Constipation: Symptoms, Causes, Diagnosis, Treatment & Prevention

 

Stool passing is a symptom of constipation. In general, constipation is characterized by difficulty passing stool or less than three stools per week.

Constipation happens quite frequently. Constipation can be brought on by a lack of exercise, fluids, and dietary fiber. However, the cause might be other medical conditions or medicines.

Usually, nonprescription medications or dietary and exercise modifications are used to treat constipation. A health care provider may prescribe medications, medication adjustments, or other treatments for constipation.

Treating chronic constipation, also known as long-term constipation, may necessitate managing another disease or condition that worsens or causes constipation.

What is constipation?

In technical terms, constipation is defined as having fewer than three bowel movements per week. However, the frequency of bowel movements varies greatly from person to person. While some people only poop once or twice a week, others poop multiple times a day. As long as you don't deviate too much from your pattern, your bowel movement pattern is distinct and typical for you.

One thing is for sure, regardless of your bowel patterns: It gets longer for poop to pass the longer you wait to void. Other salient characteristics that typically characterize constipation are:

• You have hard, dry stools.

• Your stools are hard to pass, and your bowel movements was painful.

• You feel as though you haven't completely emptied your bowels.

Also Read: Gastritis: Symptoms, Causes, Risk factors, Treatment & Prevention

Symptoms:

Constipation symptoms include:

• Under three stools per week

• Lumpy, dry, or hard stools

• Pain or straining during stool pass

• A sense that some stool has not gone through

• A feeling that the rectum is blocked

• The need to use a finger to pass stool

Causes:

Bowel movement patterns differ from person to person. Three times a day to three times a week is the usual range. Therefore, it's critical to understand what is normal for you.

Constipation generally happens when stool passes through the colon, also known as the large intestine, too slowly. The body absorbs too much water from the stool if it moves slowly. The stool may become dry, hard, and difficult to pass.

Causes of lifestyle

Slow bowel movements can occur when someone doesn't:

• Be sure to consume adequate fluids

• Consume enough dietary fiber

• Engage in regular exercise

• When you feel the need to pass stool, use a toilet

Certain medications

Especially opioid painkillers, can cause constipation as a side effect. Other medications that treat the following conditions may also contribute to constipation:

• Pain

• High blood pressure

• Seizures

• Depression

• Nervous system conditions

• Allergies

Problems with the muscles of the pelvic floor

The pelvic floor muscles are responsible for supporting the organs at the base of the torso. To pass stool from the rectum, one must be able to bear down and relax these muscles. Chronic constipation may result from problems with these muscles' coordination or weakness.

Blockages in the rectum or colon

Stool passage may be obstructed by damage or alterations to the tissues in the colon or rectum. A blockage may also result from tumors in the colon, rectum, or nearby tissues.

Further factors

Stool-passing muscles, nerves, and hormones can be impacted by a variety of conditions. Numerous factors can be connected to chronic constipation, such as:

• The syndrome of irritable bowel

• Diabetes

• Multiple sclerosis

• Nerve injury or dysfunction

• Hyperthyroidism is another name for an overactive thyroid

• Parkinson's disease

• Pregnancy

There are situations when the cause of persistent constipation is unknown.

Risk factors:

The following variables could raise your risk of developing chronic constipation:

• Being an older adult

• Being a women

• Engaging in minimal or no physical activity

• Possessing mental health conditions like eating disorders or depression

Complications:

Chronic constipation can lead to the following complications:

• Hemorrhoids are the term for the enlarged tissues surrounding the anus

• Anal fissures are another name for torn anus tissues

• Fecal impaction is the term for hard stools that back up into the colon

• Rectal prolapse is the term for exposed rectum tissues that have slipped out of the anal opening

Testing and Diagnosis:

When I discuss my constipation with my healthcare provider, what can I expect?
Discussing your bowel movements (or lack thereof) with a healthcare professional or anybody else may not be the most agreeable of topics. However, know that you have your provider's support. They are qualified medical professionals who have discussed to their patients about almost any health issue you can imagine.

