Constipation refers to the difficulty in passing bowel movements. It is a common condition and affects millions of individuals worldwide. Constipation may be associated with infrequent bowel movements (less than three per week), poor emptying, straining and/or hard stools.
Common causes of constipation include the following:
• Medication side effects
• Poor diet
• Thyroid disease
• Irritable bowel syndrome
• Chronic idiopathic constipation
• Impaired intestinal motility
• Bowel obstructions
• Colorectal cancer
It is important to consult a physician when symptoms of constipation begin to have a significant impact on quality of life. Furthermore, there are certain instances which may be signs of a problem and require the consultation of a doctor. These include new onset of symptoms (particularly if older than 40 years of age), symptoms lasting longer than three weeks, abdominal pain, weight loss, inability to pass gas, persistent vomiting and signs of blood within the stools or on wiping.
Successful treatment of constipation can at times be achieved through lifestyle, behavioral and diet modifications. It is important to act on the urge to have a bowel movement rather than suppressing the urge. With time, this signal can become weaker and lead to worsening of symptoms. Increasing dietary fiber is a key step in improving passage of bowel movements. It is recommended to get at least 25 to 30 grams of dietary fiber to help soften stools and promote a good bowel movement. Furthermore, drinking an adequate amount of fluids will prevent stool from becoming hard and difficult to pass.
A thorough physical examination including a rectal examination is generally recommended in the setting of chronic constipation not improving with dietary and lifestyle modifications. Testing may be required to further work up chronic constipation. Blood tests, stool tests and imaging tests may be used to help establish a cause. In certain settings (i.e. new onset of symptoms, rectal bleeding, weight loss, older age), a colonoscopy may be required for further evaluation. Specific functional testing may be performed if there is poor response to treatment or concern for an underlying motility disorder.
If dietary and lifestyle modifications do not improve symptoms, laxatives are typically the next approach to treatment. Many different types of laxatives exist in a variety of different forms (i.e. powder, pill, enema, suppository). Most laxatives are available over the counter. If an over the counter approach does not improve symptoms, a prescription medication may be required. It is important to consult your gastroenterologist to review potential treatment options.
The information provided above is meant to be used as an informative guide for patients. For precise and individualized recommendations, please consult with one of our board certified gastroenterologists to discuss your symptoms.
For additional information or to book an appointment at the Gastroenterology Center of New York, please feel free to reach out to our dedicated team by calling us at 718-210-2960. You can also schedule online or reach out to us via the Contact Us form.