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Constipation

Constipation

Definition

Constipation is infrequent and/or uncomfortable bowel movements. Stool is often hard and dry. This is a common gastrointestinal complaint.

Causes

Constipation has many causes, including:

  • Not enough fluid intake
  • Overuse of laxative medications
  • Too little exercise
  • Lengthy bed rest
  • Certain medications, including:
    • Pain relievers
    • Opioids
    • Aluminum-containing antacids
    • Antidepressant and antipsychotic medications
    • Medications for epilepsy and Parkinson’s disease
    • Antispasmodic medications
    • Iron supplements
    • Calcium channel blockers
  • Frequently delaying the need to have a bowel movement
  • Pregnancy
  • Diabetes
  • Spasm of the anal sphincter; due to painful anal fissures or hemorrhoids
  • Underactive thyroid
  • Irritable bowel syndrome —periods of constipation may alternate with episodes of diarrhea
  • Neurological diseases such as:
    • Parkinson’s disease
    • Multiple sclerosis
    • Stroke
    • Spinal cord injuries or tumors
  • Intestinal disorders, including:
    • Scarring
    • Tumors
    • Cancer
    • Inflammation
  • Travel due to schedule changes, stress, and poor diet

Risk Factors

Constipation is more common in older adults.

Risk factors include:

  • Sedentary lifestyle
  • Prolonged bed rest due to surgery or an accident
  • Diet that is high in fat and sugar and low in fiber

Symptoms

Symptoms include:

  • Abdominal pain
  • Sensation of abdominal fullness
  • Rectal pain and pressure
  • Difficulty passing stool, despite straining
  • Hard, dry, small stool
  • Feeling of incomplete emptying after a bowel movement

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. It may include a digital rectal exam of the rectum with the doctor’s gloved, lubricated finger inserted into your rectum.

Your bodily fluids may be tested. This can be done with blood tests.

Your bodily structures may need to be viewed. This can be done with:

  • Abdominal x-ray
  • Barium enema
  • Flexible sigmoidoscopy or colonoscopy
Barium Enema
Radiology colon
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Treatment

Treatment may include:

Prevention

To reduce your chance of getting constipation:

  • Eat a healthy, balanced diet that is high in fiber.
  • Exercise regularly.
  • Drink plenty of water a day.
  • In an effort to train your bowels, schedule a time daily to sit on the toilet just after a meal.
  • Do not rush yourself when using the bathroom.
  • If you feel the urge to move your bowels, do not ignore this feeling. Go to the bathroom right away.
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