According to the , constipation is one of the most common digestive problems in the
United States, affecting around 42 million Americans. Constipation is defined
as having hard, dry bowel movements, or going fewer than three times a week.
Your colon’s main job is to absorb water from
residual food as it’s passing through your digestive system. It then creates
stool (waste). The colon’s muscles eventually propel the waste out through the
rectum to be eliminated. If stool remains in the colon too long, it can become
hard and difficult to pass.
Poor diet frequently causes constipation.
Dietary fiber and adequate water intake are necessary to help keep stools soft.
Fiber-rich foods are generally made from
plants. Fiber comes in soluble and insoluble forms. The soluble fiber can
dissolve in water and creates a soft, gel-like material as it passes through the
digestive system. Insoluble fiber retains most of its structure as it goes
through the digestive system. Both forms of fiber join with stool, increasing its
weight and size while also softening it. This makes it easier to pass through
Stress, changes in routine, and conditions
that slow muscle contractions of the colon or delay your urge to go may also
lead to constipation.
Common causes of constipation include:
- low-fiber diet
(particularly diets high in meat, milk, or cheese)
- lack of exercise
- delaying the impulse to
have a bowel movement
- travel or other changes
- certain medications,
such as high calcium antacids and pain medications
The following are some underlying medical
problems that can bring on constipation:
- certain diseases, such
as stroke, Parkinson’s disease, and diabetes
- problems with the colon
or rectum, including intestinal obstruction, irritable bowel syndrome, or
- overuse or misuse of
laxatives (medications to loosen stools)
- hormonal problems,
including an underactive thyroid gland
Each person’s definition of “normal” bowel
movements may be different. Some individuals go three times a day, while others
go three times a week. However, you may be constipated if you experience the
- fewer than three bowel
movements a week
- passing hard, dry
- straining or pain
during bowel movements
- a feeling of fullness,
even after having a bowel movement
- experiencing a rectal
Eating a poor diet and not exercising are
major risk factors for constipation. You may also be at greater risk if you
- Age 65
or older: Older adults tend to be less physically active, have
underlying diseases, and eat poorer diets.
to bed: Those who have certain medical conditions, such as
spinal cord injuries, often have difficulty with bowel movements.
woman or child: Women have more frequent
episodes of constipation than men, and children are affected more often than
Hormonal changes and pressure on your intestines from your growing baby
can lead to constipation.
Many people affected by constipation
choose to self-treat by changing their diets, increasing exercise, or using
over-the-counter laxatives. However, laxatives should not be used for more than
two weeks without consulting a physician. Your body can become dependent on
them for colon function.
You should talk to your primary care
- you have had
constipation for more than three weeks
- you have blood in your
- you have abdominal pain
- you are experiencing
pain during bowel movements
- you are losing weight
- you have sudden changes
in your bowel movements
Your doctor will ask questions about your
symptoms, medical history, and any medications or underlying conditions. A
physical examination may include a rectal exam and blood tests to check your
blood count, electrolytes, and thyroid function.
In severe cases, additional tests may be
required to identify the cause of your symptoms. Tests may include the
examination of how food is moving through your colon, called a marker study or
colorectal transit study. For this test, you will swallow a
pill that contains tiny markers that will show up on an X-ray. Numerous
abdominal X-rays will be taken over the next few days so the doctor can
visualize how the food is moving through your colon and how well your
intestinal muscles are working. You may also be asked to eat a diet high in
fiber during the test.
examination of the anal sphincter muscle function, called anorectal manometry. For this
test, your doctor will insert a thin tube with a balloon tip into your anus.
When the tube is inside, the doctor will inflate the balloon and slowly pull it
out. This test allows him or her to measure your anal sphincter’s muscle
strength and see if your muscles are contracting properly.
examination of the colon with a barium enema X-ray. For this
test, you will drink a special liquid the night before the test to clean out
the bowel. The actual test involves the insertion of a dye called barium into
your rectum, using a lubricated tube. The barium highlights the rectum and
colon area, allowing the doctor to better view them on an X-ray.
examination of the colon with a colonoscopy. In this
test, your doctor will examine your colon using a tube that is outfitted with a
camera and light source (colonoscope). A sedative and pain medication is often
given, so you will likely not even remember the examination and should feel no
pain. To prepare for this test, you will be on a liquid-only diet for one to
three days, and you may have to take a laxative or enema the night before the
test to clean out the bowel.
Changing your diet and increasing your
physical activity level are the easiest and fastest ways to treat and prevent
constipation. Try the following techniques as well:
- Every day, drink 1.5 to
2 quarts of unsweetened, decaffeinated fluids, like water, to hydrate the
- Limit consumption of
alcohol and caffeinated drinks, which cause dehydration.
- Add fiber-rich foods to
your diet, such as raw fruits and vegetables, whole grains, beans, prunes,
or bran cereal. Your daily intake of fiber should be between 20 and 35
- Cut down on low-fiber
foods, such as meat, milk, cheese, and processed foods.
- Aim for about 150
minutes of moderate exercise every week, with a goal of 30 minutes per day
at least five times per week (try walking, swimming, or biking).
- If you feel the urge to
have a bowel movement, don’t delay. The longer you wait, the harder your
stool can become.
- Add fiber supplements
to your diet if needed. Just remember to drink plenty of fluids because
fluids help fiber work more efficiently.
- Use laxatives
sparingly. Your doctor may prescribe laxatives or enemas for a short
period of time to help soften your stools. Never use laxatives for more
than two weeks without talking to your doctor. Your body can become
dependent on them for proper colon function.
- Consider adding probiotics
to your diet, like those found in yogurt and kefir with live active
have shown that this dietary change can be helpful for those with chronic
If you still have trouble with
constipation, your doctor may prescribe medications to help. According to the , linaclotide (Linzess) and lubiprostone (Amitiza)
are two drugs that are strongly recommended for people with IBS-related
constipation. These medications work by increasing the secretions in your
intestines, making the stool easier to pass.
Your doctor may also advise that you stop
taking certain medications that may cause constipation. More severe colon or
rectal problems may require manual procedures to clear the colon of impacted
stool, therapy to retrain slow muscles, or surgery to remove the problem part
of your colon.
Most cases of constipation are mild and
easily treated with changes in diet and exercise. If you are experiencing
chronic constipation, or constipation along with other bowel changes, it’s
important that you talk to your doctor.