Regional Gastrointestinal Consultants

Constipation

Constipation

Constipation

Overview

Constipation is a condition of the digestive system where an individual has hard feces that are difficult to expel. In most cases, constipation usually occurs when stools remain in the colon (large intestine) for too long, and the colon absorbs too much water from the stools, causing them to become hard and dry. When this happens, defecation (emptying the bowels) can become very painful.

Constipation may sometimes be a side effect of a medicine you’re taking. Most cases of constipation aren’t caused by a specific condition and it may be difficult to identify the exact cause. However, several factors can increase your chances of having constipation, including:

  • not eating enough fibre, such as fruit, vegetables and cereals
  • a change in your routine or lifestyle, such as a change in your eating habits
  • having limited privacy when using the toilet
  • ignoring the urge to pass stools
  • immobility or lack of exercise
  • not drinking enough fluids
  • having a high temperature (fever)
  • being underweight or overweight
  • anxiety or depression
  • psychiatric problems, such as those brought on by sexual abuse, violence or trauma
  • (add) continual use of opoids for pain control or due to addiction

In rare cases, constipation can be a sign of an underlying condition, such as:

  • irritable bowel syndrome (IBS)
  • diabetes
    • hypercalcaemia – where there’s too much calcium in the bloodstream
  • underactive thyroid gland (hypothyroidism)
    • muscular dystrophy – a genetic condition that causes muscle wasting
    • multiple sclerosis – a condition that affects the nervous system
    • Parkinson’s disease – where part of the brain becomes progressively damaged, affecting the co-ordination of body movements
    • spinal cord injury
    • anal fissure – a small tear or ulcer in the skin just inside the anus
    • inflammatory bowel disease – a condition that causes the intestines to become inflamed (irritated and swollen)
  • bowel cancer

Symptoms

Difficulty passing stool and being unable to empty the bowel completely are symptoms of constipation and stools may appear dry, hard and lumpy, as well as abnormally large or small.

Other symptoms of constipation can include: * stomach ache and cramps * feeling bloated * feeling sick * loss of appetite

In children, as well as infrequent or irregular bowel movements, a child with constipation may also have any of the following symptoms:

  • loss of appetite
  • a lack of energy
  • being irritable, angry or unhappy
  • foul-smelling wind and stools
  • stomach pain and discomfort
  • soiling their clothes
  • generally feeling unwell

Treatment

Treatment for constipation depends on the cause, how long you’ve had it and how severe your symptoms are. In many cases, it’s possible to relieve the symptoms by making dietary and lifestyle changes. There are various treatments for constipation are outlined below:

Lifestyle

Changes to diet and lifestyle are often recommended as the first treatment for constipation. In many cases, this will improve the condition without the need for medication. Some self-help methods of treating constipation are listed below:

  • Increase your daily intake of fibre. You should eat at least 18-30g of fibre a day. High-fibre foods include plenty of fresh fruit and vegetables and cereals.
  • Add some bulking agents, such as wheat bran, to your diet. This will help to make your stools softer and easier to pass.
  • Avoid dehydration by drinking plenty of water.
  • Exercise more regularly – for example, by going for a daily walk or run.
  • If constipation is causing pain or discomfort, you may want to take a painkiller, such as paracetamol. Always follow the dosage instructions carefully. Children under 16 shouldn’t take aspirin.
  • Keep to a routine (a place and time of day) when you’re able to spend time on the toilet. Respond to your bowel’s natural pattern: when you feel the urge, don’t delay.
  • Try resting your feet on a low stool while going to the toilet, so that your knees are above your hips; this can make passing stools easier. 
  • If medication you’re taking could be causing constipation, your gastroenterologist may be able to prescribe an alternative.

Your gastroenterologist may prescribe an oral laxative if diet and lifestyle changes don’t help.

Laxatives 

Laxatives are a type of medicine that help you pass stools. There are several different types of laxative and each one has a different effect on your digestive system.

Treating fecal impaction 

Fecal impaction occurs when stools become hard and dry and collect in your rectum. This obstructs the rectum, making it more difficult for stools to pass along. Sometimes as a result of impaction, overflow diarrhea may occur (where loose stools leak around the obstruction). If fecal impaction occurs, you’ll most likely initially be treated with a high dose of osmotic laxative. After a few days of using the laxative, you may also have to start taking a stimulant laxative.

If you don’t respond to these laxatives, and/or if you have overflow diarrhea, you may need one of the medications described below.

  • Suppository – this type of medicine is inserted into your anus. The suppository gradually dissolves at body temperature and is then absorbed into your bloodstream. Bisacodyl is an example of a medication that can be given in suppository form.

  • Mini enema – where a medicine in fluid form is injected through your anus and into your large bowel. Docusate and sodium citrate can be given in this way.

IMPORTANT HEALTH NOTE

We recommend that people experiencing gastrointestinal symptoms do not attempt self-treatment. With many medications being available over the counter, and numerous do-it-yourself online unqualified remedy recommendation, it is natural to consider treating yourself but we highly recommend against this.

If you are experiencing gastrointestinal symptoms you may have a more significant issue than you would expect from the sometimes muted or infrequent symptom you may be experiencing. It is important to keep in mind that is you are having gastrointestinal symptoms or concerns it is best see a doctor to have those symptoms diagnosed and any conditions treated. Also, it is worth noting, that if health conditions do exist, the earlier they are diagnosed and treated, the greater the probability will be to successfully eliminate or manage a present condition, in fact successful outcomes will increase significantly with early detection.

If you have gastrointestinal concerns or are experiencing any gastrointestinal symptoms, please contact us promptly to schedule a consultation with a physician.


DISCLAIMER: PLEASE READ CAREFULLY

The information on this website is to provide general information. In no way, does any of the information provided reflect definitive medical advice and self-diagnoses should not be made based on information obtained online. It is important to consult a best in class physician regarding ANY and ALL symptoms or signs as it may a sign of a serious illness or condition. A thorough consultation and examination should ALWAYS be performed for an accurate diagnosis and treatment plan. Be sure to call a physician or call our office today at (215) 321-4700 to schedule a consultation.