- Infrequent bowel movements
- Hard stools that can cause strain and pain when passing
- Abdominal swelling
- Continued sensation of fullness after a bowel movement
- No bowel movement in at least three days (four days for children)
- Drink plenty of nonalcoholic fluids. These will soften the stool, and soft stools are easier to pass than hard ones. Be sure to drink at least eight glasses of water or fruit juice a day.
- Eat a diet high in fiber. Examples of high-fiber foods are grains (including unprocessed wheat bran), fruits, vegetables, and legumes. As your grandmother may have told you, prunes are particularly effective in preventing constipation, as are raisins and figs. Try to eat five to six servings of fiber-rich foods daily (which should provide 20 to 30 grams of dietary fiber). But be careful to increase your fiber intake gradually: consuming excessive amounts of fiber can lead to bloating and gas.
- Get regular exercise. Physical activity helps stimulate bowel movements by strengthening your abdominal and pelvic floor muscles.
- Set aside regular bathroom time. Try not to ignore the urge to defecate, even when it may not be convenient.
- Use laxatives or enemas sparingly, if at all. Chronic use of either interferes with the colon’s ability to contract.
- Constipation accompanied by fever, severe lower abdominal cramping, bloating, or pain. This may indicate a diverticular disorder.
- Bright red bloody streaks on your bowel movement. This can be a sign of hemorrhoids, caused when the hardened stool stretches and tears the anal opening. Bloody streaks can also signal anal fissures or even rectal carcinoma.
- Constipation after beginning a new prescription medication, vitamin, or mineral. You may need to discontinue the medication, change it, or reduce the dosage.
- Impacted bowel movement. The fecal mass becomes hardened, cannot be excreted, and must be removed by a physician.
- Any other significant changes in your bowel habits.
- American Gastroenterological Association
- Intestinal Disease Foundation
- National Digestive Diseases Information Clearinghouse
What Is Constipation?
Constipation is really more a complaint than a disorder—in fact, it is the most common gastrointestinal complaint in the United States. It is usually defined as the failure to have a bowel movement after three days or more and is often accompanied by a hardening of the stool and by straining during defecation.
Though constipation can be a sign of an underlying health problem, in most cases it’s nothing you need to worry about and can be remedied with self-care measures.
One of the biggest myths about constipation is that you’re constipated if you don’t have a daily bowel movement. Although a daily bowel movement is often thought of as “regular,” there is no norm for regularity. It is perfectly normal for a person to have a bowel movement once a day, twice a day, every other day, or perhaps only two or three times a week.
What Causes Constipation?
A lack of fiber in the diet is probably the most common cause; fiber adds bulk to stool, it absorbs water to help soften stool, and it stimulates peristalsis, the colonic contractions that produce the urge to defecate. A lack of fiber and fluids can result in hardened stools that are slow to pass.
Other common causes of constipation include not drinking enough fluids on a daily basis; a sedentary lifestyle; emotional stress, obsessive-compulsive disorder, or depression, which can bring about a change in bowel habits; ignoring the urge to defecate; travel or any other shift in your daily routine that changes your regular toilet habits; laxative abuse; and a lack of access to toilet facilities.
Constipation can be caused by various medications, including pain medications, calcium supplements, antacids containing aluminum, iron supplements, antidepressants, and diuretics. There are also medical conditions associated with constipation, including diabetes, kidney failure, backache, bowel disease, and irritable bowel syndrome. Pregnancy can also cause constipation because of hormonal changes.
What if You Do Nothing about Constipation?
If you have no other symptoms, constipation may clear up on its own in a matter of days; however, at the very least you may need to make some changes in your diet or other lifestyle habits to alleviate it.
Home Remedies for Constipation
Treatment depends on the specific cause, severity, and duration of the problem, but in most cases these straightforward measures will quickly bring relief.
Prevention of Constipation
The steps for alleviating constipation should also prevent its recurrence. In short, keep your fiber intake high; drink a minimum of eight glasses of water or other nonalcoholic fluid daily; exercise on a regular basis; try to keep regular toilet hours; and don’t ignore the urge to defecate.
When To Call Your Doctor about Constipation
Constipation that lasts longer than a week without apparent cause and continues despite self-care measures is a signal to consult a doctor, for it can occasionally be a symptom of some underlying disorder. You also should contact your physician if any of the following occurs.
What Your Doctor Will Do
After taking a thorough history, the doctor may perform a physical examination, including a digital rectal exam (DRE) with a gloved finger to evaluate the anal sphincter (the muscle that closes off the anus) and to detect any signs of impaction, tenderness, or blood. Diagnostic tests may also be prescribed, including one or more of the following: special blood tests, stool study, upper GI (gastrointestinal) series, barium enema x-ray, proctosigmoidoscopy.