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Definition of Constipation
Constipation is defined as having less than three bowel movements a week and affects roughly 30% of Americans. It occurs when the colon absorbs an excessive amount of water, causing the stool to become hard, dry, small in size and difficult to eliminate. People who are constipated often find it painful to have a bowel movement and sometimes experience straining, bloating and the sensation of a full bowel. However, most cases of constipation are temporary and not serious.
Common Signs and Symptoms
What is considered the normal frequency of bowel movements varies with each individual and depends on several factors, such as a person's age, diet, exercise and overall health. While some people have a bowel movement once a day, others may go more or less. Constipation occurs when a person passes fewer than three stools a week, and people with chronic constipation may experience one or more of the following symptoms:
¦Experience hard stools
¦Strain excessively during bowel movements
¦Experience a sense of rectal blockage
¦Have a feeling of incomplete evacuation after having a bowel movement
¦Feeling bloated or sluggish
¦Need to use manual maneuvers to have a bowel movement, such as finger evacuation or manipulation of the lower abdomen
Since almost everyone experiences constipation at some point in their life, most people do not go to see a doctor. However, in some cases chronic constipation may lead to complications or be a symptom of a more serious health problem. A person may want to seek medical care if any of the following signs or symptoms are experienced:
¦Bowel movements occurring more than three days apart, despite corrective changes in diet or exercise
¦Intense abdominal pain
¦Blood in your stool
¦Constipation that alternates with diarrhea
¦Rectal pain
¦Thin, pencil-like stools
¦Unexplained weight loss
Causes of Constipation
The most common cause of constipation is a lack of fiber in one's diet, but other common causes include the following:
¦Not getting enough liquids or dehydration
¦Lack of exercise (especially in older adults)
¦Irritable bowel syndrome (IBS)
¦Lifestyle changes, including pregnancy, aging and travel
¦Ignoring the urge to have a bowel movement
¦Frequent use or abuse of laxatives
¦Specific diseases, such as stroke, diabetes, thyroid disease and Parkinson's disease
¦Problems with the colon and rectum, such as intestinal obstruction or diverticulosis
¦Certain medications, including pain medications, diuretics and those used to treat Parkinson's disease, high blood pressure and depression
¦Hormonal disturbances, such as an underactive thyroid gland
¦Anal fissures and hemorrhoids, which can produce a spasm of the anal sphincter muscle
¦Loss of body salts through vomiting or diarrhea
¦Injuries to the spinal cord, which can affect the nerves that lead to the intestine
Risk Factors
Constipation typically affects women more than men and children more than adults. Pregnant women may experience bouts of constipation because of hormonal changes or from pressure on the intestines from the expanding uterus. Other risk factors include the following:
¦Older adults
¦Eating a diet low in fiber
¦Not getting enough liquids
¦Sedentary lifestyle
¦Medications, including sedatives, narcotics or certain medications that lower blood pressure
¦Undergoing chemotherapy
Treatment Options
Although treatment depends on the cause, severity and duration of the constipation, simple changes in a person's diet and lifestyle will often relieve symptoms and help a person manage constipation.
Try one or more of the following lifestyle changes:
¦A high-fiber diet with at least 20 to 35 grams of fiber each day. High-fiber foods include beans, whole grains and fresh fruits and vegetables
¦Regular exercise to help stimulate intestinal activity
¦Drinking plenty of water and other fluids will help soften the stool
¦Take the time for bowel movements and do not ignore the urge to have a bowel movement
¦Over-the-counter laxatives should be considered as a last resort because they can become habit-forming
¦Chloride channel activators are available by prescription and increase fluid content of stool
¦5-HT-4 agonists stimulate release of compounds in the body that increase fluid secretion in the intestines and decrease colonic transit time
If a person's constipation is related to an underlying disorder, treatment will focus on the initial cause. Other treatment methods may include bowel retraining, rectal suppositories, enemas, biofeedback, or in more severe cases, surgical removal of the problem segment/segments of the anal sphincter or rectum
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