Introduction

Constipation is when bowel movements become less frequent and difficult to pass stools. Constipation is a symptom, not a disease. Almost everyone experiences constipation at some point in their life, and a poor diet typically is the cause. Most constipation is temporary and not serious. Understanding its causes, prevention, and treatment will help most people find relief.

Signs & Symptoms

The following are the most common symptoms of constipation. However, each individual may experience symptoms differently. Symptoms may include:

• not having a bowel movement for several days, or passing hard, dry stools.
• abdominal bloating, cramps, or pain
• decreased appetite
• clenching teeth, crossing legs, squeezing buttocks together, turning red in the face as the child tries to hold in a bowel movement to avoid discomfort
• A little liquid or soft stool smears that soil the child’s underwear.

Some people who are constipated find it painful to have a bowel movement and often experience straining, bloating, and the sensation of a full bowel. Or we may feel like we still need to have a bowel movement even after we’ve had one.

Causes of Constipation

As food moves through the colon, the colon absorbs water from the food while it forms waste products, or stool. Muscle contractions in the colon then push the stool toward the rectum. By the time stool reaches the rectum it is solid, because most of the water has been absorbed. Constipation occurs when the colon absorbs too much water or if the colon’s muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry. Common causes of constipation are:

• not enough fiber in the diet
• lack of physical activity (especially in the elderly)
• medications
• milk
• irritable bowel syndrome
• changes in life or routine such as pregnancy, aging, and travel
• abuse of laxatives
• ignoring the urge to have a bowel movement
• dehydration
• specific diseases or conditions, such as stroke (most common)
• problems with the colon and rectum
• problems with intestinal function (chronic idiopathic constipation)

Complication

Prolong and serious constipation may lead to Hemorrhoids, caused by straining to have a bowel movement, or anal fissures (tears in the skin around the anus) caused when hard stool stretches the sphincter muscle. As a result, rectal bleeding may occur, appearing as bright red streaks on the surface of the stool.
Sometimes straining causes a small amount of intestinal lining to push out from the anal opening. This condition, known as rectal prolapse, may lead to secretion of mucus from the anus. Usually eliminating the cause of the prolapse, such as straining or coughing, is the only treatment necessary. Severe or chronic prolapse requires surgery to strengthen and tighten the anal sphincter muscle or to repair the prolapsed lining.
Constipation may also cause hard stool to pack the intestine and rectum so tightly that the normal pushing action of the colon is not enough to expel the stool. This condition, called fecal impaction, occurs most often in children and older adults. An impaction can be softened with mineral oil taken by mouth and by an enema. After softening the impaction, the doctor may break up and remove part of the hardened stool by inserting one or two fingers into the anus.

Treatment

The main thing in treating constipation is to be sure you’re eating enough fiber and drinking enough fluids. This helps your stools move through your intestines by increasing the bulk of your stools and making your stools softer. Talk to your family doctor if:

• Constipation is new and unusual for you
• You have constipation for 3 weeks or more
• You’re in pain
• You notice any blood in your stools

Prevention

In most cases, following these simple tips will help:

• Eat a variety of foods. Eat a lot of beans, bran, whole grains, fresh fruits, and vegetables.
• Drink plenty of liquids.
• Exercise regularly.
• Do not ignore the urge to have a bowel movement.
• Understand that normal bowel habits are different for everyone.
• If your bowel habits change, check with your doctor.