Constipation is not usually a serious medical problem, but it can be very inconvenient and a tremendous nuisance. Most everyone feels better once constipation resolves.
Bowel habits can vary tremendously between people. Some people have three bowel movements per day and others only a few times per week.
The medical definition of constipation is going three or more days without a bowel movement and having painful, hard feces that are very difficult to pass. Often constipation can be accompanied by abdominal pain, swelling and vomiting
What are the causes of constipation?
- Too little fluids in the diet
- Too little fiber in the diet
- Lack of physical activity (especially as we age)
- Medications (especially antacids containing calcium or aluminum or strong pain medications, iron pills or antidepressants)
- Malignancy (rare)
- Diet high in dairy
- Laxative abuse
- Retentive bowel habits; children may hold back a bowel movement for a variety of reasons that can cause constipation
- Thyroid problems
- Holding back bowel movements due to painful hemorrhoids
- Eating disorders
- Neurologic disease such as Parkinson’s or multiple sclerosis
How is constipation diagnosed?
Constipation is fairly easy to diagnose, based on a patient’s history. Additional tests may be ordered by a doctor such as hormone levels, imaging studies (to make sure there is no blockage), or even a colonoscopy.
Action steps to take if one is constipated
- Drink plenty of water.
- Increase fiber in the diet by increasing fruits, vegetables, bran and prunes, beans and whole grains.
- Drink hot green tea.
- Use gentle over-the-counter laxatives (like milk of magnesia). Your doctor or pharmacist can help you select an appropriate laxative. Do not use laxatives for more than 10 days or they can actually worsen constipation.
- Stay active.
- Develop regular bowel movement habits, usually once per day. Go whenever you have the urge; don’t hold back.
- Review your medications to make sure they are not contributing to the cause of constipation.
- Limit caffeine.
- Limit dairy products.
For severe cases, other treatments like special stool softeners and enemas may be required. Be sure to call your doctor immediately if your constipation is sudden, painful, and you can’t pass gas.
Also contact your doctor if:
- Constipation is a new problem for you.
- You have constipation and notice weight loss.
- There is blood in your stools.
- Your bowel movements are painful.
- Your constipation lasts more than two weeks.
- Your stools are very thin like a pencil.
Remember, constipation is common and usually not serious. Be sure to eat a diet rich in fruits and vegetables, drink plenty of water, stay active, and don’t hold back when you feel the urge to have a bowel movement. If you have any questions or concerns, contact your doctor for advice.
Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.