, including lifestyle choices, medications, and medical conditions.
Lifestyle Factors
Common lifestyle-related causes of constipation include:
- Low fiber intake
- Dehydration
- Lack of exercise
- Changes in routine, such as travel or irregular eating/sleeping patterns
- High consumption of dairy products like milk and cheese
- Stress
- Ignoring the urge to have a bowel movement
Medications
Certain medications can lead to constipation, including:
- Strong painkillers like narcotics containing codeine, oxycodone and hydromorphone.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.
- Antidepressants including SSRIs and tricyclic antidepressants).
- Antacids containing calcium or aluminum.
- Iron supplements.
- Allergy medications such as antihistamines.
- Certain blood pressure medications, including calcium channel blockers and nifedipine and beta-blockers.
- Psychiatric medications like clozapine and olanzapine.
- Antiseizure medications such as phenytoin and gabapentin.
- Antinausea medications like ondansetron.
If you have concerns about any medication causing constipation, consult your healthcare provider or pharmacist.
Medical Conditions
Several health conditions can contribute to constipation, including:
- Endocrine disorders like hypothyroidism, diabetes, uremia, and hypercalcemia.
- Colorectal cancer.
- Irritable bowel syndrome (IBS).
- Diverticulitis.
- Outlet dysfunction constipation, where pelvic floor muscles don’t coordinate properly to release stool.
- Obstructed defecation syndrome, involving complex or unexplained issues preventing normal bowel movements.
- Intestinal pseudo-obstruction, where the colon’s motor function temporarily paralyzes.
- Neurological disorders such as spinal cord injury, multiple sclerosis, Parkinson’s disease, and stroke.
- Lazy bowel syndrome, where the colon contracts poorly and retains stool.
- Intestinal obstruction.
- Structural defects in the digestive tract, like fistula, colonic atresia, volvulus, intussusception, imperforate anus, or malrotation.
- Multiple organ diseases like amyloidosis, lupus, and scleroderma.
- Pregnancy.
Symptoms of Constipation
Common symptoms of constipation include:
- Fewer than three bowel movements a week.
- Dry, hard, and/or lumpy stools.
- Difficulty or pain when passing stools.
- Stomachaches or cramps.
- Feeling bloated or nauseated.
- A sensation of incomplete bowel evacuation.
Risk Factors for Constipation
Anyone can experience constipation, but some factors increase the risk of chronic constipation:
- Age: People over 65 are often less active, have slower metabolism, and reduced muscle contractions in the digestive tract.
- Gender: Those assigned female at birth, especially during pregnancy and postpartum, due to hormonal changes and pressure from the fetus on the intestines.
- Diet: Low intake of high-fiber foods.
- Medications: Certain drugs can contribute to constipation.
- Neurological and digestive diseases: Conditions affecting the brain, spinal cord, and digestive system.
Understanding these risk factors and symptoms can help manage and prevent constipation effectively.
How to Relieve Constipation
You can often manage mild to moderate constipation at home by adjusting your diet and lifestyle. Here are some tips for immediate relief:
- Increase Water Intake: Drink an extra two to four glasses of water daily. Avoid caffeine and alcohol, which can dehydrate you. Also, skip juice and sugary drinks.
- Avoid Certain Foods: Stay away from processed meats, fried foods, and refined carbs like white bread, pasta, and potatoes. Lean meats like poultry and low-fat dairy are fine.
- Eat High-Fiber Foods: Incorporate more fruits, vegetables, whole grains, and other high-fiber foods into your diet. Reduce intake of high-fat foods like meat, eggs, and cheese.
- Try High-Fiber Fruits: Eat prunes, bran cereal, and other high-fiber fruits like oranges, pineapples, berries, mangoes, avocados, and papayas.
- Keep a Food Diary: Track your meals to identify foods that may cause constipation.
- Exercise: Regular physical activity can help stimulate bowel movements.
- Adjust Toilet Posture: Elevate your feet, lean back, or squat to make bowel movements easier.
- Use Stool Softeners or Laxatives: If necessary, use a mild over-the-counter stool softener or laxative. Mineral oil enemas and stimulant laxatives are other options. Consult your healthcare provider for advice and avoid using laxatives for more than two weeks without professional guidance, as overuse can worsen symptoms.
- Avoid Distractions: Don’t read or use electronic devices while trying to have a bowel movement.
- Heed Nature’s Call: Don’t ignore the urge to use the bathroom, as delaying can disrupt the natural signals from your colon to your brain.
How to Prevent Constipation
To prevent constipation from becoming a chronic issue, you can use the same home-based methods that are effective for treating it:
- Eat a Fiber-Rich Diet: Include plenty of fruits, vegetables, legumes, and whole-grain breads and cereals in your meals. Fiber and water help your colon move stool more easily. Most fiber in fruits is found in the skin, such as in apples. Fruits with edible seeds, like strawberries, are high in fiber. Bran is another excellent fiber source—try eating bran cereal or adding it to other foods like soup and yogurt. Aim for 18 to 30 grams of fiber daily. If you have diverticulitis, your doctor may recommend avoiding fruits with seeds.
- Stay Hydrated: Drink eight 8-ounce glasses of water each day. Be aware that milk can cause constipation for some people. Avoid caffeinated drinks like coffee and soft drinks as they can dehydrate you, potentially worsening constipation.
- Exercise Regularly: Even light activities like walking can help keep your digestive system moving.
- Consider Supplements: A dietary supplement like magnesium can help prevent constipation. However, consult your healthcare provider before taking any new supplements.
- Respond to Your Body's Signals: Go to the bathroom as soon as you feel the urge to avoid disrupting the natural process.
By maintaining these habits, you can help keep your digestive system functioning smoothly and prevent constipation from becoming a recurring issue.