Constipation is a change in bowel habits affecting the consistency or the frequency of the stools. Patients may have hard difficult to pass stools or they may have infrequent bowel movements (less than 3 times a week). Constipation is a common problem affecting millions of Americans. Occasional constipation is very common, but some people suffer from chronic constipation that can interfere with their quality of life. Although many factors can contribute to constipation, in most people no single cause can be identified.
- Having infrequent bowel movements (less than 3 times a week)
- Passing hard lumpy stools
- Straining to have a bowel movement
- Feeling that the bowel movements are incomplete
Constipation is usually diagnosed based on the symptoms and clinical examination. Your medications are reviewed to make sure they are not contributing to the symptoms. In some cases additional tests (blood tests, imaging or a colonoscopy) are needed to rule out other conditions, particularly if the constipation represents a change in bowel habits or if it is associated with rectal bleeding or if you have other associated symptoms or a family history of colorectal cancer.
When to see a doctor:
Most cases of mild intermittent constipation can be treated with over-the-counter laxatives and with dietary changes, however, it is important to seek medical help if the constipation:
- Is new and represents a change in bowel habits
- Is severe
- Lasts more than 3 weeks
- Is associated with other worrisome symptoms such as blood in the stools or on the toilet paper, weight loss or weakness.
The treatment starts with diet and lifestyle changes. Several prescription medications are also available if needed. The treatment options include:
- Eating a diet rich in fiber
- Exercising on a regular basis
- Taking over the counter stool softeners, fiber supplements or laxatives
- Taking probiotics
- Taking prescription laxatives
- Biofeedback which is a behavioral approach is indicated in some cases when the constipation is due to a dysfunctional contraction of the pelvic floor muscles.