Constipation


Constipation is most often defined as having a bowel movement less than 3 times per week, and is usually is associated with hard stools or difficulty passing stools.

Causes

  • Low-fiber diet
  • Lack of physical activity
  • Not drinking enough water
  • Delay in going to the bathroom when you have the urge to move your bowels
  • Stress and travel

Risk Factors

  • Poor diet or sedentary lifestyle
  • Pregnancy
  • Certain medication
  • Under-active thyroid
  • Colon cancer
  • Bowel, neurological or mental health disorders/diseases

Symptoms

  • Difficulty or pain passing stools
  • Hard stools
  • Less than 3 bowel movements per week
  • Inability to have a bowel movement after straining/pushing for more than 10 minutes

Diagnostic Tests

  • Physical exam, often including a rectal exam

Treatment

Treatment includes the addition of fiber to the diet, including vegetables, fresh fruits, dried fruits, whole wheat, bran, or oatmeal cereals. To reap the benefits of fiber, drink plenty of fluids to help pass the stool.

 

Frequently Asked Questions


What causes constipation?
Constipation has a variety of causes, including lifestyle, medication use, pregnancy or other medical conditions.

Common lifestyle causes of constipation include:

  • A low-fiber diet
  • Dehydration
  • Inadequate exercise
  • Changes in daily eating/sleeping routine
  • Eating large amounts of milk or cheese
  • Stress
  • Resisting the urge to pass a bowel movement

How common is constipation?
If you are experiencing constipation, you are not alone. In fact, constipation is one of the most frequent GI conditions in the United States, with at least 2.5 million patients visiting their doctor each year in search of relief.

Constipation can affect anyone, but it is more frequently experienced by the following:

  • Older adults
    Because older people tend to have a slower metabolism and weaker digestive tract muscles, they may become constipated more often than younger people. 
  • Women
    Women, especially while pregnant and after childbirth, have a higher chance of becoming constipated. Fluctuating hormone levels may be to blame, as well as the baby’s position in the womb.

    Hormone Changes in a woman’s hormones make them more prone to constipation. The baby inside the womb squishes the intestines, slowing down the passage of stool.
  • People with low-fiber diets
    Fiber helps food move through the digestive system, so people whose diet lacks adequate fiber are more prone to constipation.
  • People taking certain medications
    Constipation can be a side effect of some medications, so consult with your GI specialist.
  • People with certain neurological and digestive disorders
    Certain diseases that affect the brain, spinal cord, and digestive system may cause constipation.

How can I relieve constipation?
Treatment may involve lifestyle changes, like the addition of fiber to the diet – including vegetables, fresh fruits, dried fruits, whole wheat, bran, or oatmeal cereals. To enjoy the full benefits of fiber, be sure to also drink plenty of fluids. This will help pass the stool. To learn more, schedule an appointment with a board certified gastroenterologist near you!

Can constipation cause back pain?
Because retained fecal matter causes the intestines to swell, constipation can cause discomfort in the back as well as the abdomen. An aching, dull pain is common. The blockage itself may also be responsible for any discomfort if it presses on a nerve or muscle. In this case, back pain will intensify as the mass grows.

Can constipation cause nausea?
Due to the blockage of stool in the intestines, food may remain longer in the stomach instead of continuing through the digestive tract. This may cause nausea or bloating. An imbalance of bacteria in the gut may also lead to feelings of nausea.

Can constipation cause headaches?
In some cases, the stress of constipation or the straining to pass a bowel movement may cause headaches. Research shows a possible link between headaches and constipation, but no definitive connection has been made.

Does stress cause constipation? 
Long-term stress may cause unpleasant symptoms like constipation or stomach aches. Because stress can result in GI tract inflammation, it increases the risk of constipation. Stress can also cause your muscles to tense, often worsening symptoms.

