Constipation

How common is constipation?

You are not alone if you have constipation. Constipation is one of the most frequent gastrointestinal complaints.

People of all ages can have an occasional bout of constipation. There are also certain people and situations that are more likely to lead to becoming more consistently constipated (“chronic constipation”). These include:

• Older age
• Not eating enough high-fibre foods
• Taking certain medications
• Having certain neurological (diseases of the brain and spinal cord) and digestive disorders

What causes constipation?

There are many causes of constipation – lifestyle choices, medications, endocrine disease (such as an underactive thyroid), irritable bowel syndrome, slow transit and obstructive defecation.

What are the symptoms of constipation?

Symptoms of constipation include:

• You have fewer than three bowel movements a week
• Your stools are dry, hard and/or lumpy
• Your stools are difficult or painful to pass
• You have abdominal pain or cramps
• You feel bloated and nauseous
• You feel that you haven’t completely emptied your bowels after a movement

What lab tests and other medical tests may be done to find the cause of my constipation?

Your doctor can order no tests or many types of tests and procedures.

Lab tests: Blood and stool tests

Colonoscopy: A colonoscopy may be performed (link to colonoscopy)

Imaging tests: Abdominal imaging may be useful to identify other problems that could be causing your constipation

Colorectal transit studies: These tests involve consuming a small dose of a radioactive substance, either in pill form or in a meal, and then tracking both the amount of time and how the substance moves through your intestines.

Other bowel function tests: Your doctor may order tests that check how well your anus and rectum hold and release stool. These tests include a certain type of x-ray, done to rule out causes of outlet dysfunction constipation, and the insertion of a small balloon into the rectum.

How is constipation treated?

Self-care

Most cases of mild to moderate constipation can be managed by you at home. Self-care starts by taking an inventory of what you eat and drink and then making changes.

Some recommendations to help relieve your constipation include:

• Drink two to four extra glasses of water a day
• Add fruits, vegetables, whole grains and other high-fibre foods to your diet
• Get moving, exercise
• Check how you sit on the toilet. Raising your feet, leaning forward or squatting may make having a bowel movement easier
• Add an over-the-counter supplemental fibre to your diet
• If needed, take a very mild over-the-counter stool softener or laxative. There are many laxative choices. Ask your pharmacist or doctor for help in making a choice

Medication/supplement review

In addition to self-care methods, your doctor will review your medications and supplements (if you take any). Some of these products can cause constipation.

When should I call my doctor?

Call your healthcare provider if:

• Constipation is a new problem for you
• You see blood in your stool
• You are losing weight unintentionally
• You have severe pain with bowel movements
• Your constipation has lasted more than three weeks
• You have symptoms of outlet dysfunction constipation

Remember, talk openly and honestly with your doctor about your bowel movements and any questions or concerns you may have. Constipation may be a temporary situation, a long-term problem or a sign of a more serious condition. Be safe. See your doctor, especially if you’ve noticed a change in your bowel pattern or if your life is being ruled by your bowels.