What are the signs of severe constipation. How can you alleviate constipation symptoms at home. When should you seek medical attention for constipation. What are the potential complications of untreated constipation. Which diagnostic tests can help identify the underlying cause of chronic constipation.

Understanding Constipation: Symptoms and Frequency

Constipation is a common digestive issue characterized by infrequent or difficult bowel movements. While the normal frequency of bowel movements varies among individuals, going more than three days without one is generally considered problematic. After this point, stools become harder and more challenging to pass.

Common symptoms of constipation include:

• Infrequent bowel movements
• Straining during defecation
• Hard or small stools
• Incomplete evacuation
• Abdominal bloating

In severe cases, individuals may resort to manual methods to facilitate bowel movements, such as applying pressure to the abdomen or using digital manipulation.

Identifying the Root Causes of Constipation

Constipation can stem from various factors, ranging from lifestyle choices to underlying medical conditions. Understanding these causes is crucial for effective management and prevention.

Lifestyle and Dietary Factors

• Inadequate fiber intake
• Insufficient hydration
• Lack of physical activity
• Ignoring the urge to defecate
• Excessive consumption of dairy products

Medical and Pharmacological Causes

• Certain medications (e.g., strong pain relievers, antidepressants, iron supplements)
• Antacids containing calcium or aluminum
• Irritable bowel syndrome (IBS)
• Pregnancy
• Neurological conditions (e.g., Parkinson’s disease, multiple sclerosis)
• Hypothyroidism
• Hypercalcemia

Can stress contribute to constipation? Yes, stress can significantly impact digestive function, potentially leading to constipation. Stress may alter gut motility, affect dietary habits, and disrupt normal bowel routines.

Effective Home Remedies for Constipation Relief

For many individuals, simple lifestyle modifications and home remedies can provide significant relief from constipation symptoms.

1. Increase fluid intake: Aim for 2-4 extra glasses of water daily, unless medically contraindicated.
2. Boost fiber consumption: Incorporate more fruits, vegetables, and whole grains into your diet.
3. Consider natural laxatives: Prunes and bran cereal can be particularly effective.
4. Engage in regular physical activity: Exercise stimulates intestinal muscles and promotes bowel regularity.
5. Respond promptly to bowel urges: Delaying defecation can exacerbate constipation.

Are over-the-counter laxatives safe for treating constipation? While generally safe for short-term use, it’s important to choose the appropriate type of laxative and follow dosage instructions carefully. Consult a healthcare provider if symptoms persist or worsen.

When to Seek Medical Attention for Constipation

While occasional constipation is common, certain symptoms warrant prompt medical evaluation:

• Constipation lasting 3 weeks or longer
• Sudden onset of constipation, especially if accompanied by abdominal pain
• Blood in stools
• Unexplained weight loss
• Complete inability to pass stool or gas
• Severe pain during bowel movements
• Significant changes in stool size, shape, or consistency

What are the potential complications of untreated constipation? Chronic constipation can lead to hemorrhoids, anal fissures, and in severe cases, rectal prolapse. It may also cause fecal impaction, which can be a medical emergency.

Diagnostic Approaches for Chronic Constipation

When constipation persists or is associated with concerning symptoms, healthcare providers may recommend various diagnostic tests to identify underlying causes:

• Blood tests to assess hormone levels and rule out systemic disorders
• Anorectal manometry to evaluate muscle function in the anal and rectal area
• Colonic transit studies to assess the movement of waste through the colon
• Colonoscopy to visualize the entire colon and detect any structural abnormalities or obstructions

How does a colonoscopy help in diagnosing constipation-related issues? A colonoscopy allows direct visualization of the colon’s interior, enabling detection of polyps, tumors, or other structural abnormalities that may contribute to constipation.

Tailoring Treatment Strategies for Severe Constipation

Management of severe constipation often requires a multifaceted approach, combining lifestyle modifications, dietary changes, and medical interventions.

Lifestyle and Dietary Interventions

• Implement a high-fiber diet (aim for 25-30 grams daily)
• Establish a regular toileting routine
• Practice proper toilet posture using a footstool
• Engage in regular physical activity, focusing on exercises that stimulate abdominal muscles

Pharmacological Approaches

• Bulk-forming laxatives (e.g., psyllium)
• Osmotic laxatives (e.g., polyethylene glycol)
• Stimulant laxatives for short-term use
• Prescription medications for chronic constipation (e.g., linaclotide, plecanatide)

Can probiotics help alleviate constipation? Some studies suggest that certain probiotic strains may improve stool frequency and consistency in individuals with chronic constipation. However, more research is needed to establish definitive guidelines for probiotic use in constipation management.

Special Considerations for Constipation in Specific Populations

Certain groups may require tailored approaches to constipation management due to unique physiological factors or underlying health conditions.