Your healthcare provider will start by inquiring about your routines, lifestyle, bowel movements, and medical history.

Medical history

These inquiries could consist of:

• Which diseases and conditions do you currently have or have you had in the past?

• Have you recently gained or lost weight?

• Have you ever undergone surgery on your digestive tract?

• Which medications and supplements do you take to treat other conditions, such as constipation?

• Does anyone in your family have a history of colon cancer, digestive tract disorders, or constipation?

• Do you have a colonoscopy history?

History of bowel movement

These inquiries could consist of:

• What is the frequency of your bowel movements?

• How do your stools look like?

• Have there been any red or bloody stains in your stool?

• After wiping, have you ever noticed blood on the toilet paper or in the toilet bowl?

Routines and lifestyle choices

What do you typically eat for each meal of the day?

How frequently do you consume vegetables and fruits?

What is your water intake?

How do you work out?

Your vital signs (blood pressure, pulse, and temperature) will be checked as part of your physical examination. They will listen to the sounds in your abdomen with a stethoscope. Additionally, they will touch your abdomen to feel for lumps, pain, swelling, and tenderness.

Be advised that a rectal examination may also be performed by your provider. This is a finger examination of your rectum's inside. It's a fast check for any lumps or issues that the finger can detect.

In order to determine the cause of my constipation, what laboratory and other medical tests might be performed?

Your doctor may order a variety of tests and procedures, or they may order none at all. Tests will be conducted based on your symptoms, medical history, general health, and their suspected cause. In most cases, a diagnosis can be made without further laboratory testing. However, depending on your symptoms, your doctor might decide to take further action.

• Lab tests: Anaemia, diabetes, and hypothyroidism are detected by blood and urine tests. A stool sample looks for indications of cancer, inflammation, and infection.

• Imaging tests: To find additional issues that might be contributing to your constipation, your doctor might prescribe a computed tomography (CT), magnetic resonance imaging (MRI), or lower gastrointestinal tract series. These aren't typically ordered, though.

• Colonoscopy: Your healthcare provider may use a scope to view your colon internally during a colonoscopy or sigmoidoscopy. A biopsy, or tiny sample of tissue, may be taken during this procedure to check for cancer or other problems, and any polyps will be removed.

• Colorectal transit studies: In these tests, a small dose of a radioactive material is taken orally or through food, and the passage of the material through the intestines is monitored over time.

• Additional bowel function tests: Your doctor might prescribe tests to assess the capacity of your rectum and anus to hold and release stool. These tests include the insertion of a tiny balloon into your rectum (balloon expulsion test and anorectal manometry), as well as a specific kind of X-ray called defecography, which is performed to rule out causes of outlet dysfunction constipation.

Treatment:

How can constipation be relieved?

Most mild to moderate cases of constipation are manageable at home. Making dietary and beverage changes is the first step in practicing self-care.

Here are some suggestions for quick at-home constipation relief:

• Increase your daily water intake by two to four glasses. Steer clear of alcohol and beverages with caffeine as they can dehydrate you. Avoid of juice and other highly sweetened drinks as well.

• Avoid clear of fried foods, processed meats, and refined carbohydrates like potatoes, pasta, and white bread. Lean meats, such as poultry, and low-fat dairy products are acceptable.

• Include whole grains, fruits, vegetables, and other foods high in fiber in your daily diet. Reduce your intake of foods high in fat, such as cheese, eggs, and meat.

• Consume bran cereal, prunes, and other fruits high in fiber, such as papaya, oranges, pineapples, berries, mangos, and avocados.

• Keep a food journal and identify foods that cause constipation.

• Get up and move—work out.

• Examine your sitting position on the toilet. Pooping may be made easier by squatting, leaning back, or raising your feet.

• Supplement your diet with an over-the-counter fiber supplement, such as Metamucil®, MiraLAX®, Citrucel®, or Benefiber®. With these, it's best to begin gradually.

