Constipation: Causes, Symptoms, Treatment and More

Constipation is a condition in which bowel movements become difficult or infrequent, making it challenging to pass stool. It is important to note that constipation can range from mild to severe, with chronic constipation being a more serious and long-term issue. Understanding the causes, symptoms, and treatment options can help individuals manage the condition and improve their overall digestive health.

Causes of Constipation

Following are some of the most common causes of constipation:

Poor Diet: A diet that is low in fiber and high in processed foods and sugar can lead to constipation. Fiber plays an important role in promoting healthy digestion and bowel movements. Without enough fiber, stool can become hard and dry, making it difficult to pass.
Dehydration: Not drinking enough water can also contribute to constipation. Water helps to soften stool and makes it easier to pass.
Lack of Exercise: Physical activity is important for maintaining healthy bowel movements. Exercise helps to stimulate the muscles in the digestive tract, promoting the movement of stool through the intestines. Without regular exercise, stool can become stagnant and lead to constipation.
Medications: Certain medications can also cause constipation. Some of the most common culprits include painkillers, antacids, and antidepressants. These medications can slow down digestion and make it harder to have a bowel movement.
Underlying Health Conditions: Constipation can also be a symptom of an underlying health condition, such as irritable bowel syndrome (IBS), hypothyroidism, or diabetes. In these cases, treating the underlying condition is key to resolving constipation.
Pregnancy: Constipation is common during pregnancy due to hormonal changes that slow down digestion and the added pressure of the growing uterus on the intestines. Pregnant women should aim to eat a high-fiber diet, stay hydrated, and engage in regular physical activity to help prevent constipation.
Ignoring the Urge to Defecate: Ignoring the urge to have a bowel movement can also contribute to constipation. When stool stays in the colon for too long, it can become hard and difficult to pass. Responding promptly to the urge to defecate is important for maintaining healthy bowel movements.

Symptoms of Constipation

following are some of the most common symptoms of constipation:

Infrequent Bowel Movements: One of the most obvious symptoms of constipation is infrequent bowel movements. People who are constipated may only have a bowel movement once or twice a week, or even less frequently.
Difficulty Passing Stool: When stool moves slowly through the digestive tract, it can become hard and dry, making it difficult to pass. People who are constipated may have to strain to pass stool or may feel like they are unable to completely empty their bowels.
Abdominal Pain and Bloating: Constipation can cause abdominal pain and bloating. The build-up of stool in the colon can cause pressure and discomfort, leading to bloating and cramping.
Nausea and Loss of Appetite: People who are constipated may experience nausea and a loss of appetite. This is because the build-up of stool in the colon can lead to a feeling of fullness and discomfort.
Rectal Bleeding: Constipation can cause rectal bleeding in some cases. Straining to pass hard stool can cause small tears in the skin around the anus, leading to bleeding.
Hemorrhoids: Constipation can also cause hemorrhoids, which are swollen veins in the anus or lower rectum. Hemorrhoids can be painful and can cause bleeding during bowel movements.
Foul-Smelling Gas and Stool: When stool sits in the colon for too long, it can begin to ferment and produce foul-smelling gas and stool.

Types of Constipation

Understanding the different types of constipation can help in identifying the root cause and treating the condition effectively. The following are some of the most common types of constipation:

Chronic Constipation

Chronic constipation is a long-term condition that lasts for several weeks or months. It is usually caused by underlying health conditions such as irritable bowel syndrome (IBS), hypothyroidism, or diabetes. People with chronic constipation may experience infrequent bowel movements, difficulty passing stool, abdominal pain and discomfort, and bloating.

Traveler’s Constipation

Traveler’s constipation is a type of acute constipation that occurs when people travel and experience changes in their routine and diet. Long hours of sitting during travel, changes in time zones, and dehydration can all contribute to traveler’s constipation. People with traveler’s constipation may experience infrequent bowel movements, difficulty passing stool, and abdominal pain.

Drug-Induced Constipation

Certain medications can cause constipation as a side effect. These include painkillers, antacids, and antidepressants. The medications slow down digestion, making it harder to have a bowel movement. People taking these medications may experience infrequent bowel movements, difficulty passing stool, and abdominal discomfort.

Idiopathic Constipation

Idiopathic constipation is a type of chronic constipation with no identifiable cause. It is more common in women and older adults. People with idiopathic constipation may experience infrequent bowel movements, difficulty passing stool, and abdominal pain.

Pregnancy-Related Constipation

Constipation is common during pregnancy due to hormonal changes that slow down digestion and the added pressure of the growing uterus on the intestines. Pregnant women may experience infrequent bowel movements, difficulty passing stool, and abdominal discomfort.

Functional Constipation

Functional constipation is a type of chronic constipation that is not caused by underlying health conditions. It is usually caused by lifestyle factors such as a low-fiber diet, lack of exercise, and ignoring the urge to have a bowel movement. People with functional constipation may experience infrequent bowel movements, difficulty passing stool, and abdominal discomfort.

Fecal Impaction

Fecal impaction is a severe type of constipation that occurs when stool becomes hard and dry and cannot be passed. It can cause abdominal pain, bloating, and nausea. Fecal impaction is a medical emergency and requires immediate treatment.