Can constipation cause internal damage or lead to other health problems?
If left untreated, constipation may result in any of the following complications:

  • Hemorrhoids
  • Anal fissures (tears in the anal lining) from passing hardened stool 
  • Diverticulitis (infection in pouches that form off the colon wall)
  • Fecal impaction (build-up of stool in the rectum and anus) 
  • Stress urinary incontinence (straining-induced damage to your pelvic floor muscles)

Can too much fiber cause constipation? 
Too much or too little fiber can cause constipation. Too much fiber may also result in other unpleasant symptoms, such as bloating and gas. Drinking more fluids, exercising, and making other lifestyle changes can help relieve symptoms. Our gastroenterologists recommend getting no more than 70 grams of fiber per day.

Should I push during constipation?
If you feel the urge to have a bowel movement, get to the bathroom immediately. Relax first and avoid excessive pushing.

 Do bananas cause constipation?
Although one survey found a possible link between bananas and constipation, strong evidence does not exist. In many cases, patients find that unripe bananas cause constipation, while ripe bananas encourage regular bowel movements. This could be due to the difficult-to-digest starch found in unripe bananas. 

Does cheese cause constipation? 
Yes. Because cheese has little to no fiber and is rich in fat, it may cause constipation or worsen symptoms. 

Can peanut butter cause constipation? 
Peanut butter is high in fiber food, making it an unlikely trigger for constipation. In fact, peanut butter is thought to keep constipation at bay, with a two tablespoon serving containing about 10% of women’s and 7% of men’s recommended fiber intake. 

How do I poop with constipation? 
Here at Charleston GI, our gastroenterologists recommend the following:

  • Drink two to four extra glasses of water a day, unless your doctor recommends limited fluids.
  • Try warm liquids, especially in the morning.
  • Incorporate additional fruits and vegetables into your diet.
  • Add high-fiber foods like prunes and bran cereal.
  • Exercise most days of the week. 
  • Go to the bathroom as soon as you feel the urge to poop.
  • Take an over-the-counter laxative.

What does constipation feel like?
Most patients suffering from constipation describe stomach cramps or a tightening in their abdomen. Many also report a feeling of fullness, even when they haven’t eaten for hours. Gas is another symptom, although passing it often does not bring much relief. Constipated people may also have small bowel movements that are followed by the urge to go to the bathroom again – without successfully passing a bowel movement.

What foods help with constipation? 
Our GI specialists often recommend the BRAT diet, including high-fibers foods like bananas, rice, applesauce, and toasts. Other fiber-rich options are:

  • whole grains (whole wheat bread, pasta, oatmeal)
  • Legumes (lentils, beans)
  • Fruit (berries, apples with the skin on)
  • Vegetables (carrots, broccoli) 

Does prune juice relieve constipation? 
Prune juice is an effective, at-home remedy for constipation in both children and adults. For adults, our GI specialists recommend drinking 4 to 8 ounces each morning to stimulate bowel movement. 

How can I prevent constipation?
These helpful tips can help prevent constipation:

  • Eat a well-balanced, fiber-rich diet. Our gastroenterologists recommend 18 to 30 grams of fiber every day.
  • Drink eight 8-ounce glasses of water a day. Note: Because caffeinated beverages can cause dehydration, skip them until normal bowel habits have resumed.
  • Exercise regularly.
  • Move your bowels when you feel the urge. Do not wait.

Is constipation a symptom of pregnancy?
Changing hormone levels can trigger a slowing of the digestive system. This may lead to constipation. About 16-39% of pregnant women become constipated at some point in their pregnancy, particularly in the third trimester.

When does constipation happen during pregnancy? 
Constipation may occur at any point, but is most common in the third trimester when the growing baby’s weight rests on the bowel.

How do you relieve constipation during pregnancy?
Pregnant women may find relief with the following:

  • Eat 25 to 30 grams of fiber-rich foods each day. This will help soften your stools and make it easier to pass a bowel movement.
  • Drink eight to 12 cups of water each day. Pregnant women require more fluids, and while water is best, other healthy options include juice (with no added sugar), tea, and low-fat milk. 
  • Get 20 to 30 minutes of moderate exercise three times a week.

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