• Take a very mild over-the-counter laxative or stool softener (like docusate) if necessary. Other options include stimulant laxatives and mineral oil enemas. There are numerous options for laxatives. Seek assistance from your healthcare provider or pharmacist when making a decision. Avoid taking laxatives for longer than two weeks without first contacting your doctor. Using laxatives excessively can make your symptoms worse.

• When attempting to empty your bowels, avoid using electronics such as your phone or reading.

• Refrain from resisting the urge to go to the restroom. It will eventually stop your colon from sending a signal to your brain telling you to relax and release the waste.

Review of medications and supplements

Your healthcare provider will go over your medications and supplements (if you take any) in addition to self-care techniques. Constipation may result from using some of these products. If they do, your doctor might ask you to stop taking the supplement, change the dosage, or switch to a different medication. Consult your provider before ceasing to take any supplements or medications.


Prescription medication for constipation

Constipation can be treated with a few prescription medications. These consist of:

• (Amitiza®) Lubiprostone

• Prucalopride (Motegrity®, Prudac®)

• Trulance® (plecanatide)

• Lactulose (Kristitalose®, Cephulac®)

• (Linzess®) Linaclotide

Based on the outcomes of your tests, your doctor will determine which medication might be most effective for you.

Surgery

Constipation is rarely treated with surgery. However, if constipation is brought on by a structural issue in your colon, your doctor might suggest surgery. These issues include, for instance:

• Intestinal obstruction, which is a blockage in your colon.

• Intestinal stricture, which is a narrowing of a section of your intestine.

• An anal fissure is a tear in your anus.

• Rectal prolapse is when a portion of your rectum collapses into your vagina.

• Surgery may be used to treat certain causes of outlet dysfunction constipation. It is best to talk about this after testing. If a colonoscopy finds cancer in your colon, rectum, or anus, you might also require surgery.

Prevention:

You can prevent constipation by following these tips.

• Consume a lot of foods high in fiber, such as fruits, vegetables, whole grains, and beans.

• Reduce your intake of low-fiber foods like processed foods, dairy products, and meats.

• Continue to be active and get regular exercise.

• Establish a regular stool-passing routine, particularly after eating.

• Every day, drink eight 8-ounce glasses of water. (Note: Some people might get constipation after consuming milk.) Caffeine-containing liquids, like coffee and soft drinks, can cause dehydration. It might be necessary for you to cease consuming these products until your bowel habits stabilize.

•  Regular physical activity. It does not include to be much—even a little stroll can be very beneficial.

• For constipation, take a dietary supplement such as magnesium. Magnesium should not be taken by everyone. Before taking, consult your healthcare provider.)

References:

• American Gastroenterological Association. Constipation (https://patient.gastro.org/constipation/). Accessed 7/18/2023.

• Constipation. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/all-content. Accessed May 30, 2023.

• Wald A. Management of chronic constipation in adults. https://www.uptodate.com/contents/search. Accessed May 30, 2023.

• American Gastroenterological Association. Constipation (https://patient.gastro.org/constipation/). Accessed 7/18/2023.

• Ma W, et al. The gut microbiome and colonic motility disorders: A practical framework for the gastroenterologist. Current Gastroenterology Reports. 2022; doi:10.1007/s11894-022-00847-4.

• International Foundation for Gastrointestinal Disorders. Chronic Constipation (https://www.iffgd.org/lower-gi-disorders/constipation.html). Accessed 7/18/2023.

• National Institute of Diabetes and Digestive and Kidney Diseases (U.S.). Constipation (https://www.niddk.nih.gov/health-information/digestive-diseases/constipation?dkrd=hispt0164). Last reviewed 5/2018. Accessed 7/18/2023.

• 2020-2025 Dietary Guidelines for Americans. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://www.dietaryguidelines.gov. Accessed June 7, 2023.

• Constipation and defecation problems. American College of Gastroenterology. https://gi.org/topics/constipation-and-defection-problems/. Accessed May 30, 2023.