Pregnancy-Related Constipation

Constipation is common during pregnancy due to hormonal changes and physical pressure on the intestines. Safe management strategies include:

• Increased fluid and fiber intake
• Gentle exercise (e.g., walking, prenatal yoga)
• Use of pregnancy-safe laxatives under medical supervision

Pediatric Constipation

Childhood constipation requires special attention to prevent long-term complications. Approaches may include:

• Dietary modifications
• Behavioral interventions to establish regular toileting habits
• Careful use of child-appropriate laxatives

Constipation in Older Adults

Elderly individuals are at increased risk of constipation due to reduced mobility, medication side effects, and underlying health conditions. Management strategies should focus on:

• Addressing medication-related causes
• Ensuring adequate hydration and fiber intake
• Promoting physical activity within individual limitations

How does aging affect bowel function and constipation risk? Aging can lead to decreased intestinal motility, weakened pelvic floor muscles, and changes in diet and activity levels, all of which contribute to an increased risk of constipation in older adults.

Emerging Therapies and Research in Constipation Management

The field of gastroenterology continues to evolve, with ongoing research into novel treatments for chronic constipation.

Biofeedback Therapy

This technique helps individuals with dyssynergic defecation improve coordination of pelvic floor muscles during bowel movements.

Sacral Nerve Stimulation

Originally developed for urinary incontinence, this approach shows promise in treating severe constipation refractory to conventional treatments.

Fecal Microbiota Transplantation (FMT)

While primarily studied for other gastrointestinal disorders, emerging research explores the potential of FMT in treating chronic constipation.

What role does the gut microbiome play in constipation? The gut microbiome influences various aspects of digestive health, including motility and stool consistency. Alterations in microbial composition may contribute to constipation, suggesting potential for microbiome-targeted therapies.

Preventing Recurrence: Long-Term Strategies for Bowel Health

Maintaining optimal bowel function requires ongoing attention to lifestyle and dietary habits. Key strategies for long-term prevention of constipation include:

• Consistent adherence to a high-fiber diet
• Regular physical activity
• Adequate hydration
• Stress management techniques
• Prompt response to bowel urges
• Regular health check-ups to address emerging issues

Can mindfulness practices improve bowel regularity? Some evidence suggests that mindfulness and relaxation techniques may help reduce stress-related digestive symptoms, potentially improving bowel function and regularity.

By understanding the multifaceted nature of constipation and implementing comprehensive management strategies, individuals can effectively address this common yet often distressing condition. Regular communication with healthcare providers and a proactive approach to digestive health can significantly improve quality of life and prevent complications associated with chronic constipation.

What to Do for Severe Constipation

Written by WebMD Editorial Contributors

• Constipation Symptoms
• Constipation Causes
• Constipation Remedies
• How Long Does Constipation Last?
• When Should I Call My Doctor?

Being constipated means your bowel movements are tough or happen less often than normal. Almost everyone goes through it at some point.

Although it’s not usually serious, you’ll feel much better when your body is back on track.

The normal length of time between bowel movements varies widely from person to person. Some people have them three times a day. Others have them just a few times a week.

Going longer than 3 or more days without one, though, is usually too long. After 3 days, your stool gets harder and more difficult to pass.

You may have:

• Few bowel movements
• Trouble having a bowel movement (straining to go)
• Hard or small stools
• A feeling that everything didn’t come out
• Belly bloating

You also may feel like you need help to empty your bowels, such as pressing on your belly or using a finger to remove stool from your bottom.

Some causes of constipation include:

• Changes to what you eat or your activities
• Not enough water or fiber in your diet
• Eating a lot of dairy products
• Not being active
• Resisting the urge to poop
• Stress
• Overuse of laxatives
• Some medications (especially strong pain drugs such as narcotics, antidepressants, and iron pills)
• Antacid medicines that have calcium or aluminum
• Eating disorders
• Irritable bowel syndrome
• Pregnancy
• Problems with the nerves and muscles in your digestive system
• Colon cancer
• Neurological conditions such as Parkinson’s disease or multiple sclerosis
• An underactive thyroid (called hypothyroidism)
• Excess calcium in your blood (hypercalcemia) due to overactive parathyroid glands, medications, cancer (lung, breast, multiple myeloma), or other causes

Take these steps:

• Drink two to four extra glasses of water a day, unless your doctor told you to limit fluids for another reason.
• Try warm liquids, especially in the morning.
• Add fruits and vegetables to your diet.
• Eat prunes and bran cereal.
• Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
• Don’t ignore the urge to poop.

You can try taking a laxative, too. There are several types of laxatives, and you can buy many of them over the counter. Each of them works in a different way to ease constipation. Ask your doctor or pharmacist which kind might work for you and how long you should take it.

When constipation lingers for 3 weeks or more, get a checkup just to make sure a medical condition isn’t causing the problem. Also see your doctor if:

• You’ve never been constipated before now.
• You have stomach pain.
• You notice blood in your stools.
• You’re losing weight without trying.

Don’t let constipation go unchecked for too long. When untreated, constipation can lead to unpleasant complications such as hemorrhoids and rectal prolapse, a condition in which part of the intestine pushes out through the anus from too much straining.

