What To Know About Constipation? | Gastroenterology


Overview of constipation

Constipation is one of the most common digestive problems in the United States, affecting approximately 2.5 million people. It is defined as dry, strenuous bowel movements, or less than three times a week.


Your colon’s main job is to absorb water from residual food as it’s passing through your digestive system. It then creates stool (waste).

The colon’s muscles eventually propel the waste out through the rectum to be eliminated. If stool remains in the colon too long, it can become hard and difficult to pass.

A proper diet often causes constipation. Dietary fibre and adequate water intake are essential to keep stools soft. Foods high in fibre are usually made from plants. Fibre comes in both soluble and insoluble forms. Soluble fibre dissolves in water, creating a soft, gel-like substance that passes through the digestive tract.

Insoluble fibre retains most of its structure as it passes through the digestive tract. The two forms of fibre combine with stool, increasing its weight and size. This facilitates passage through the rectum.

Common causes of constipation are:

  • A low fibre diet is especially rich in meat, milk, or cheese.
  • Dehydration
  • Lack of exercise
  • Delays stimulation to defecate
  • Other changes in travel or routine
  • Some medications, such as high-calcium antacids and pain relievers.
  • Pregnancy

Underlying medical problems

The following are some of the underlying medical problems that can cause constipation:

  • Some diseases such as stroke, Parkinson’s disease, and diabetes.
  • Overuse or inappropriate use of laxatives (diuretics).
  • Hormonal problems, including a dysfunctional thyroid gland.

What are the symptoms of constipation?

Each person’s normal bowel movements may be different. Some people go three times a day, others three times a week.

However, you may be constipated if you experience the following symptoms:

  • Less than three bowel movements per week.
  • Crossing dry and rough peaks.
  • Leaking or painful bowel movements.
  • Feeling of fullness even after defecation.
  • Facing rectal obstruction.

Who is at risk for constipation?

Poor diet and lack of exercise are the main risk factors for constipation. You are also at higher risk if:

  • 65 years or older. The elderly are physically active, have underlying diseases, and eat poorly.
  • A woman or a child. Constipation episodes are more common in women than men, and children are more affected than adults.
  • Hormonal changes in your growing baby and stress on your intestines can lead to constipation.

How is constipation diagnosed?

Many people with constipation choose to self-medicate by changing their diet, increasing exercise, or using over-the-counter laxatives. However, laxatives should not be used for more than two weeks without consulting a doctor. Your body depends on them for colon function.

You can talk to your primary care provider about:

  • You have been constipated for more than three weeks.
  • You have blood in your stool.
  • You have a stomach ache.
  • You have pain when you have a bowel movement.
  • You are losing weight.
  • You have sudden changes in your bowel movements.

Your doctor will ask you questions about your symptoms, medical history, and any underlying medications or conditions. A physical exam may include a stool test and blood tests to check your blood count, electrolytes, and thyroid function.

In severe cases, additional tests may be needed to determine the cause of your symptoms. Exams may include the following:

Marker study

A marker study, also known as a colorectal transit study is used to examine how food moves through the colon. For this test, you swallow a pill that has small marks that show up on the x-ray. Over the next few days, several abdominal X-rays will be taken so the doctor can visualize how food is moving through your colon and how well your intestinal muscles are working. You may also be asked to eat a high-fibre diet during the test.

Anorectal manometry

Anorectal manometry is a test used to evaluate anal sphincter muscle function. For this test, your doctor will insert a thin tube with a balloon tip into your anus.

When the tube is inside, the doctor will inflate the balloon and slowly pull it out. This test allows them to measure your anal sphincter’s muscle strength and see if your muscles are contracting properly.

Barium enema x-ray

The barium enema x-ray is a type of test used to examine the colon. For this test, you drink a special liquid the night before the test to cleanse your bowel. The actual test involves inserting a dye called barium into the rectum using a lubricated tube. The barium highlights the area of the rectum and colon, allowing the doctor to see them better on an X-ray.


Another type of colonoscopy that doctors use to examine the colon. In this test, your doctor will examine your colon using a tube made with a camera and a light source (colonoscope). Pain relievers and pain relievers are often given so you don’t even remember the test and feel no pain.

To prepare for this test, you will be on a liquid-only diet for 1 to 3 days and will need to take a laxative or enema the night before the test to cleanse your bowel.

How to treat and prevent?

Changing your diet and increasing your level of physical activity are quick and easy ways to treat and prevent constipation.

Also, try the following methods:

  • Every day, drink 1 1/2 to 2 quarts of decaffeinated sweet liquids and water to hydrate the body.
  • Limit alcohol and caffeinated beverages that can cause dehydration.
  • Include foods high in fibre in your diets, such as raw fruits and vegetables, whole grains, beans, prunes, or whole grains. Your daily fibre intake should be between 20 and 35 grams.
  • Cut down on low-fibre foods like meat, milk, cheese, and processed foods.
  • Aim for about 150 minutes of moderate exercise each week and 30 minutes at least five times a week. Try walking, swimming, or biking.
  • If you feel the need to have a bowel movement, don’t delay. The longer you wait, the harder your stool will be.
  • Add fibre supplements to your diet if necessary. Remember to drink plenty of fluids as fluids help the fibres work more efficiently.
  • Consider adding probiotics to your diet as found in yoghurt and kefir with live active cultures. Studies show that this change in diet helps people with chronic constipation.

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