Constipation

Constipation Treatment

Constipation is a very common gastrointestinal problem that nearly everyone experiences at one time or another. Most often, it’s not a serious problem, and can be caused by a low-fiber diet, changes in routine, medication, and other reasons. However, when constipation is comorbid with other symptoms, such as blood in the stool, it can be indicative of a more serious problem. Read on to learn more about constipation treatment, how to relieve constipation, and when you should contact a gastroenterologist.

What Is Constipation?

Technically, constipation is considered having three or fewer bowel movements per week. However, everyone’s digestive tract is different. Some people may pass stool several times a day, while others may only have one to two bowel movements per week. It’s a very individual pattern—it can be okay to have one to two bowel movements a week, as long as that is your body’s natural pattern and you are experiencing no other noticeable symptoms. However, if your pattern changes and you are experiencing dry, hard stools often, you may want to treat constipation, whether you use over-the-counter medications, such as stimulant laxatives, or consult a physician.

What Are the Symptoms of Constipation?

Symptoms of constipation are quite noticeable. In addition to having less than three bowel movements per week, the symptoms of constipation include:

• Dry, hard stool
• Stool that is difficult to pass
• Painful bowel movements 
• A feeling that you have not emptied your bowels completely
• Straining when having a bowel movement
• Trouble emptying the rectum (such as pressing on your abdomen to pass stool)

Constipation is considered chronic if this occurs two to three times per week for several months.

Common Causes of Constipation

There are many common causes and risk factors when it comes to constipation. With risk factors, you are predisposed to constipation if:

• You are older. Those who are older often have a slower metabolism and less contraction of muscles in the digestive tract.
• You are female. This is especially true if you are pregnant or have just given birth. This is due to a change in hormones.
• Not consuming high-fiber foods. Eating a diet high in fiber or taking fiber supplements helps keep stool moving throughout the GI tract.

Constipation occurs when food moves too slowly through the digestive tract and the bowel movement is delayed. When your body absorbs too much water from your stool, it makes it difficult to pass. This means that your stool remains in your colon too long, and the colon continues to absorb water. This problem can have many causes, which include:

• Not drinking enough water
• Not going to the bathroom when it’s time to have a bowel movement 
• Being sedentary and not getting enough exercise
• Eating a low-fiber diet
• Changes in routine, such as going to bed at different times, or traveling 
• Stress
• Eating large amounts of dairy, such as milk and cheese

Also, certain medications can cause constipation, particularly opioids. Other medications that can cause constipation include ibuprofen, antidepressants, such as selective serotonin uptake inhibitors (SSRIs), diphenhydramine, calcium channel blockers, gabapentin, and anti-nausea medications, such as ondansetron (commonly known as Zofran®). You can speak to either your gastroenterologist or pharmacist if you believe your constipation may be caused by medications.

Underlying conditions can also cause constipation, and this is when constipation treatment is required. Constipation can be a symptom of a more serious problem, such as:

• Irritable bowel syndrome (IBS)
• Lupus 
• Fistulas in the digestive tract
• Rectal prolapse
• Colorectal cancer
• Thyroid problems, such as hypothyroidism
• Diabetes
• Diverticular disease
• Intestinal obstruction
• Stroke
• Multiple sclerosis (MS)
• Parkinson’s disease

This is why when your constipation is chronic or presents with other symptoms, you should consult your gastroenterologist.

When to See a Doctor About Your Constipation

Most often, constipation is not a serious problem, although it can seriously affect quality of life, especially if you have chronic constipation. There are a few things you can do to prevent constipation and make stools easier to pass. To soften stool, your doctor may recommend over-the-counter treatments, such as mineral oil, milk of magnesia, or stool softeners. There are also osmotic laxatives, such as polyethylene glycol (commonly known as MiraLAX®). These can be easier on the digestive system than stimulant laxatives. Also, the amount of fiber you eat is very important. Women should try to consume 21 to 25 grams of fiber per day, while men should aim for 30 to 38 grams per day.

Generally, you should consult a physician whenever you experience a change in your bowel movements, including constipation. When you consult with a gastroenterologist about your constipation treatment, they will likely ask about your full medical history, what you eat and drink, what your stool looks like, and how often you exercise, among other questions.

Your provider will also listen to your abdomen and check it for pain or lumps. Also, be prepared for a rectal exam. During this exam, your physician will use their finger to examine the rectum. This is to check for any noticeable problems.

Your doctor may also order a battery of diagnostic tests, particularly if they suspect an underlying condition. Some of these tests may include:

• Colonoscopy or sigmoidoscopy. These two very similar procedures involve inserting a long, thin tube into the colon with a tiny camera attached at the end. Colonoscopy is also the first-line diagnostic test to look for colorectal cancer.
• Lab tests. Your GI doctor may order blood tests to look for conditions such as hypothyroidism and diabetes.
• Imaging tests. You may have a CT scan or MRI to look for potential problems causing constipation.
• Colorectal transit study. During this procedure, you eat a radioactive pill or food, which allows the doctor to track how long the substance takes to move through your digestive system.

Constipation treatment varies with the root cause. If constipation is a symptom of an underlying condition, then the underlying condition will be treated. If there is not a more serious underlying condition, your doctor will likely recommend that you drink more water, eat more fiber, exercise more, and add fiber supplements to your diet. These constipation treatments will typically help common constipation.