Constipation

Constipation is infrequent bowel movements or difficult passage of stools. Constipation is a common gastrointestinal problem.

What's considered normal frequency for bowel movements varies widely. In general, however, you're probably experiencing constipation if you pass fewer than three stools a week, and your stools are hard and dry.

Fortunately, most cases of constipation are temporary. Simple lifestyle changes, such as getting more exercise, drinking more fluids and eating a high-fiber diet, can go a long way toward alleviating constipation. Constipation may also be treated with over-the-counter laxatives

Symptoms

By Mayo Clinic staff

Not having a bowel movement every day doesn't necessarily mean you're constipated. You likely have constipation, however, if you've had at least two of the following signs and symptoms for at least three of the past six months:

• Pass fewer than three stools a week
• Experience hard stools
• Strain excessively during bowel movements
• Experience a sense of rectal blockage
• Have a feeling of incomplete evacuation after having a bowel movement
• Need to use manual maneuvers to have a bowel movement, such as finger evacuation or manipulation of your lower abdomen

When to see a doctor
Although constipation may be bothersome, it's usually not serious. Most people who have constipation don't seek a doctor's care. However, chronic constipation may lead to complications or be a sign of a serious underlying disorder.

See your doctor if you experience an unexplained onset of constipation or change in bowel habits, or if symptoms are severe and last longer than three weeks. Also seek medical care if you experience any of the following signs or symptoms, which might indicate a more serious health problem:

• Bowel movements occurring more than three days apart, despite corrective changes in diet or exercise
• Intense abdominal pain
• Blood in your stool
• Constipation that alternates with diarrhea
• Rectal pain
• Thin, pencil-like stools
• Unexplained weight loss

Causes

By Mayo Clinic staff

Gastrointestinal tract

Constipation most commonly occurs when waste or stool moves too slowly through the digestive tract, causing it to become hard and dry.

Normally, the waste products of digestion (stool) are propelled through your intestines by muscle contractions. In the large intestine (colon), most of the water and salt in this waste mixture are reabsorbed because they're essential for many of your body's functions.

However, when there is not enough fluid or fiber-rich food in your diet — or if the colon's muscle contractions are slow — the stool hardens, dries and passes through your colon too slowly. This is the root cause of constipation.

You may also experience constipation if the muscles you use to move your bowels aren't properly coordinated. This problem is called pelvic floor dysfunction (anismus), and it causes you to strain with most bowel movements — even soft ones.

A number of factors can cause an intestinal slowdown, including:

• Inadequate fluid intake or dehydration
• Inadequate amounts of fiber in your diet
• Ignoring the urge to have a bowel movement or delaying until later
• Lack of physical activity (especially in older adults)
• Irritable bowel syndrome
• Changes in lifestyle or routine, including pregnancy, aging and travel
• Illness
• Frequent use or misuse of laxatives
• Specific diseases, such as stroke, diabetes, thyroid disease and Parkinson's disease
• Problems with the colon and rectum, such as intestinal obstruction or diverticulosis
• Certain medications, including pain medications, diuretics and those used to treat Parkinson's disease, high blood pressure and depression
• Hormonal disturbances, such as an underactive thyroid gland
• Anal fissures and hemorrhoids, which can produce a spasm of the anal sphincter muscle
• Loss of body salts through vomiting or diarrhea
• Injuries to the spinal cord, which can affect the nerves that lead to and from the intestine

In rare cases, constipation may signal more-serious medical conditions, such as colorectal cancer, hormonal disturbances or autoimmune diseases. In children, constipation might indicate Hirschsprung's disease, a congenital condition that results from missing nerve cells in the colon.

Children may also become constipated if they are afraid of or unwilling to use the toilet. Older children may ignore or forget to attend to bowel movements.