Call your doctor right away if you have sudden constipation with belly pain or cramping and you aren’t able to poop or pass gas at all.

Also, make the call if:

• Constipation is a new problem for you and lifestyle changes haven’t helped.
• You have blood in your stool.
• You’re losing weight even though you’re not trying to.
• You have severe pain with bowel movements.
• Your constipation has lasted more than 2 weeks.
• The size, shape, and consistency of your stool has changed dramatically.

Your doctor may recommend some tests to find the cause of your constipation:

• Blood tests to check on hormone levels
• Tests that check the muscles in your anus
• Tests that show how waste moves through and out of your colon
• Colonoscopy to look for blockages in your colon

Top Picks

What to Do for Severe Constipation

Written by WebMD Editorial Contributors

• Constipation Symptoms
• Constipation Causes
• Constipation Remedies
• How Long Does Constipation Last?
• When Should I Call My Doctor?

Being constipated means your bowel movements are tough or happen less often than normal. Almost everyone goes through it at some point.

Although it’s not usually serious, you’ll feel much better when your body is back on track.

The normal length of time between bowel movements varies widely from person to person. Some people have them three times a day. Others have them just a few times a week.

Going longer than 3 or more days without one, though, is usually too long. After 3 days, your stool gets harder and more difficult to pass.

You may have:

• Few bowel movements
• Trouble having a bowel movement (straining to go)
• Hard or small stools
• A feeling that everything didn’t come out
• Belly bloating

You also may feel like you need help to empty your bowels, such as pressing on your belly or using a finger to remove stool from your bottom.

Some causes of constipation include:

• Changes to what you eat or your activities
• Not enough water or fiber in your diet
• Eating a lot of dairy products
• Not being active
• Resisting the urge to poop
• Stress
• Overuse of laxatives
• Some medications (especially strong pain drugs such as narcotics, antidepressants, and iron pills)
• Antacid medicines that have calcium or aluminum
• Eating disorders
• Irritable bowel syndrome
• Pregnancy
• Problems with the nerves and muscles in your digestive system
• Colon cancer
• Neurological conditions such as Parkinson’s disease or multiple sclerosis
• An underactive thyroid (called hypothyroidism)
• Excess calcium in your blood (hypercalcemia) due to overactive parathyroid glands, medications, cancer (lung, breast, multiple myeloma), or other causes

Take these steps:

• Drink two to four extra glasses of water a day, unless your doctor told you to limit fluids for another reason.
• Try warm liquids, especially in the morning.
• Add fruits and vegetables to your diet.
• Eat prunes and bran cereal.
• Exercise most days of the week. When you move your body, the muscles in your intestines are more active, too.
• Don’t ignore the urge to poop.

You can try taking a laxative, too. There are several types of laxatives, and you can buy many of them over the counter. Each of them works in a different way to ease constipation. Ask your doctor or pharmacist which kind might work for you and how long you should take it.

When constipation lingers for 3 weeks or more, get a checkup just to make sure a medical condition isn’t causing the problem. Also see your doctor if:

• You’ve never been constipated before now.
• You have stomach pain.
• You notice blood in your stools.
• You’re losing weight without trying.

Don’t let constipation go unchecked for too long. When untreated, constipation can lead to unpleasant complications such as hemorrhoids and rectal prolapse, a condition in which part of the intestine pushes out through the anus from too much straining.

Call your doctor right away if you have sudden constipation with belly pain or cramping and you aren’t able to poop or pass gas at all.

Also, make the call if:

• Constipation is a new problem for you and lifestyle changes haven’t helped.
• You have blood in your stool.
• You’re losing weight even though you’re not trying to.
• You have severe pain with bowel movements.
• Your constipation has lasted more than 2 weeks.
• The size, shape, and consistency of your stool has changed dramatically.

Your doctor may recommend some tests to find the cause of your constipation:

• Blood tests to check on hormone levels
• Tests that check the muscles in your anus
• Tests that show how waste moves through and out of your colon
• Colonoscopy to look for blockages in your colon

Top Picks

causes, symptoms and treatments for the condition

Contents

• 1 Causes, symptoms and treatment of constipation: features of the condition
  • 1. 1 What is constipation?
  • 1.2 Causes of constipation
  • 1.3 Symptoms of constipation
  • 1.4 How to diagnose constipation
  • 1.5 Prevention of constipation
    • 1.5.1 Proper nutrition
    • 1. 5.2 Regular exercise
    • 1.5.3 Avoid bad habits
    • 1.5.4 Regular health checks
  • 1.6 Constipation diet
    • 1.6.1 Key recommendations
    • 1.6.2 Good foods
    • 1.6.3 Unwanted foods 90 008
  • 1.7 Medicines for constipation
  • 1.8 Exercise for constipation
  • 1.9 Traditional treatments for constipation
  • 1.10 When should you see a doctor for constipation?
  • 1.11 Related videos:
  • 1.12 Q&A:
    • • 1.12.0.1 What is constipation and how does it occur?
      • 1.12.0.2 What are the symptoms of constipation?
      • 1.12.0.3 How can constipation be prevented?
      • 1.12.0.4 What role does diet play in the treatment of constipation?
      • 1. 12.0.5 What medicines can be taken to treat constipation?
      • 1.12.0.6 When should I see a doctor if I have constipation?

