What is constipation?
Constipation is a change in bowel habits that can mean passing stool less often than usual, having hard or lumpy stools, straining or having pain when passing stool, or feeling that you have not completely emptied your bowels. Having a bowel movement every day is not necessary for everyone—normal patterns vary. Fewer than three bowel movements a week is one common sign, but symptoms and changes from your usual pattern matter too. [1, 2]
Constipation can be short-term or chronic. It may occur when stool moves slowly through the colon, so more water is absorbed and the stool becomes dry and difficult to pass. Several factors can contribute at the same time. [1, 2]
What can cause it?
Possible contributors include:
- Not getting enough fiber or fluids, or being less physically active
- Changes in routine, travel, pregnancy, aging, or repeatedly ignoring the urge to go
- Medicines or supplements, including opioid pain medicines, iron, calcium-containing products, some antacids, and certain blood-pressure or depression medicines
- Health conditions such as diabetes, an underactive thyroid, or disorders affecting the nerves or muscles that coordinate bowel movements
- Pelvic-floor coordination problems, which can make it difficult to relax and pass stool
- Less commonly, a blockage or another structural problem [1, 2]
Do not stop or change a prescribed medicine on your own. Ask your healthcare professional whether a medicine or supplement may be contributing. [1, 3]
How is constipation evaluated?
Your clinician will usually begin by asking about your bowel habits, stool appearance, symptoms, diet, fluid intake, activity, medicines, health conditions, and family history. A bowel and symptom diary can help. A physical examination may include checking your abdomen and, when appropriate, a rectal examination. [2, 4]
Many people do not need extensive testing at the first visit. Depending on your symptoms and history, your clinician may recommend blood, stool, or urine tests; colonoscopy if you have concerning symptoms or are due for colorectal cancer screening; or specialized tests if constipation continues despite treatment. Specialized tests can assess how stool moves through the colon or how the rectum and pelvic-floor muscles work. [2, 4]
How is constipation treated?
Treatment is selected for the individual cause and symptoms. Your clinician may suggest one or more of these approaches:
Food, fluids, and activity
- Gradually increase fiber from foods such as vegetables, fruit, beans, and whole grains. Adults generally need about 22–34 grams of fiber a day, depending on age and sex. Adding fiber gradually may help reduce gas or bloating. [3, 5]
- Drink enough liquids to support the added fiber, unless your clinician has told you to restrict fluids.
- Regular physical activity may help bowel function. [3]
- Try sitting on the toilet at a regular time, such as after breakfast. Respond to the urge to go, allow enough time, and consider using a small footstool to make the position more comfortable. [3]
Over-the-counter medicines
If lifestyle measures are not enough, a clinician or pharmacist can help you choose an appropriate option. Options include fiber supplements and osmotic laxatives, which draw water into stool. Stimulant laxatives may be recommended in some situations, often for brief or rescue use. Some laxatives containing magnesium may be unsafe for people with kidney problems. Follow product directions and get professional advice if you need laxatives regularly, have other medical conditions, or take several medicines. [3, 6]
Prescription or targeted treatment
If symptoms persist, your clinician may discuss prescription medicines. If difficulty coordinating the pelvic-floor muscles is identified, specialized pelvic-floor biofeedback or muscle retraining may help. Treatment for constipation related to opioid medicines may differ from treatment for other causes. [3, 6]
What are the next steps?
- Track your symptoms for several days or weeks. Note bowel-movement frequency, stool consistency, straining, pain, blood, and medicines or supplements. [4]
- Review your medication and supplement list with your clinician. Do not stop prescriptions without medical advice. [3]
- Ask whether colorectal cancer screening is due. Constipation alone does not automatically mean you need a colonoscopy; your symptoms, medical history, and screening schedule guide that decision. [2]
- Contact a healthcare professional if symptoms do not improve with self-care, keep returning, or represent a new or lasting change in your usual bowel habits. [1, 2]
When to seek medical care
Contact a healthcare professional promptly if you have rectal bleeding or blood in your stool, unexplained weight loss, fever, persistent abdominal pain, or constipation that does not improve. [1]
Seek emergency care for severe or constant abdominal pain, vomiting, or inability to pass gas—especially if your abdomen is swollen or symptoms are worsening. These symptoms need urgent assessment. [1]
Set up an appointment
Call Digestive Healthcare of Georgia to set up an appointment with one of our providers. For appointments, call the office serving your area:
- Atlanta: (404) 355-3200
- Cartersville or Jasper: (706) 253-7340
- Fayetteville: (770) 719-3240
- Newnan: (678) 326-4812
- Ellijay: (706) 253-5514
- Woodstock, Marietta, or Canton: (404) 425-5570
Call to confirm the appropriate location and appointment availability. [7]
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms & Causes of Constipation. (niddk.nih.gov)
- American College of Gastroenterology (ACG). Constipation and Defecation Problems. (gi.org)
- NIDDK. Treatment for Constipation. (niddk.nih.gov)
- NIDDK. Diagnosis of Constipation. (niddk.nih.gov)
- NIDDK. Eating, Diet, & Nutrition for Constipation. (niddk.nih.gov)
- ACG. Chronic Idiopathic Constipation: Patient Information Based on ACG/AGA Guidelines. (webfiles.gi.org)
- Digestive Healthcare of Georgia. Contacts & Locations. (digestivehealthcare.net)
This information is for general education only. It does not replace medical advice, diagnosis, or treatment. Please discuss your symptoms and treatment options with your healthcare professional.
