Constipation is defined as having a bowel movement fewer than three times per week. ‘Normal’ is defined as anywhere from 3 bowel movements a day to three a week. People with constipation will often describe hard, small, stools which are difficult to pass. There is occasionally associated straining, bloating and a sense of fullness. Most people will experience constipation at some point in their lives, and it is usually temporary and not serious.
Constipation occurs when the colon absorbs too much water from food as it passes thru and forms waste products. It can also occur if stool moves thru the colon too slowly, which can happen when the colon’s muscle contractions are sluggish. Common causes of constipation include: not enough fiber or liquid in the diet, lack of physical activity, medications, and changes in life or routine, such as traveling. There are a variety of specific diseases that can cause constipation, in addition to various structural abnormalities, such as a stricture or tumor. Constipation can sometimes be a symptom of irritable bowel syndrome.
The evaluation of constipation generally includes a thorough history and physical exam and basic blood tests. Additional testing is often recommended for those with more severe symptoms or a sudden change in bowel habits. This testing often includes: sigmoidoscopy or colonoscopy, and occasionally testing of the motility and functioning of the colon and rectum.
Treatment of constipation generally depends on the cause, severity and duration of symptoms. It often starts with diet and lifestyle changes, and often goes on to include laxative use. Since there are a variety of laxatives available with different mechanisms of action, it is best to discuss with your doctor which is appropriate for you.