Find out why constipation occurs, what symptoms accompany this pathological condition, and how to treat them. Read the article on our website and get useful information for the health of your body.

Constipation is one of the common problems faced by people of all ages and genders. This is a pathological condition characterized by difficulty or retention of stool for more than 48 hours. In some cases, the stool may be empty, hard, and large. This condition can become quite problematic and cause discomfort, soreness and even depression in some people.

Constipation can be caused by various reasons. Some of these include lack of physical activity, lack of fluid in the body, changes in regular diet, stress, and even certain medications. However, sometimes constipation can be associated with serious conditions such as colon cancer or irritable bowel syndrome (IBS).

The symptoms of constipation can vary from person to person. However, the most common symptoms are difficult or infrequent bowel movements, a feeling of incomplete bowel movement, abdominal pain, and malaise.

It must be remembered that constipation is an issue in dire need of attention, and if you suffer from the corresponding symptoms, it is best to see a specialist for diagnosis and treatment of this problem.

What is constipation?

Constipation is a pathological condition when there is a slowdown in intestinal motility, which leads to the fact that the feces become denser and difficult to excrete from the body.

The frequency of bowel movements varies from person to person, and may be twice a day or twice a week. However, if emptying occurs less frequently, and the process itself becomes difficult, they speak of a violation – constipation.

Constipation can occur for many reasons, from malnutrition to the presence of diseases of the gastrointestinal tract. The main symptom of constipation is infrequent (most often less than once every two days) and difficult bowel movements.

Causes of constipation

Constipation can be caused by various factors. One of the main reasons is malnutrition, when an insufficient amount of fiber does not contribute to normal intestinal motility. Inadequate fluid intake can also lead to constipation. It is important to remember that the consumption of large amounts of fatty and fried foods also affects the functioning of the intestines.

Constipation can also be caused by certain medications, such as antidepressants, magnesium and calcium sulfates, antihistamines, and others. Acute psycho-emotional overload and stress can also affect bowel function and lead to constipation.

Finally, constipation can also be caused by certain diseases, such as diabetes, thyroid disease, colitis, and others. In such cases, a passenger approach to treatment and selection of prescriptions is necessary.

Symptoms of constipation

Constipation is a disorder of the gastrointestinal tract characterized by difficult and infrequent passage of feces through the intestines. The main symptom of constipation is the absence of stool for more than 48 hours. But besides this, patients may have other signs of this pathology.

• Abdominal pain – often occurs with constipation, especially when a large amount of stool accumulates in the intestines and the large intestine is distended.
• Abdominal distension – the intestines may become dilated due to the accumulation of feces, resulting in an unnatural bulge on the abdomen.
• Heartburn and nausea – When constipated, the contents of the stomach can be pushed back up the esophagus, causing heartburn and nausea.
• General weakness – occurs due to the constant feeling of heaviness in the abdomen, the inability to carry out the normal movement of feces and the lack of vitamins and nutrients that the body does not have time to absorb.

If you have one or more of these symptoms, see your doctor to find out the cause and prescribe the necessary treatment.

How to Diagnose Constipation

Constipation is a common condition in people of all ages and genders. However, in order to properly treat any pathological condition, it is necessary to properly diagnose it. There are several methods for diagnosing constipation:

1. Interview. The doctor should ask the patient questions about the type of bowel movement and other symptoms such as abdominal pain and stool leakage.
2. Physical examination. The doctor may examine the abdomen and proctal opening to assess the condition of the anal canal and rectum.
3. Intestinal transfusion. This is a procedure in which aqueous solutions or oil are injected into the intestines to more accurately determine the location of the obstruction in the intestines.
4. Intestinal examination. Examination methods may include colonoscopy, rectosigmoidoscopy, and other tests that can see the bowel inside.

The results of the diagnosis will help determine the causes of constipation and prescribe appropriate treatment.

Prevention of constipation

Proper nutrition

One of the main factors affecting bowel function is nutrition. To prevent constipation, you need to eat more fresh fruits and vegetables, including those rich in fiber and dietary fiber. You should also include cereals and liquids in the diet.

Regular exercise

Exercise helps speed up and improve bowel movement. Constant training and exercise also contribute to a positive effect on the functioning of the large and small intestines. Particularly useful among physical exercises are yoga and swimming.

Quitting bad habits

Smoking, alcohol and some medications can affect intestinal motility, which can cause constipation. Therefore, to prevent constipation, it is necessary to abandon bad habits and limit the use of drugs that can affect the functioning of the gastrointestinal tract.

Regular health check-ups

To prevent constipation, it is necessary to have regular check-ups with a doctor and follow his recommendations for maintaining the health of the body as a whole. Early detection and treatment of gastrointestinal disorders can prevent or reduce the risk of constipation.

