What Is Constipation?

Normal bowel movement frequency can differ greatly from person to person. Some people may pass stools several times a day, while others may only poop once or twice a week. Constipation becomes an issue when a lack of bowel movements becomes distressing or interferes with daily life.

• Lumpy, dry, or hard stools
• Stools that are difficult or painful to pass
• Feeling as though your rectum is blocked
• Feeling as though you can’t completely empty your bowels
• Needing help to empty your rectum, such as using a finger to remove stool

Constipation is considered chronic if you experience two or more of these symptoms for three months or more.

Lifestyle Causes

• Lack of fiber
• Inadequate fluids
• Too much coffee, tea, or alcohol
• Lack of physical activity
• Pregnancy

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• Changes in your daily routine, such as traveling

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Medications

• Pain, such as opioids
• Antacids
• Antihistamines (allergy medications)
• Antidepressants
• High blood pressure medications
• Seizure medications
• Anticholinergics (drug used to treat nervous system disorders)
• Antipsychotics
• Obesity and diabetes

Medical Conditions

• Pelvic floor disorders
• Neurological disorders, such as Parkinson's disease, multiple sclerosis, or stroke
• Diabetes
• Conditions that cause blockages, such as a tumor
• Gastrointestinal disorders, such as irritable bowel syndrome (IBS)
• Migraine

In addition to a general physical exam, your doctor may also:

• Gently feel your abdomen to check for tenderness, pain, or irregular lumps
• Examine your anus and the surrounding tissue
• Use a gloved finger to examine your rectum

In some cases, an initial doctor's visit may be enough to diagnose constipation and make a treatment plan. But, if lifestyle interventions don't resolve constipation, you may need additional tests to determine the underlying cause.

• Lab Tests A stool sample test can check for signs of infection, inflammation, and cancer. Blood and urine tests can reveal underlying conditions, such as diabetes, hypothyroidism, and anemia.
• Imaging Tests An X-ray, MRI, or CT scan can reveal blockages in your colon or other problems causing constipation.
• Endoscopy Your healthcare provider may perform a colonoscopy or endoscopy. This procedure involves inserting a small tube with a scope to examine your rectum and colon.
• Colorectal Transit Study This involves swallowing a pill that tracks how food moves through your digestive system.
• Rectum and Anus Tests These assess how well your rectum and anus are functioning. They include insertion of a small balloon into your rectum to check how your muscles are working and X-ray or MRI imaging to reveal how your rectum and anus work when passing stool.

If these changes don't help, other options may be necessary, like laxatives, enemas, prescription medications, or rarely, surgery.

Diet and Lifestyle Changes

• Eat plenty of fiber.
• Drink enough water.
• Get regular physical activity.
• Don't avoid the urge to pass stool.

Laxatives

• Fiber supplements These help your stool retain fluid, increasing their consistency and making them easier to pass. Examples include psyllium and methylcellulose
• Osmotics These draw water into your intestines, helping stool move more easily through your colon. Common osmotics include milk of magnesia, lactulose, sorbitol, and polyethylene glycol (PEG).
• Lubricants Lubricants, like mineral oil, aid the passage of stool by lubricating the intestines.
• Stimulants These cause your intestines constrict (peristalsis) and decrease the amount of water they absorb, helping to push stool through your colon. Examples include bisacodyl, senna, cascara, and sodium picosulfate (SPS).

Enemas and Suppositories

Suppositories are small, tube-shaped objects inserted into your rectum. They slowly dissolve and release laxative medications such as osmotics, lubricants, or stimulants.

Prescription Medications

• linaclotide (Linzess)
• lubiprostone (Amitiza)
• plecanatide (Trulance)
• prucalopride (Motegrity)
• prescription osmotics, such as lactulose

• methylnaltrexone (Relistor)
• naldemedine (Symproic)
• naloxegol (Movantik)

Biofeedback Therapy

During biofeedback therapy, a physical therapist inserts a probe into your rectum and places pads on your abdomen to monitor your muscle coordination. They then lead you through breathing, strengthening, and relaxation exercises to retrain the movement and coordination of your pelvic floor.

Surgery

• Hemorrhoids Swollen, inflamed veins in the rectum caused by repeated straining
• Anal Fissures Small tears in the skin around the anus caused by overstretching, often accompanied by bleeding
• Impacted Stool Stool that has become hardened and stuck in the colon
• Rectal Prolapse When a small part of your intestinal lining pushes out of your anus, caused by straining

• Constipation is difficulty having bowel movements or having fewer than three bowel movements a week.
• Common causes of constipation include a lack of dietary fiber, pregnancy and other life changes, medication side effects, and certain medical conditions.
• Treatment for constipation includes diet and lifestyle changes, laxatives and other medications, enemas, and rarely, surgery.
• Eating a healthy diet, getting regular physical activity, and practicing good bowel habits can help prevent constipation.