Alternative names: Irregularity of bowels, Lack of regular bowel movements
A person who is constipated has trouble making bowel movements. Usually this means having a bowel movement less than three times a week. When a constipated person finally has a bowel movement, the process is difficult, and sometimes painful.
When it comes to bowel movements, every healthy person is "regular" in his or her own way. One person may have three bowel movements a day; another only three a week. But an adult is considered constipated if he or she has:
- A bowel movement less than three times a week
- Pain when trying to defecate
- Hard, dry stools
- The inability to defecate
Straining, or pushing hard when defecating, can lead to hemorrhoids, or swelling of the anal tissue. Hard stools and straining can also lead to tears in the skin around the anus, or even rectal prolapse, where a small amount of the intestinal lining pushes out through the anus.
Constipation is a common problem that can be caused by many different conditions. Possible causes include:
- A low-fiber diet that is high in fat and sugar
- A lack of physical activity
- Not drinking enough water
- Delaying trips to the bathroom. This can cause constipation in young children who are toilet training.
- Irritable bowel syndrome (spastic colon), a condition that slows the passage of waste products through the intestine
- Travel that changes your schedule, diet, and drinking water
- Overuse of laxatives. In time, the intestine fails to work properly.
- Problems with the lower intestine and rectum
Unless a doctor suspects an underlying cause, most people with constipation do not need extensive testing. Your doctor will want to discuss your medical history and your symptoms, and perform a physical exam.
To find out if your constipation is caused by another disorder, your doctor may perform one or more of these tests:
- Routine blood, urine, and stool tests
- Flexible sigmoidoscopy uses a thin, flexible tube - about two feet long - to examine the lower intestine and the rectum. The tube has a tiny video camera and a light mounted at its tip. The video camera transmits images to a television monitor, which allows your doctor to see inside your body. The procedure takes about three minutes, and causes only slight discomfort.
- In a colonoscopy, a doctor uses a thin, flexible tube to examine the entire large intestine. The tube has a tiny video camera and a light mounted at its tip. The video camera transmits images to a television monitor, which allows your doctor to see inside your body. This will take about an hour, and you will be given medication to make you relaxed and drowsy.
- Your doctor may suggest a barium enema X-ray test. Barium is a white substance that allows problem areas of the colon to show up on an X-ray. You will be given a barium enema before taking the X-ray.
- An upper gastrointestinal X-ray (upper GI series) shows the condition of your esophagus and stomach. Before the test, you will drink a chalky material that helps the esophagus and stomach show up on the X-ray.
For most people, changes in their diet and lifestyle can reduce constipation. Some suggestions:
- Eat a well-balanced diet that includes fiber-rich foods, such as bran cereals, whole-grain bread, and fresh fruits and vegetables. Limit foods that have little or no fiber, such as ice cream, cheese, meat, and processed items.
- Drink plenty of fluids
- Exercise regularly. This can be as simple as taking a short walk three times a week.
- Don't ignore your body's need to have a bowel movement
Doctors may prescribe laxatives for patients who have made diet and lifestyle changes, and are still constipated. Ask your doctor which laxative may be best for you. Laxatives come in several forms, including liquids, tablets, gums, powders, and as granules. These agents should not be used over a long period, as your body can become dependent on them. Never give laxatives to children without instruction from a doctor.