Constipation Diet

Key Recommendations

A constipation diet should be high in fiber, contain adequate fluids, and avoid foods that may cause constipation. Key Recommendations:

• Eat fiber-rich vegetables and fruits
• Drink at least 1.5 liters of water a day
• Increase your protein intake
• Limit your intake of foods containing animal fats and simple carbohydrates

Also desirable eat food in small portions, but often, so that the food lump does not linger in the stomach and intestines.

Healthy Foods

Constipation diet should include fiber rich foods such as:

• Vegetables: broccoli, cauliflower, carrots, pumpkins, cucumbers, tomatoes and other vegetables
• Fruits: apples, pears, oranges, mangoes, bananas, cherries, etc.
• Cereals: oatmeal, buckwheat, corn, rice and other grains
• Legumes: beans, peas, chickpeas, lentils and other legumes
• Nuts: almonds, cashews, hazelnuts, walnuts and other types

Lean fish, meat and dairy products are also beneficial.

Undesirable foods

When constipated, it is necessary to limit the consumption of foods that can provoke constipation, such as:

• Fatty foods: margarine, mayonnaise, butter, lard and others
• Simple carbohydrates: sweets, pies, white bread and others white flour products
• Canned and processed foods
• Beans, radishes, cabbages and other foods that can cause bloating

It is also necessary to limit the consumption of coffee, alcohol and other drinks that can dry out the body and cause constipation.

Medicines for constipation

Constipation is a common medical condition that is often caused by poor lifestyle habits or undesirable factors. One way to treat constipation is to take medication.

The main goals of drug therapy are to improve and accelerate intestinal motility, increase stool volume and soften its consistency. Depending on the type of constipation (atonic, spastic) and its causes, different types of drugs are used.

• Osmotic solvents. These preparations facilitate the process of defecation, improve the quality and consistency of the stool. They do not cause irritation of the intestinal mucosa, which makes them safe to use. These include lactulose, glycerin suppositories.
• Decoupling preparations. They increase the volume of the stool, facilitate its passage, improve peristalsis and protect against fluid deficiency in the body. These include magnesium sulfate, mannitol, sodium picosulfate.
• Preparations that improve intestinal motility. These drugs increase the strength and frequency of bowel contractions and hasten the passage of stool. One such drug is metoclopramide, which acts on nerve receptors.
• Probiotics. They increase the amount of beneficial microflora in the intestines, increase immunity, soften hard stools and improve the general condition of the body.

Before eliminating constipation with medicines, it is necessary to consult a doctor and undergo the necessary set of examinations. And only after that start the treatment of constipation.

Exercise for constipation

Exercise can be an effective treatment for constipation and general health. They help to activate the intestines and speed up the process of digestion of food.

Leg Raises

One of the easiest exercises to combat constipation is the supine leg raise. The legs should be raised up, pressed and lowered, repeating the exercise 10-15 times.

Ship Pose

This exercise resembles the shape of a ship, with the body and legs raised in the air and the arms extended forward. The “ship” pose strengthens the abdominal muscles, which also has a positive effect on the process of digestion.

Pear Pose

Pear Pose is an exercise in which the legs are extended to the sides and the body is straight. You can also do this pose while sitting on a mat. Repeat the pose 8-10 times.

All of the above exercises help improve digestion and promote regular bowel movements without harming your health. In addition, it is important to remember about proper diet and water intake to prevent constipation.

Traditional treatments for constipation

Constipation is a disorder of the gastrointestinal tract in which a person has difficulty emptying their bowels. To avoid this problem, many people resort to traditional methods of treatment. One such method is to eat foods rich in plant fibers, such as fruits, vegetables, and cereals. The fibers help soften the stool and help it pass through the intestines.

Another traditional treatment for constipation is abdominal massage. The method consists in performing special movements designed to stimulate the bowels. Massage can be performed independently or contact a massage therapist or a specialist.

• Recommended products for consumption: fruits (apples, apricots, peaches), vegetables (beets, carrots, marrows), cereals (wheat, rye, oats).
• Herbal decoctions and infusions: hay infusion, dandelion root decoction, yarrow infusion.
• Abdominal massage: kneading the abdomen in a clockwise direction, stroking and circular movements through the intestines.

When should I see a doctor for constipation?

Constipation is a common medical condition that can affect anyone. In milder cases, it can be treated on its own, but there are situations when you definitely need to see a doctor.

• If constipation goes along with abdominal pain, then this may indicate a more serious problem in the body;
• Constipation does not resolve within a few days and the gastrointestinal tract is sluggish. In this case, it is important to immediately consult a doctor;
• There is severe bleeding from the anus;
• The patient has symptoms of intoxication such as vomiting or diarrhea, fever, and pale skin;
• In especially severe cases, the pain becomes unbearable and the patient needs emergency medical care.

It is important to understand that slowing down the process of removing feces from the body can lead to serious consequences. The sooner you see a doctor, the sooner treatment will begin and the sooner everything will return to normal.

