Constipation

Having trouble going to the bathroom regularly is called constipation. This means you're having fewer than three bowel movements in a week, or you're having a hard time passing stool.

Constipation is quite common. Not eating enough fiber, drinking enough water, and not getting enough physical activity can all contribute to constipation. However, other health problems or certain medications can also be the cause.

Most often, constipation is treated by making changes to your diet and exercise routine, or by taking over-the-counter medications. Sometimes, constipation might need medicine adjustments or other treatment options recommended by a doctor.

If you have constipation that lasts a long time, also known as chronic constipation, there might be an underlying medical condition that's causing or worsening the problem. A doctor can help figure out the root cause and recommend appropriate treatment.

Having trouble going to the bathroom regularly can be a sign of constipation. This happens when you have fewer than three bowel movements in a week, and those movements are hard, dry, and lumpy. You might also feel like you're straining or experiencing pain during bowel movements. Sometimes, you may feel like you haven't completely emptied your bowels, or that your rectum is blocked. You might even need to use your finger to help pass stool.

Constipation is considered chronic if you experience two or more of these symptoms for three months or longer. It's important to talk to your doctor if you have constipation, especially if:

• The symptoms last longer than three weeks. This is a key sign that something might need medical attention.
• The symptoms make it hard to do everyday tasks. If constipation is interfering with your daily routine, it's a good idea to seek help.
• You notice blood in your rectum, on toilet paper, or in your stool. Blood in your stool or black stools are serious signs and require immediate medical attention.
• You see unusual changes in your stool's shape or color. Any noticeable changes in the appearance of your stool warrant a discussion with your doctor.
• You have ongoing stomach pain. Persistent stomach pain related to constipation needs to be evaluated.
• You've lost weight without trying. Unexplained weight loss can be a symptom of various issues, including digestive problems.

If any of these symptoms are concerning you, schedule an appointment with your doctor to discuss what's going on. They can help determine the cause of your constipation and recommend appropriate treatment options.

See a doctor if you're having trouble with constipation and any of these things:

• It lasts a long time: If your constipation has been going on for more than three weeks, it's important to get checked out. Long-term constipation can be a sign of an underlying health issue.

• It's affecting your daily life: If constipation is making it hard to do normal things, like getting dressed or going about your day, it's a good idea to talk to your doctor. This could be a symptom of a problem that needs attention.

• You're seeing blood: If you see blood in your stool, on the toilet paper, or bleeding from your rectum, this is a serious warning sign and needs immediate medical attention. This could be due to something more than just constipation, and needs evaluation.

• Changes in your stool: If your stool has an unusual color (like black) or shape, that's a reason to contact a doctor. These changes can indicate a problem that's more serious than just constipation.

• Constant stomach pain: If you have ongoing stomach pain that won't go away, even with constipation, it's crucial to see a doctor. This pain could be related to something else.

• Unexpected weight loss: If you're losing weight without trying to, this could be a sign of a problem. It's important to discuss this with your doctor, as it can be a sign of an underlying condition.

In short, if your constipation is severe, lasts a while, or comes with other symptoms like blood, unusual stool changes, or pain, you should schedule an appointment with your doctor. Don't ignore these signals; they could be a warning sign of a more significant health issue.

People have different bowel habits. Most people have bowel movements between three times a day and three times a week. Knowing what's normal for you is key.

Constipation happens when your stool moves too slowly through your large intestine (colon). When stool moves slowly, your body takes too much water out of it. This makes the stool hard, dry, and difficult to pass.

Several things can cause slow stool movement:

• Not drinking enough water: Your body needs water to help your stool move smoothly.
• Not eating enough fiber: Fiber adds bulk to your stool, making it easier to pass. Good sources include fruits, vegetables, and whole grains.
• Lack of exercise: Physical activity can help your digestive system work better.
• Ignoring the urge to go: If you hold off too long, your body can become less efficient at passing stool.

Some medicines, especially pain relievers containing opioids, can cause constipation. Other medicines, such as those for pain, seizures, nerve disorders, or allergies, can also be a factor.

The muscles supporting your organs in your lower belly (pelvic floor muscles) are important for passing stool. You need to be able to relax these muscles and push to get the stool out of your rectum. Problems with these muscles, like weakness or poor coordination, can lead to chronic constipation.

Sometimes, things like damage or changes in the tissues of your colon or rectum can block the passage of stool. Tumors in the colon, rectum, or nearby areas can also cause blockages.

