An Overview of Constipation

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Constipation is generally defined as bowel movements that occur less than two or three times per week. Stools are small and hard to pass, and you may experience abdominal discomfort. Constipation can be caused by lifestyle factors, medications, or a variety of medical conditions, and it's something that everyone is likely to experience at some point or another.

Luckily, most cases are improved with lifestyle changes, such as to diet, exercise, and bowel habits. In others, laxatives or other treatments may be needed.

Chronic constipation may be cause for concern and is worth bringing to the attention of your doctor.

Symptoms

Infrequent bowel movements are the hallmark of constipation, though what's "normal" is highly variable.

Stools can be challenging or painful to pass. Once they do, you may notice that they are hard and possibly small, dry, or lumpy. After defecating, you might feel like you still have to go. You might also experience abdominal pain and/or bloating.

Chronic constipation should not be ignored, as it may result in complications such as:

Call your doctor if your constipation persists for longer than three weeks and/or you experience any of the following symptoms:

  • Blood in your stool
  • Unexplained weight loss
  • Severe pain in the abdomen

In Children

Constipation in children is fairly common. In the vast majority of cases, it is short-lived and does not indicate a more serious illness.

In addition to difficult-to-pass stools and infrequent bowel movements, children may show some behaviors that are not necessarily seen in adults experiencing constipation. They may actively balk at using the toilet, clench their buttocks, or rock in an unusual way as if to hold in stool.

You may also notice signs of stool in diapers or underwear. A large stool mass may even trigger daytime urinary accidents or bedwetting in a child who has been previously toilet trained and/or dry through the night.

You should contact your child's pediatrician if constipation lasts longer than two weeks or immediately if you see any signs of fever, vomiting, blood in the stool, swollen belly, or unexplained weight loss.

Causes

Although constipation is a common phenomenon for people of all ages, it is more likely to be an issue for older adults, pregnant and postpartum women, and people who have lower income levels.

You are also more likely to experience constipation if you:

  • Eat too much dairy or not enough fiber
  • Don't drink enough water throughout the day
  • Do not engage in enough physical activity
  • Travel or otherwise change your routine
  • Are stressed
  • Ignore urges to use the bathroom
  • Take certain kinds of medications (e.g., antacids with calcium or aluminum, antihistamines, antidepressants, calcium channel blockers, diuretics)
  • Are recovering from surgery

Constipation can also be a symptom of several health conditions including, but not limited to:

Diagnosis

Your doctor will take your medical history, perform a physical exam, and perhaps order blood work. Based on your clinical picture, further tests may be recommended. If you are over the age of 50, it is likely that you will be sent for a colonoscopy. A flexible sigmoidoscopy is another possible option.

Should the need arise, your doctor might send you for more specialized testing to try to gather information as to what is behind your constipation. Such tests include those that measure colonic transit time (how long it takes for stool to move through your colon) and anorectal manometry (which measures the tone and strength of the muscles in your anus and rectum).

Less frequently used tests are X-ray defecography and MRI defecography, both of which identify any functional or structural problems relating to having bowel movements.

Treatment

If you are experiencing a new onset of constipation without any of the symptoms listed above, try to increase your fluid intake and your physical activity level. Also, gradually increase the amount of dietary fiber you are consuming.

If that doesn't provide relief, discuss the use of over-the-counter options with your doctor:

For chronic constipation, your doctor may prescribe medication:

  • Amitiza (lubiprostone), which targets specific cells to stimulate the digestive tract to release more fluids 
  • MiraLax (polyethylene glycol), an osmotic laxative
  • Linzess (linaclotide), which works similarly to Amitiza

Your doctor may also decide to switch or adjust the dosage of a medication that you are taking for a different health issue if it is believed to be contributing to your constipation.

Other treatments for chronic constipation include biofeedback and/or physical therapy to retrain the muscles in your pelvic floor. In very, very rare cases, a surgical procedure might be indicated.

Treatment options may differ depending on the age of a child with constipation. Speak to their pediatrician about the best course, which may also include addressing fears related to toilet use.

A Word From Verywell

Constipation is relatively common and rarely indicates a serious health concern. Working with your doctor and tweaking your self-care is often all that is needed to ease symptoms. Should they persist, your doctor has options for developing an optimal management plan for you or your child. Never let chronic constipation persist without seeking a medical opinion.

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