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Constipation

Constipation is common gastrointestinal condition in which bowel movements become infrequent or difficult or painful to pass.  What’s considered regularity varies widely based on age, diet and activity level, but norms range from passing 3 stools per day to 3 stools per week. In general, though, you’re most likely experiencing constipation if you’re passing less than 3 stools per week for more than 2 weeks in a row and your stools are hard and dry.

There are many causes for constipation, but the end result is the same. In your digestive system, it’s normal for nutrients to be removed from the foods you’ve eaten, passed into the bloodstream, and what’s left over is moved through the intestinal tract and into the colon, where it’s temporarily stored while being readied for disposal. In general, this leftover residue is excreted through bowel movements within 1-2 days.

Constipation starts when fecal material sits in the colon for too long. If there’s not enough fluid or fiber-rich food in your diet, the colon can’t move the material through quickly enough, which causes the stool to harden and dry. Another root cause of constipation may be if the muscles you use to move your bowels are improperly coordinated.  This issue is called pelvic floor dysfunction, and can cause you to strain with any type of bowel movement- even soft ones.

Causes:

There are a number of factors that can create constipation, including:

  • Nutritional deficiencies
  • Not enough fiber in your diet
  • Not enough fluid intake dehydration
  • Ignoring the urge to go to the bathroom or delaying too long
  • Sedentary lifestyle (especially in older adults)
  • Stress
  • Pregnancy
  • Cancer
  • Depression
  • Changes in lifestyle or routine, including travel
  • Illness
  • Frequent or misuse of laxatives or narcotic pain medication
  • Specific diseases such as Parkinson’s, diabetes, stroke, thyroid disease
  • Underactive thyroid glands or other hormonal deficiencies
  • Hemorrhoids and anal fissures, which can cause spasms in the sphincter muscle
  • Spinal cord injuries

In some cases, constipation may be an indication of a more serious medical disease such as colorectal cancer or autoimmune diseases.

Children may experience constipation if they are unwilling or afraid to use the toilet, especially in school, where they are embarrassed to ask to use the bathroom.  Toddlers often become constipated during toilet training because they are afraid to use the toilet. Some children may avoid having bowel movements because they have experienced minute tears in the anus from straining, and are sensitive to the pain.

Symptoms

There are several symptoms that indicate constipation, including:

  • Hard or compacted stools that are painful or difficult to pass
  • Fewer bowel movements
  • Cramps or stomachache that is relieved by bowel movements
  • Bloody stools caused by tearing of hemorrhoids
  • Straining to pass bowel movements
  • Wet, diarrhea-like stool leaking between regular bowel movements
     
Treatment

There are several ways to treat constipation. You should contact your physician if your constipation is accompanied by fever or lower abdominal pain/swelling, vomiting, loss of appetite or blood in your stools. Another sign to contact a doctor is if constipation starts after your start using a new prescription drug or mineral supplements, if there’s pain when passing bowel movements, or you’re losing weight without dieting.

For children, it’s time to see a doctor if the child has been constipated for more than 2 weeks. For elderly or disabled patients, if you have been constipated for more than a week, there is a possibility of having an impacted stool.

Fortunately, constipation is very treatable. There are a number of different avenues of treatment based on the severity of the constipation, accompanying issues and the age and lifestyle of the patient. If you’re experiencing constipation and looking for help or more information, please contact GI Associates for answers or to schedule an appointment.