Related videos:

Q&A:

What is constipation and how does it occur?

Constipation is the absence or difficulty of stool. The problem can arise due to many reasons, including poor diet, sedentary lifestyle, certain medications, and medical conditions.

What are the symptoms of constipation?

Symptoms of constipation may include a feeling of incomplete emptying of the bowels, heaviness and discomfort in the abdomen, hot flashes and sweating, and infrequent or difficult defecation.

How can constipation be prevented?

You can prevent constipation by following your doctor’s recommendations for proper nutrition, regular physical activity, and lifestyle changes.

What role does diet play in the treatment of constipation?

Diet can play an important role in the treatment of constipation. Including plenty of plant-based, high-fiber foods in your diet can help speed up the digestion process and make bowel movements easier.

What medicines can be taken to treat constipation?

Medicines for constipation may include laxatives, digestive aids, and other medicines that help stimulate bowel movement.

When should I see a doctor if I have constipation?

If you have frequent constipation or if your symptoms do not improve with lifestyle changes or diet and medication, you should see your doctor. Persistent constipation may indicate a serious illness.

Symptoms of constipation – signs and manifestations of constipation in adults

2 Signs of constipation

Table of contents

• What is constipation
• Causes of constipation
• Why constipation is dangerous
• Diagnosis and examination of constipation
• Methods of treatment

According to surveys, 32% of patients of gastroenterologists are sure that defecation should be daily, and consider the absence of stool during the day as a delay ¹ . Approximately 44% pay attention to stool hardening, 52% – to the need to strain to empty the rectum ¹ . What is actually considered constipation, what symptoms require intervention – about this in the article.

What is considered constipation

To find out what symptoms characterize constipation, or, as doctors say, colostasis, you need to determine the physiological norms of defecation.

They depend on individual characteristics: functional activity and the state of the microflora of the digestive tract, the nature of nutrition. A number of external conditions also play a role.

Gastroenterologists consider it normal ¹ :

• emptying of the rectum from three times a day to 1 time in three days;
• daily stool volume from 200 g to 40 g;
• soft feces, shaped like a cylinder;
• no need for prolonged straining (more than 25% of the time of defecation) when visiting the toilet “in a big way”.

Of course, the concept of the norm is individual, but still there are general signs that indicate a violation of the stool.

Symptoms of constipation in adults ¹ :

• stool less than every three days;
• daily stool volume less than 35 g;
• dry fragmented (“sheep”) feces;
• strong and prolonged straining, taking more than 25% of the time from the moment the urge to defecate to the bowel movement ¹ .

In addition, subjective sensations must be taken into account in the diagnosis of colostasis ¹ :

• pain when going to the toilet “in a big way” – dense feces injure the anus mucosa, which causes its inflammation; feeling of incomplete bowel movement;
• inability to free the rectum and feeling of its “blockage”;
• the need for prolonged attempts during defecation, even despite the soft feces;
• Forced use of fingers (pressure on the perineum) to successfully expel feces ¹ .

It is important to understand that constipation cannot be diagnosed by one of the above signs ^1,2 . For example, the allocation of small portions of dense feces and the feeling of incomplete emptying of the rectum, even with daily bowel movements, indicate the presence of colostasis, and soft plentiful stools every four days in the absence of discomfort can be quite normal.

The stool disorder may be chronic. According to international experts in the field of gastroenterology, for the diagnosis of chronic constipation, it is enough that during the year for three months in a quarter of defecation cases two of the above signs are observed ^1.2 .

Causes of constipation

Stool retention is a common problem. According to statistics, up to 50% of adults and up to 20% of children in developed countries have problems with defecation to some extent ² . Moreover, stool retention can occur for a variety of reasons.

Stool retention can be caused by external factors, various diseases and conditions of the body. The most common of them are the following.

The predominance in the diet of refined products with a low content of dietary fiber (flour, meat dishes, cereals from refined grains, etc.) leads to the death of the normal microflora of the digestive tract, which makes up almost half of the dry residue of feces ² and decrease in intestinal motility due to a decrease in the volume of feces.

Insufficient fluid intake is usually accompanied by hardening of the feces, slowing down peristalsis.

Low physical activity and sedentary work can lead to weakening of the abdominal muscles involved in the act of defecation ¹ .

Symptoms of constipation during pregnancy are associated with a physiological increase in the level of the hormone progesterone, which reduces the tone of the smooth muscles of the intestine and its motor activity, as well as with difficulty moving feces as a result of compression of the colon by the growing uterus.

Difficulty defecation in the elderly occurs twice as often as in young people ² . Most likely, this is due to such age-related changes as a general weakening of the muscles, a slowdown in peristalsis and digestion, prolapse of organs, and other processes.

Constipation in adults and children may be a sign of endocrine disorders and accompany such conditions ² , as:

• diabetes mellitus, characterized by impaired carbohydrate metabolism;
• hypothyroidism, or decreased thyroid function;
• hyperparathyroidism – excessive hormonal activity of the parathyroid glands;
• hypercalcemia – increased level of calcium in the blood;
• hypokalemia – decrease in the level of potassium in the blood;
• uremia – an increase in the blood level of toxic products of protein metabolism as a result of renal failure ² .