Many different health conditions can affect the muscles, nerves, or hormones that control bowel movements. Chronic constipation can be linked to:

• Irritable bowel syndrome (IBS): A common digestive disorder.
• Diabetes: A condition affecting blood sugar levels.
• Multiple sclerosis (MS): A disease affecting the nervous system.
• Nerve problems or damage: This can impact how your body controls bowel movements.
• An overactive thyroid (hyperthyroidism): A condition where the thyroid gland produces too much hormone.
• Parkinson's disease: A neurological disorder.
• Pregnancy: The physical changes of pregnancy can sometimes affect bowel movements.

In some cases, the reason for chronic constipation isn't clear. If you're concerned about your bowel habits, it's best to talk to your doctor.

Several factors can make you more likely to have chronic constipation. One is age; as people get older, their digestive systems can sometimes slow down, leading to constipation. Women are also more prone to constipation than men. This isn't fully understood, but there are likely several biological reasons.

Another factor is a lack of physical activity. Regular exercise helps keep things moving through your digestive system. If you're not active, your bowels might not work as efficiently.

Finally, certain health conditions can increase the risk of constipation. Mental health issues like depression or eating disorders can affect digestion and contribute to this problem. These conditions can change how your body functions, making it harder to have regular bowel movements.

Long-term constipation can lead to several problems. One common issue is hemorrhoids, which are swollen blood vessels around the anus. This swelling can be painful and uncomfortable. Another complication is anal fissures. These are tiny tears in the lining of the anus, often caused by hard stools. They can also be quite painful.

Constipation can also cause a buildup of hard stool in the colon, called fecal impaction. This happens when the stool becomes so hard and packed that it's difficult or impossible to pass. Fecal impaction can be very uncomfortable and even dangerous if it's not treated.

Finally, long-term constipation can sometimes cause rectal prolapse. This is when part of the rectum (the final part of the large intestine) slips out of the anus. This can be painful and may require medical attention. It's important to remember that these issues are all related to the difficulty of passing stool due to chronic constipation.

Preventing Constipation: Simple Steps for a Healthy Bowel

Constipation is a common problem, but it's often preventable. Here are some easy ways to keep your digestive system running smoothly:

1. Fuel Your Body with Fiber: Fiber is like the scrubbing brush for your digestive system. It helps move food through your intestines, preventing things from getting stuck. Load up on high-fiber foods. This means plenty of:

• Vegetables: Think broccoli, carrots, spinach, and more. The more colorful, the better! Aim for a variety.
• Fruits: Apples, berries, pears, and prunes are all good choices. Don't forget the skins when possible, as they often contain extra fiber.
• Beans and Legumes: Lentils, chickpeas, and kidney beans are excellent sources of fiber.
• Whole Grains: Brown rice, whole-wheat bread, and oatmeal are better choices than refined grains. Look for "whole grain" on food labels.

2. Limit Processed Foods, Dairy, and Meat (Sometimes): While these foods can be part of a healthy diet, they often have less fiber. Try to balance them with high-fiber options. This doesn't mean you need to completely cut them out, just be mindful of portion sizes.

3. Hydration is Key: Just like a car needs oil, your body needs water to function properly. Drink plenty of water throughout the day. Other fluids, like juice and milk, can also help.

4. Get Moving: Regular exercise helps keep everything moving along in your digestive tract. Aim for at least 30 minutes of moderate-intensity exercise most days of the week. This could be brisk walking, swimming, or any activity you enjoy.

5. Listen to Your Body: Don't ignore the urge to go to the bathroom. Holding it in can make constipation worse.

6. Establish a Routine: Try to go to the bathroom around the same time each day, especially after meals. This helps your body get into a regular pattern, making bowel movements easier and more predictable.

By following these simple tips, you can help prevent constipation and maintain a healthy digestive system. If you have persistent or severe constipation, it's always best to talk to a doctor.

Understanding Constipation: Diagnosis and Testing

When you have constipation, a healthcare professional will likely perform a physical exam and ask you questions to understand your situation better. This includes:

• Physical Exam: A gentle touch on your abdomen helps check for any pain, tenderness, or unusual lumps. The doctor will also examine the area around your anus and the anus itself. They may use a gloved finger to feel the rectum and the muscles controlling your bowel movements.

• Medical History and Lifestyle: The healthcare provider will also ask about your medical history, diet, exercise routine, and bowel habits (including the characteristics of your stools). This information often helps in diagnosing the cause of your constipation.

• Laboratory Tests: Sometimes, blood samples are sent to a lab to test for conditions that can cause constipation. This can help identify underlying health issues.

