What Is Constipation? A Gastroenterologist Weighs In

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This informational guide, part of POPSUGAR’s Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

For a health problem that strikes around four million people in the US and is common across all ages, constipation is rarely talked about. But having infrequent or painful bowel movements is uncomfortable at best, and it can sometimes be a sign of a more serious health problem. Constipation also affects more women than men (particularly premenopausal women), so becoming familiar with the signs and treatments can ensure you know what to do if pooping becomes problematic — including when to see a doctor.

What Is Constipation?

Almost everyone has times in their lives when they don’t go for a day or two. Travel can mess up your bathroom schedule, as can stress. But if you have three or fewer bowel movements a week on a regular basis, the stool is hard and difficult to pass, and your sluggish poop schedule makes you feel uncomfortable and unwell, you likely have the diagnosable condition known as constipation.

“The ‘uncomfortable’ part is key,” Shanti Eswaran, MD, a gastroenterologist with the University of Michigan Health System, says. “People’s bodies are different, and some people feel fine when they move their bowels less frequently. But if you’re straining when you move your bowels and you feel bloated and it’s bothering you, it’s time to make some simple dietary and lifestyle changes that will help correct the problem.”

Constipation usually isn’t a cause for alarm, she adds. But if you have new-onset constipation that’s accompanied by rectal bleeding and abdominal pain, you should see your doctor to rule out more serious issues like thyroid disease or possibly colon cancer.

How to Tell If You’re Constipated

Think about your trips to the bathroom recently. Have you passed at least four bowel movements this week? Three or fewer bowel movements a week on a regular basis is considered a pretty sure sign that you’re constipated. Stool that is hard and difficult to pass, accompanied by a general discomfort are also signs that you may be constipated.

Symptoms of Constipation

Constipation is typically marked by the following signs and symptoms, per the Mayo Clinic:

  • Three or fewer bowel movements a week
  • Hard, dry, or lumpy stool
  • Stool that’s difficult to pass
  • Feeling like your stool hasn’t passed or the rectum is blocked
  • Having to use a finger to help stool pass

If your symptoms are long-lasting (longer than 3 weeks), impact quality of life, or are accompanied by rectal bleeding and abdominal pain, it’s best to see a doctor.

What Causes Constipation?

There are lots of reasons you may get backed up, Dr. Eswaran says.

  • A variety of medications have constipation as a side effect, for instance. Common ones include antacids with aluminum and calcium; diuretics; iron supplements; narcotic pain medications; and some antidepressants.
  • Health problems — like celiac disease, diabetes, hypothyroidism, Parkinson’s disease, irritable-bowel syndrome, and intestinal obstructions (from a tumor, for instance) — can all cause constipation.
  • Poor motility in your colon, which keeps waste moving, might slow digestion to an uncomfortable degree.
  • Women are more affected, partly because some conditions that cause constipation, like hypothyroidism, affect them more often, Dr. Eswaran tells PS. “Also, constipation commonly crops up during pregnancy and after giving birth because they can damage the pelvic-floor muscles, making it more difficult to have bowel movements.” Hormonal shifts that affect women can add to the problem, and so can the length of one’s colon. Also, women’s colons are typically longer than men’s, meaning that they empty slower, which could make them more prone to getting backed up.
  • Certain lifestyle habits may cause slow stool movement, including not drinking enough fluids, lack of fiber in one’s diet, infrequent exercise, and putting off bowel movements when there’s an urge to pass stool, per the Mayo Clinic.

How to Treat Constipation

Most cases of constipation can be safely and effectively treated at home with basic lifestyle changes. Eating around 25 grams of fiber a day — whole grains, oatmeal, beans, berries, vegetables, and nuts have it in abundance — can soften your stool, making it one of the best ways to alleviate constipation. (Processed foods, on the other hand, can actually cause constipation.) “Fiber is good for your overall health, too,” Dr. Eswaran says. Just make sure to increase your intake slowly if you’ve been eating very little up until now to avoid bloating, and drink plenty of water and other fluids at the same time to help the fiber work its magic.

“Exercising on a regular basis can increase the wavelike contractions of your colon that move its contents along, and the faster your stool moves through your large intestine, the less likely it is to become hard and dry,” Dr. Eswaran adds.

Sticking with a regular sleep schedule can help, too. “Inconsistent sleep throws your whole body out of whack, including your GI tract,” she says.

If you’ve already tried these strategies and you’re still having problems, see your doctor. “We often start with over-the-counter fiber supplements, and if that doesn’t fix the problem, we move on to prescription laxatives, which work very well,” Dr. Eswaran says. “The vast majority of patients find relief with simple treatments.”

Ginny Graves is an award-winning writer in the San Francisco Bay Area whose work focuses on science, psychology, health, nature, and the human-animal bond.

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