Since intestinal peristalsis is regulated by the nervous system, in adults the symptoms of constipation can occur as one of the manifestations of stroke, chronic cerebrovascular accident, Parkinson’s disease, multiple sclerosis and other neurotic diseases ¹ .

The influence of the psyche on the digestive system can be traced in acute and chronic stress, anxiety disorder, depressive states ² . Violation of defecation in the form of colostasis occurs as a symptom of irritable bowel, among the causes of which physicians primarily single out psychological problems ² .

Stool retention can occur when there are mechanical obstructions to the passage of intestinal contents, for example, as a result of postoperative complications, adhesive disease, colon tumors ² .

Colostasis may be the result of side effects of certain drugs: antihypertensive, diuretic and non-steroidal anti-inflammatory drugs, antidepressants, anticonvulsants and antiulcer drugs, antispasmodics ^{1. 2} .

Stool retention can be caused by muscle weakness and prolapse of the rectum, uncoordinated work of anal sphincters, increased tone and their paradoxical contraction when an urge to defecate occurs, and other factors.

Why constipation is dangerous

Long-term retention of stool in the colon is accompanied by the development of processes of putrefaction and fermentation, which occur with the formation of a large amount of gases and the release of toxic products of the breakdown of proteins and carbohydrates ^1.2. Excessive accumulation of gases is accompanied by the development of flatulence, the appearance of a feeling of heaviness, fullness and pain in the abdomen.

Absorption of toxins leads to nausea, “dirty” coating on the tongue, bad breath, headache, weakness and decreased performance ^1.2 . The mucous membrane of the colon becomes inflamed, polyps may appear on it, which are dangerous for degeneration into malignant tumors.

From the point of view of the development of colon cancer, warning signs of constipation are considered ² :

• progression of problems with defecation in the absence of them in the past;
• age 50 and over;
• the appearance of scarlet or dark blood in the stool;
• pallor of the skin and visible mucous membranes, which may indicate the development of anemia;
• weight loss without changing eating habits and diet;
• cases of colon cancer in close relatives ² .

In the case of chronic problems with bowel movements, especially when the above alarming symptoms appear, a doctor’s consultation and examination is mandatory to clarify the causes of bowel problems and rule out cancer.

Diagnosis and examination of constipation

Diagnosis of constipation begins with determining its nature ⁴ .

A detailed questioning and examination of the patient allows the doctor to determine whether the colostasis is acute or chronic, to exclude alimentary, that is, nutrition-related, causes of stool disorders, and if they are detected, to choose a diet to normalize the stool ⁴ .

If it is determined that there are no nutritional causes of stool retention, first of all, it is necessary to exclude the most dangerous tumor diseases ⁴ .

For this purpose, an x-ray examination of the intestine is carried out, as well as sigmoidoscopy and colonoscopy – examination of all parts of the large intestine using special endoscopic equipment.

Ultrasound, MRI and laboratory tests of blood, urine, and feces help diagnose diseases of the internal organs and endocrine diseases accompanied by problems with defecation.

Taking into account the fact that stool retention may be associated with psycho-emotional disorders, diseases of the nervous, endocrine, reproductive systems, consultations of a psychotherapist, neurologist, endocrinologist, gynecologist (for women), urologist or andrologist (for men) are required ⁴ .

In the absence of diseases of the internal organs, the doctor may prescribe a general treatment for constipation, including diet, taking laxatives that thin and soften the stool ⁴ .

The duration of treatment usually does not exceed 1-2 months ⁴ . If the problem remains unresolved, a further in-depth examination is carried out aimed at the complete exclusion of intestinal pathology, establishing the nature of intestinal motility disorders, assessing the composition of the intestinal microflora, the state of the pelvic floor and the work of the anal sphincters. After analyzing the results, the doctor selects the necessary treatment.

Methods of treatment

Treatment of defecation disorders depends on the causes that caused them.

The treatment of constipation, which is a symptom of a disease, means, first of all, the fight against this disease ³ . For example, restoring the function of the thyroid gland and the balance of its hormones has a beneficial effect on intestinal motility and the nature of the stool, and the normalization of the psycho-emotional state helps to cope with irritable bowel syndrome.

Lifestyle and Dietary Changes

Recommendations regarding lifestyle and dietary modifications apply to all cases of constipation.

• Nature of nutrition

Changing the nature of nutrition involves expanding the diet at the expense of foods that contain a large amount of indigestible dietary fiber: greens, raw rough vegetables and fruits, bran, mushrooms, whole grain bread and cereals ³ .

Experts recommend consuming up to 25-30 g of dietary fiber per day ^1.3 . They bind water, hold it in the digestive tract, increase the volume of intestinal contents, thereby stimulating intestinal motility and the movement of feces into the rectum.