• Endoscopy: A procedure called endoscopy may be used. A thin, flexible tube with a camera is inserted into your colon (large intestine). This allows the healthcare professional to see the condition of your colon and look for any unusual tissue. Before an endoscopy, you might need to follow a special diet, use an enema, or drink a solution to clear your colon. There are two main types:

  • Colonoscopy: This test examines the entire colon and rectum.
  • Sigmoidoscopy: This test examines the lower part of the colon (the sigmoid colon) and rectum.

• Imaging Tests: Depending on your symptoms, X-rays or more advanced imaging like CT scans or MRIs might be ordered. These tests can show the position of stool in your colon and help identify any blockages.

• Tests to Track Stool Movement: Some tests track how quickly stool moves through your colon. These include:

  • Radiopaque Marker Study: A pill containing tiny markers is swallowed. X-rays track the movement of these markers through your colon over time.
  • Scintigraphy: You eat a meal containing tiny radioactive substances. Special equipment tracks how these substances move through your colon.

• Tests of Rectum and Anus Function: These tests assess how well your rectum and anus work:

  • Anorectal Manometry: A thin, flexible tube is inserted into your rectum and anus. After a small balloon is inflated, it is removed. This measures the coordination of muscles used for bowel movements.
  • Balloon Expulsion Test: A small, water-filled balloon is placed in your rectum. The time it takes to push the balloon out measures how well your muscles work.
  • Defecography: A special, trackable substance is placed in your rectum. X-rays or MRI images show how well your rectum and anus function during a simulated bowel movement.

These tests help healthcare professionals understand the cause of your constipation and develop a personalized treatment plan. If you are concerned about constipation, talk to your doctor. They can help you understand the process and any necessary tests.

Treating Constipation: A Guide

Constipation is a common problem that can be managed effectively. Treatment often starts with changes to your diet and lifestyle to help stool move through your intestines more easily. Your doctor might also adjust your medications if they're contributing to the problem. If these initial steps don't work, other treatments may be necessary.

Dietary and Lifestyle Changes:

• High-Fiber Diet: Eating plenty of fiber is crucial. Fiber adds bulk to your stool, helping it hold water and maintain the right consistency for easy passage. Good sources include fruits (apples, berries), vegetables (broccoli, carrots), beans, and whole grains (like whole-wheat bread, brown rice). Gradually increase your fiber intake to avoid bloating and gas. The recommended daily amount of fiber is 25-34 grams, depending on your calorie needs.

• Hydration: Drink plenty of water and other fluids without caffeine. This keeps your stool soft and prevents the bloating and discomfort that can come with eating more fiber.

• Regular Exercise: Physical activity helps your intestines work more efficiently. Aim for most days of the week. If you're not already active, talk to your doctor about starting safely.

• Regular Bowel Habits: Establish a routine for bowel movements. Try to have a bowel movement 15-45 minutes after meals, as digestion helps move things along. Don't ignore the urge to go.

Other Treatments:

• Prunes: Dried plums (prunes) are a good source of fiber and contain natural substances that draw water into the intestines, making stool softer.

• Laxatives: These are medications that help move stool through the intestines. Different types work in various ways:

  • Fiber Supplements: These help stool absorb water, making it softer and easier to pass. Examples include psyllium husk (Metamucil), calcium polycarbophil (FiberCon), and methylcellulose (Citrucel).
  • Osmotic Laxatives: These increase the amount of water in your intestines, softening your stool. Examples include magnesium hydroxide (Phillips' Milk of Magnesia), magnesium citrate, lactulose, and polyethylene glycol (Miralax).
  • Stimulant Laxatives: These directly stimulate the intestines to contract and move stool. Examples include bisacodyl and sennosides.
  • Lubricants: These, like mineral oil, coat the stool, making it easier to pass.
  • Stool Softeners: These, like docusate sodium, help draw water into the stool, making it softer.

• Enemas and Suppositories: These are used when other treatments don't work. An enema involves inserting a liquid into the rectum, while a suppository is a medication-filled object inserted into the rectum. These methods can provide temporary relief.

• Prescription Medications: If other treatments are unsuccessful, your doctor might prescribe medications like Lubiprostone, Linaclotide, Plecanatide, or Prucalopride. If constipation is related to opioid pain medications, other medications that block the effects of opioids on bowel movements might be prescribed. These include Methylnaltrexone, Naldemedine, or Naloxegol.

• Pelvic Muscle Training and Biofeedback: Working with a therapist using biofeedback devices can help you improve control over the muscles in your pelvis, rectum, and anus, which can be beneficial for chronic constipation.

• Surgery: In rare cases, surgery might be necessary to correct structural problems in the intestines or rectum. This is typically a last resort.

Important Note: Always talk to your doctor before making significant changes to your diet, starting any new medications, or trying new treatments for constipation. They can help you determine the best course of action for your specific situation.