Constipation is not a popular topic that people like to talk about. However, if you’ve suffered from this problem you know it can be both painful and frustrating.

Almost everyone gets constipated at some time during his or her life. It affects approximately 4% of the population in the U.S. Though not usually serious, constipation can be a concern and may lead to other health problems.

The following article reviews the things you should know about constipation.

What is Constipation?

Constipation occurs when bowel movements become difficult or less frequent. You are considered constipated if you are going longer than three days without a bowel movement. After three days, the stool or feces become harder and more difficult to pass.

What are the Symptoms and Causes of Constipation?

Symptoms of constipation can include:

  • Infrequent bowel movements and/or difficulty having bowel movements.
  • Swollen abdomen or abdominal pain.
  • Pain.
  • Vomiting.

What causes constipation?

Constipation occurs when stool passes through the large intestine too slowly. When stool stays in the large intestine too long, the intestine removes too much water, and the stool becomes hard and dry.

Some lifestyle habits that may cause constipation include:

  • Changing your normal diet, exercise, or travel habits
  • Resisting the urge to have a bowel movement, which is sometimes the result of pain from hemorrhoids.
  • Stress
  • Eating a low-fiber diet
  • Taking calcium or iron supplements
  • Not drinking enough liquids
  • Taking medicines such as painkillers with codeine; diuretics, also known as water pills
  • Medicine for depression
  • Some calcium supplements and antacids
  • Inadequate activity or exercise or immobility
  • Eating large amounts of dairy products

Some medical conditions that may cause constipation include:

  • Pregnancy or having given birth
  • Problems with the muscles and nerves in the intestine, rectum, or anus
  • Irritable bowel syndrome, a condition in which the nerves that control the muscles in the intestine don’t function correctly; the intestine becomes sensitive to food, stool, gas, and stress.
  • Overuse of laxatives (stool softeners) which, over time, weaken the bowel muscles.
  • Neurological conditions such as Parkinson’s disease or multiple sclerosis.
  • Colon cancer
  • Diabetes, a condition in which a person has high blood sugar, also called hyperglycemia, because the body cannot use blood glucose, or blood sugar, for energy.
  • Hyperthyroidism, a condition in which the thyroid gland does not produce enough hormone to meet the body’s needs and many of the body’s functions slow down.

How is Constipation Diagnosed?

Most people do not need extensive testing to diagnose constipation. Only a small number of patients with constipation have a more serious medical problem. If you have constipation for more than two weeks, you should see a doctor so he or she can determine the source of your problem and treat it. If constipation is caused by colon cancer, early detection and treatment is very important.

Tests your doctor may perform to diagnose the cause of your constipation include:

  • Blood tests if a hormonal imbalance is suspected.
  • Barium studies to look for obstruction of the colon.
  • Colonoscopy to look for obstruction of the colon.

The vast majority of patients with constipation do not have any obvious illness to explain their symptoms and suffer from one of two problems:

• Colonic inertia. A condition in which the colon contracts poorly and retains stool.

• Obstructed defecation. A condition in which the person excessively strains to expel stool from the rectum.

What Can I Do About Constipation?

You can take several steps to prevent and relieve constipation.

1. Eat more fiber.

Fiber helps form soft, bulky stools and is found in many vegetables, fruits, and grains. Be sure to add fiber to your diet a little at a time so your body gets used to it. Limit foods that have little or no fiber such as pizza, ice cream, cheese, meat, snacks like chips, and processed foods such as instant mashed potatoes or frozen dinners.

Fruits Vegetables Breads, Cereals, and Beans
• apples

• peaches

• raspberries

• tangerines

• oranges

• pears

• prunes

• acorn squash

• broccoli

• brussels sprouts

• cabbage

• carrots

• cauliflower

• spinach

• zucchini

• kidney beans

• lima beans

• cold whole-grain cereal (All-Bran, Total, Bran Flakes)

• hot whole-grain cereal (oatmeal)

• wheat or 7-grain bread

Your doctor may suggest you take fiber pills or powder to help soften and bulk up the stool. You can buy fiber products in a pharmacy or grocery store without a prescription. Some fiber products are flavored while others are not. Be sure and take the fiber with plenty of water as directed.

Some people have gas and bloating at first when taking extra fiber. Let your doctor know if you are having problems that do not go away after a few days.

2. Drink plenty of water and other liquids such as fruit and vegetable juices.

Liquids have little effect on stool form; however, drinking enough fluids is important because dehydration can cause constipation. Try not to drink liquids that contain caffeine or alcohol if you feel thirsty or dehydrated.

3. Get regular exercise.

Regular exercise helps your digestive system stay active and healthy. Exercising 20 to 30 minutes every day may help.

4. Visit the restroom when you feel the urge to have a bowel movement.

Sometimes people feel so hurried that they don’t pay attention to their body’s needs. Make sure you visit the restroom when you feel the urge to have a bowel movement. If you cannot have a bowel movement within 10 minutes, get up and return the next time you get the urge. Reading a book or magazine in the restroom may help you relax.

5. Use laxatives only if a doctor recommends them as an alternative.

Laxatives are medicines that help you pass stool. Most people who are mildly constipated do not need laxatives. However, if you are doing all the right things and you are still constipated, your doctor may recommend a laxative for a limited time.

Things to Remember?

  • Constipation may be present if you have three or fewer bowel movements in a week or if the stool is hard, dry, painful, or difficult to pass.
  • Constipation affects almost everyone at one time or another.
  • In most cases, following these simple steps will help prevent constipation:

o Eat a variety of foods, especially vegetables, fruits, and grains. 

o Drink plenty of liquids.

o Exercise regularly.

o Visit the restroom when you feel the urge to have a bowel movement.

  • Fiber pills and powders may help relieve constipation.
  • Most people with mild constipation do not need laxatives. However, your doctor may recommend a laxative for a limited time if you have constipation that does not improve.
  • Some medicines can cause constipation.

For More Information

American Gastroenterological Association
National Office
4930 Del Ray Avenue
Bethesda, MD 20814
Phone: 301–654–2055

International Foundation for Functional Gastrointestinal Disorders
P.O. Box 170864
Milwaukee, WI 53217
Phone: 1–888–964–2001 or 414–964–1799