Since it is problematic to cover the need for dietary fiber through diet alone, doctors recommend that patients take concentrated fiber ³ : wheat bran, agar-agar, flaxseed, psyllium seed husk, milk thistle meal ^{1, 2} .

Psyllium ¹ has the highest ability to bind and retain water. However, when taking it, it is necessary to consume a sufficient amount of liquid, otherwise the opposite effect is possible. In addition, one should not wait for a quick normalization of the stool – for this it is necessary to take fiber for 1-2 weeks ^1.2 .

• Right Habits

To develop regular reflex urge to defecate, experts recommend emptying the rectum in the morning at the same time ^1.3.

The preferred time is 15-45 minutes after breakfast, when the intake of food into the stomach stimulates intestinal peristalsis and facilitates its emptying ³ .

To normalize the stool, it is important not only to change the nature of the diet, but also to make adjustments to the diet.

Breakfast must be hearty ³ . Foods rich in fats ³ are best suited for him – acting on the stomach, they reflexively increase the motility of the digestive tract, which contributes to defecation.

To maintain water and electrolyte balance, an adult should consume 30-40 mg of liquid per 1 kilogram of body weight per day ^1.2 . Basic needs must be covered by drinking water ² or still mineral water.

In addition, adults with symptoms of constipation are advised to limit their intake of coffee and tea, as they are diuretic and cause stool hardening ¹ .

An active lifestyle and special exercises aimed at strengthening the anterior abdominal wall and mechanical stimulation of peristalsis help to solve bowel problems ¹ .

Medical therapy

It is prescribed by a doctor according to the type of constipation in order to empty the rectum, relieve the condition and normalize the digestive tract.

Laxatives include several groups of drugs. Only a doctor can determine which one is best suited for certain symptoms of constipation in an adult. Despite the common indications for use, such drugs have different mechanisms of action and side effects – this should always be taken into account.

• Osmotic laxatives (saline laxatives, lactulose, macrogol) act throughout the entire intestine ² . They are practically not absorbed inside and, remaining in the intestinal lumen, attract water ³ . Liquefaction and an increase in the volume of feces stimulate peristalsis, accelerate and facilitate defecation. The downside is that often the use of drugs in this group can lead to dehydration and leaching of the necessary microelements from the body ^3.4 .
• Drugs that irritate the intestines and thereby increase its contractions can act in the small (eg, castor oil) and large (senna, buckthorn, sodium picosulfate, and others) intestines ^2.3 . On the downside, irritant laxatives are addictive with prolonged and frequent use and can damage the intestinal mucosa and disrupt its function ³ .
• Emollients such as vaseline and almond oil act at the level of the rectum and facilitate defecation mainly by moisturizing and “lubricating” the mucosa ¹ .
• Combination laxatives acting at the level of the rectum and terminal sigmoid colon can be used to treat the problem of constipation ³ . An example of such drugs is micro enema MICROLAX ^® , the main active ingredients of which are sodium citrate, sodium lauryl sulfoacetate and sorbitol ⁵ . Sodium citrate displaces bound water from the contents of the intestine, sorbitol attracts it into the intestinal lumen, and sodium lauryl sulfoacetate thins the stool and facilitates their excretion. The action can begin within 5-15 minutes after the introduction of microclysters ⁵ . The high safety profile allows the drug to be used for symptoms of acute and chronic constipation in adults, including pregnant women ⁵ .

At the same time, it is important to understand that in the fight against colostasis it is not necessary to achieve daily bowel movements – it is necessary to “teach” it to work independently ² .

• Motor Regulators

For constipation associated with increased or decreased tone of the colon, the doctor may recommend taking antispasmodic (reducing the contractility of the intestinal muscles) or prokinetic (activating peristalsis) drugs ³ .

• Probiotics

The effect of colon microflora on peristalsis has been proven by research ¹ . Therefore, probiotic preparations based on live bifido-, lactobacilli and their combinations can promote recovery ^2.3 . If necessary, the doctor prescribes them.

Biofeedback therapy

Biofeedback therapy is used for constipation associated with pelvic floor dysfunction, including anal sphincters ^2,3,4 . Its purpose is to teach the patient to relax the muscles of the anus and at the same time strain the abdominal muscles when the urge to defecate occurs.

The treatment is based on the principle of biofeedback, carried out in the form of training using special equipment and is considered quite effective ³ .

Surgical treatment

Surgical treatment of colostasis – an exceptional measure used when other methods are ineffective ³ .

In order to restore regular stools, various operations on the intestines are performed. But studies show that a quarter of patients after the intervention remain dissatisfied with the results ¹ .

Constipation is a complex problem in gastroenterology, the solution of which largely depends on timely diagnosis and treatment. Given that difficult bowel movements can be a symptom of a serious illness, if constipation recurs, a doctor’s consultation is mandatory.

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

Literature

1. E.N. Baryshnikov, V.G. Rumyantsev . Constipation in the practice of a gastroenterologist. Consilium Medicum. 2007; 7: p. 38-43.