Are you having trouble going to the bathroom regularly? If so, you're not alone. Constipation is a common problem, with around one in three people struggling with the condition. Various factors can cause constipation, including diet, medication, and underlying medical issues.
If constipated, you may experience abdominal pain, bloating, and infrequent or difficult bowel movements. These symptoms can be uncomfortable and frustrating.
The good news is that you can often remedy constipation at home, and various over-the-counter treatment options are available. So, with a little trial and error, you can find the right solution.
Constipation symptoms can vary from person to person. For some, it may mean having infrequent bowel movements. While for others, it could be having hard or lumpy stools, feeling like you can't fully empty your bowels, or straining during a bowel movement.
There are various causes of constipation, although diet and medication are common culprits. Other potential causes include stress, pregnancy, and changes in hormone levels.
Lifestyle causes include:
- Being physically inactive
- Changing routine
- Consuming large amounts of dairy products
- Eating insufficient fiber
- Not drinking enough water
- Resisting the urge to go to the toilet
Medication and dietary supplements that can cause or worsen constipation include:
- Antacids containing aluminum or calcium – used for indigestion
- Anticholinergics and antispasmodics – used for digestive cramps
- Antihistamines – used for allergic reactions
- Anticonvulsants – used to prevent seizures
- Calcium channel blockers – used to lower blood pressure
- Diuretics – used to clear extra fluid from the body
- Iron supplements – used for deficiencies
- Narcotic pain medicines – used for severe pain
Furthermore, some psychiatric, blood pressure, and seizure medications can also cause constipation.
Medical conditions that can cause constipation include:
- Hormone problems, such as diabetes or an underactive thyroid gland (hypothyroidism)
- Colorectal cancer
- Irritable bowel syndrome (IBS)
- Diverticular disease
- Defects in the working of pelvic floor muscles
- Neurologic disorders, including spinal cord injury, multiple sclerosis, Parkinson's disease, and stroke
- Lazy bowel syndrome, where the colon retains stool
- Intestinal obstruction
- Structural defects in the digestive tract
- Multiple organ diseases, like lupus or scleroderma
If constipated, there are several things you can do at home to help relieve your symptoms.
First, consider your diet and make sure you're getting enough fiber. This nutrient is critical for digestive health, as it helps soften feces to move smoothly through the gut. Dietary guidelines recommend that adult women eat 25-28 grams of fiber per day, and for men this increases to 31-34.
Good sources of fiber include:
- Leafy green vegetables
- Whole grains
- Legumes such as lentils, beans, and chickpeas
It's best to incorporate more fiber into your diet slowly, gradually increasing the amount. Otherwise, you could experience gas and bloating.
Some people also find it useful to keep a nutrition diary, which enables them to pinpoint foods that cause constipation.
Also, to help keep everything moving through your digestive system, it's important to stay hydrated by drinking plenty of fluids. Of course, water is a good option, but you can also try juices, herbal teas, or even broths. Just be sure to avoid caffeine and alcohol, which can contribute to dehydration.
Getting regular physical activity is also important to keeping the digestive system moving. A sedentary lifestyle can make constipation worse, so try to increase physical activity. Aim for at least 150 to 300 minutes of moderate-intensity exercise each week for optimal health benefits.
Lastly, consider how you sit on the toilet. Some people find that raising their feet, leaning back, or squatting makes moving the bowels easier.
If these lifestyle changes don't relieve your constipation, there are over-the-counter treatments that may help, such as:
- Osmotic laxatives that increase fluid in the intestines to soften stools
- Lubricant laxatives that help stool slip through the intestine
- Stimulant laxatives that cause the intestines to contract and push out stools
- Emollient laxatives that pull more water and fats into stools to make them softer
- Fiber supplements
Most people can treat constipation themselves at home, and it's rarely a sign of anything serious. That said, sometimes you should seek medical attention, for example, if you:
- Notice blood in the stool
- Are losing weight unintentionally
- Have severe pain when moving the bowels
- Have had constipation for more than three weeks
Seeing a doctor
If constipation isn’t resolved with self-care, you should seek a doctor's advice. Although it can be embarrassing to talk about bowel movements, it's important to give your doctor a clear picture of your symptoms so that they can provide the best possible treatment.
The doctor will ask about your medical history, bowel movements, and lifestyle during the appointment. They may also perform a physical exam to check for pain, tenderness, swelling, or lumps, and listen to abdominal sounds using a stethoscope.
They may review your medications or dietary supplements and change your dose, prescribe an alternative medication, or ask you to stop taking them. These changes alone may be enough to resolve constipation.
Additionally, a doctor may prescribe medications, including:
- Lubiprostone – This medication increases fluid in the bowel, which reduces pain, softens stool, and increases the frequency of bowel movements.
- Linaclotide – If you have irritable bowel syndrome or long-lasting constipation without a known cause, doctors may prescribe this medication to help with regular bowel movements.
- Prucalopride – This medication supports the colon and helps it move stool.
Further diagnostic testing
Depending on the findings of the physical exam, or if constipation does not resolve with treatments, the doctor may also run further tests to rule out other conditions. These may include:
- Blood and urine tests – These can reveal hypothyroidism, anemia, diabetes, and other conditions.
- Stool sample – The laboratory can check for bacteria, viruses, parasites, blood, or cancer.
- Imaging tests – Doctors may order computed tomography (CT) or magnetic resonance imaging (MRI) to identify issues that could cause constipation.
- Colonoscopy – This procedure involves inserting a thin tube with a camera at the end through the rectum and into the bowel. The surgeon may also take a small tissue sample to check for problems.
- Colorectal transit studies – These tests measure the time it takes a marker substance to move through the intestines.
Constipation rarely requires surgery. However, doctors may recommend it if diagnostic testing reveals a structural problem in the intestines, such as:
- A blockage
- Stricture or narrowing
- Tear in the anus (anal fissure)
- Collapse of the rectum into the vagina (rectal prolapse)