The term constipation can mean irregular or hard stools, or it can mean difficulty passing stools. Constipation may involve pain during the passage of a bowel movement, the inability to pass a bowel movement after straining or pushing for longer than 10 minutes, or no bowel movements for more than 3 days.
Since normal bowel patterns differ considerably from person to person, constipation is a relative term. Not every person has a bowel movement every day. Similarly, stool consistency can vary widely and still be normal. Some healthy people generally have soft or near-runny stools, while others have firm stools, but no difficulty in passing them.
Signs and Symptoms
- Infrequent, difficult passage of stools (fewer than three bowel movements a week)
- A sudden decrease in the frequency of bowel movements
- Stools harder than normal
- Bowel still feels full after a bowel movement
- Bloated sensation
Constipation is most often caused by a low-fiber diet, lack of physical activity, inadequate intake of fluid each day, or delay in going to the bathroom when you have the urge to defecate. Stress and travel can also contribute to constipation or other changes in bowel habits.
Other times, diseases of the bowel (such as irritable bowel syndrome), pregnancy, certain medical conditions (like an underactive thyroid or cystic fibrosis), mental health problems (such as depression), neurological diseases, or medications may be the reason for your constipation. More serious causes, like colon cancer, are much less common.
Constipation in children often occurs if they hold back bowel movements when they aren’t ready for toilet training or are afraid of it.
Your doctor will perform a physical examination, which may include a rectal exam and a pelvic exam if you are a woman.
The following tests may help diagnose the cause of constipation:
- Blood tests such as a CBC, PT, or PTT
- Stool studies
- X-rays of the abdomen
- Upper GI series (to look at the esophagus, stomach, and upper part of the small intestines)
- Barium enema (to look at the colon)
- Proctosigmoidoscopy (an examination of the lower bowel) or, depending on the symptoms a colonoscopy (an examination of the entire colon from the inside)
- Eat plenty of fiber.
- Drink at least 8 glasses of water per day.
- Go to the bathroom when you have to. Don’t try to hold it in.
- Take time to eat, breathe slowly, and chew food thoroughly.
- Eat smaller, more frequent meals and avoid overeating in one sitting.
- Drink warm lemon water just before meals to stimulate digestion.
- Try eating stewed or soaked prunes each day.
Chronic constipation can usually be prevented or treated with a combination of dietary changes, extra fluid intake, exercise, and, when necessary, short-term use of a laxative.
Your health care provider may talk with you about proper bowel habits (consistent, unhurried elimination practices). He or she may have you use a laxative or stool softener over the short term or suggest a bulk-forming agent, such as psyllium, bran, or methylcellulose.
You can purchase these bulk-forming agents over the counter. Children and adults should make sure they get enough fiber in their diet. Vegetables, fresh fruits (especially dried fruits), and whole wheat, bran, or oatmeal cereals are excellent sources of fiber.
To get the benefits of fiber, you must drink plenty of fluids (especially water) to help pass the stool.
Stool softeners (such as those that contain docusate sodium) may help. Bulk laxatives such as Psyllium may help add fluid and bulk to the stool. Suppositories or gentle laxatives, such as mineral oil or milk of magnesia, may be used to establish regular bowel movements.
Enemas or laxatives should be reserved for severe cases only. Laxatives should not be used over a long period of time because you can become dependent on them.
This relieves constipation by adding bulk to stool and speeding its transit through the digestive tract. Psyllium is an example of a soluble fiber used frequently as a laxative in Asia, Europe, and North America.
The use of herbs is a time-honored approach to strengthening the body and treating symptoms.
Aloe juice (also known as aloe latex or aloe sap) is a yellow, bitter liquid derived from the outer layer of the aloe leaf. It contains substances that, when taken by mouth, have very strong laxative effects. Although aloe latex (which differs from aloe gel) is a powerful laxative, it is not used frequently because it can cause painful cramping. Other gentler, herbal laxatives from the same plant family as aloe (such as cascara and senna) are generally recommended first.
- Burdock root ( Arctium lappa/Arctium minus/Arctium tomentosum )
- Dandelion ( Taraxacum officinale )
- Dong quai ( Angelica sinensis )
- Flaxseed ( Linum usitatissimum )
- Ginger ( Zingiber officinale )