What is Constipation?
Constipation is uncomfortable even when it occurs only occasionally, but the medical diagnosis of constipation means having fewer than three bowel movements per week and/or stools that are hard, dry, lumpy, and difficult to pass. Constipation often comes with bloating, straining to pass stool, and a feeling that not all stool has passed.
Constipation is a very common gastrointestinal condition, affecting about 42 million Americans, or 15% of the population. It is more common in women, non-Caucasians, and in those who are 65 years of age or older.
Constipation can be acute or chronic. Acute constipation is short-term, doesn’t last more than a few days, and can generally be relieved by medications and minor lifestyle changes.
Chronic constipation is long-term and can continue for months or even years. It is disruptive to a person’s personal and/or professional life and can’t be relieved by minor changes in lifestyle. Chronic constipation should be diagnosed and treated by a physician.
What Causes Constipation?
When stool spends too much time in the colon, the colon absorbs water from the stool making it hard and dry. It is much more difficult to pass stool in this condition, which causes people to ‘strain’ because the muscles in the rectum are over-working to pass the stool.
Health Conditions and Injury:
Some health conditions can increase the risk of constipation, including Parkinson’s disease, spinal cord illness or injury, diabetes, hypothyroidism, celiac disease, and irritable bowel syndrome.
Other common health conditions that can cause constipation are pregnancy, surgery, hormonal changes, and conditions that affect metabolism.
Medications and supplements can cause constipation as well – even common over-the-counter medications like antacids, diuretics, iron supplements, antihistamines, ibuprofen and naproxen. *
Certain prescription medications are also known to increase the risk of constipation, including antispasmodics, anti-nauseants, blood pressure medications, narcotic pain medication, certain medications used to treat depression, and anticholinergics used to treat urinary incontinence. *
Overuse of laxatives can increase the risk of constipation, as the bowel can become reliant upon them to pass stool.
Lifestyle changes are another common cause of constipation, so it’s important to pay attention to changes in diet or habits, including:
- Reduction in physical activity or exercise: Lack of exercise or spending a lot of time sitting and/or lying down can increase risk of constipation. This can be a problem for people with health conditions or injuries that require them to be immobile.
- Not enough fluids: Fluids, especially water and non-diuretics, keep the digestive tract moving and promote healthy bowel movements. Lack of hydration slows the stool movement through the intestine which can cause constipation.
- Reduction in fiber: Fiber retains water in the intestine, making stools easier to pass. When there is a reduction in fiber stool become dry and harder to pass.
- Change in routine: When stool is not passed on a regular basis, or the urge to ‘go’ is ignored, stool builds up in the bowel and causes constipation. This is especially common in people who travel frequently or have other breaks in their regular routine.
Complications and Symptoms of Constipation
Constipation may be common, but it can have serious health consequences and should never be ignored. The symptoms of constipation can vary from person to person, so any changes in bowel movement patterns should be noted. When symptoms can’t be relieved by self-care and lifestyle changes it is important to see a physician.
Common symptoms of constipation include:
- Bloating and pain in the lower abdomen
- Less frequent bowel movements
- Slight straining to pass stool
- Hard or small feces
- A sense of incomplete evacuation of the bowel
More serious symptoms and complications from constipation include:
- Anal bleeding and fissures
- Extreme straining to pass stool
- Blood in the stool
- Lower back pain
- Inability to pass gas
- Losing weight without trying
- Perforation of the bowel
- Diverticular disease