Diagnosis

Following are the common methods used to diagnose constipation:

Physical Examination A healthcare provider will perform a physical examination to assess the abdomen for any signs of bloating, tenderness, or masses. They may also perform a rectal exam to check for any abnormalities and assess the strength and coordination of the pelvic muscles.
Medical History Review A medical history review is an important part of the diagnosis process for constipation. The healthcare provider will ask about symptoms, including how long they have been present and their severity. They will also ask about any recent changes in diet, medications, or lifestyle that may have contributed to constipation. In addition, they will inquire about any family history of bowel disorders or diseases.

Blood tests: Blood tests can be used to check for underlying health conditions that may be contributing to constipation, such as hypothyroidism, diabetes, or electrolyte imbalances.
Imaging tests: Imaging tests, such as X-rays, CT scans, or MRI, can help identify any structural abnormalities in the intestines or rectum that may be causing constipation.
Anorectal manometry: This test measures the strength and coordination of the muscles in the rectum and anus to assess their ability to move stool through the body.
Colorectal transit study: This test involves consuming a capsule that contains markers that can be seen on an X-ray. The healthcare provider can then track how long it takes for the markers to move through the digestive system to assess bowel function.

Rome IV Criteria In addition to the physical examination, medical history review, and diagnostic tests, healthcare providers may also use the Rome IV criteria to diagnose constipation. This criteria assesses the frequency and severity of symptoms such as straining during bowel movements, the sensation of incomplete evacuation, and the need for manual maneuvers to complete bowel movements.

Complications

Constipation can lead to several complications if left untreated or not managed properly. Some of the potential complications of constipation are:

Hemorrhoids: Straining during bowel movements can cause hemorrhoids, which are swollen veins in the rectum and anus. Hemorrhoids can be painful and may require medical treatment.
Fissures: Constipation can cause fissures or tears in the lining of the anus, which can be painful and may lead to bleeding during bowel movements.
Rectal prolapse: Chronic constipation can cause the rectum to stretch and protrude from the anus, a condition known as rectal prolapse. This can cause discomfort, pain, and may require surgical treatment.
Intestinal obstruction: Severe constipation can cause a blockage in the intestines, which can be a medical emergency. Symptoms may include severe abdominal pain, vomiting, and inability to pass stool.
Fecal impaction: Fecal impaction occurs when hard stool becomes lodged in the rectum and cannot be passed. This can lead to abdominal pain, nausea, and vomiting, and may require medical intervention to remove the impaction.
Incontinence: Chronic constipation can cause the muscles and nerves in the rectum and anus to become weakened, leading to fecal incontinence or the inability to control bowel movements.
Diverticulitis: Constipation can increase the risk of diverticulitis, which is a condition where small pouches form in the colon and become inflamed or infected.
Toxic megacolon: In rare cases, chronic constipation can lead to a life-threatening condition called toxic megacolon. This occurs when the colon becomes severely distended and is at risk of rupturing, which can cause infection and sepsis.

Prevention of Constipation

Eat a high-fiber diet: Eating a diet that is high in fiber can help prevent constipation. Fiber helps to add bulk to stool and promotes regular bowel movements. Foods that are rich in fiber include fruits, vegetables, whole grains, and legumes.
Drink plenty of water: Drinking plenty of water can help keep stool soft and prevent constipation. It is important to drink at least eight glasses of water per day, and more if you are exercising or in a hot climate.
Exercise regularly: Regular exercise can help stimulate bowel movements and prevent constipation. Activities like walking, running, or yoga can be particularly helpful.
Avoid holding in bowel movements: Holding in bowel movements can lead to constipation. It is important to use the restroom when you feel the urge to have a bowel movement.
Establish a regular bowel routine: Establishing a regular bowel routine can help promote regular bowel movements and prevent constipation. Try to use the restroom at the same time every day, preferably after meals.
Avoid foods that can cause constipation: Certain foods can cause constipation, including processed foods, dairy products, and fatty foods. Limiting these foods can help prevent constipation.
Manage stress: Stress can contribute to constipation. Managing stress through activities like meditation, deep breathing, or yoga can help prevent constipation.
Consider probiotics: Probiotics are live bacteria that can help promote digestive health. Taking a probiotic supplement or eating foods that are rich in probiotics, such as yogurt, can help prevent constipation.

When to See a Doctor

Here are some instances when it is recommended to seek medical attention for constipation:

Persistent constipation: If you have been experiencing constipation for several weeks and it does not improve with lifestyle changes or over-the-counter remedies, it is important to see a doctor.
Severe abdominal pain: If you experience severe abdominal pain along with constipation, it could be a sign of a more serious condition, such as an obstruction in the bowel or an infection. Seek medical attention immediately if you experience severe abdominal pain.
Blood in stool: If you notice blood in your stool, it could be a sign of a more serious condition, such as colorectal cancer or inflammatory bowel disease. Seek medical attention immediately if you notice blood in your stool.
Changes in bowel habits: If you experience sudden changes in your bowel habits, such as increased frequency or changes in stool consistency, it is important to see a doctor. This could be a sign of a more serious condition.
Age over 50: If you are over the age of 50, it is recommended to have regular screenings for colorectal cancer. If you experience symptoms like constipation or changes in bowel habits, it is important to discuss these with a healthcare provider.
Medication side effects: If you are taking medication and experience constipation as a side effect, it is important to talk to your healthcare provider. They may be able to adjust your medication or recommend other treatments to alleviate the constipation.
Other symptoms: If you experience other symptoms along with constipation, such as nausea, vomiting, fever, or weight loss, it is important to see a doctor. These could be signs of a more serious condition that requires medical attention.