Constipation is an abnormal condition in which bowel movements occur less frequently than what is usual for you. One-fourth or more of these bowel movements are accompanied with straining. Every person has differences in their normal, regular pattern of bowel movements, but constipation can be loosely defined as having fewer than three bowel movements per week.
When you are constipated, you have bowel movements that are hard, dry and difficult or painful to pass. You may also only pass small amounts of stool in small pieces at one time. Constipation is caused by food moving too slowly through the colon, or it can occur when the colon absorbs too much water from digested food as it forms waste products (stool).
Constipation is one of the most common gastrointestinal complaints. Constipation is very common in young children and the elderly but can occur in any age group or population.
A wide variety of diseases, disorders and conditions can lead to constipation, including lifestyle changes, dehydration, malignancy (cancer), inflammation, and other abnormal processes. Constipation can be due to mild to moderate conditions, such as a poor diet, pregnancy or hemorrhoids. Serious and life-threatening causes of constipation include colon cancer and bowel obstruction.
In some cases, constipation may be brief, such as may occur when you delay having a bowel movement when the urge is felt. Constipation can also persist over a longer period of time, such as when it is caused by a diet low in fiber and fluids.
If your constipation persists, recurs or causes you concern, seek prompt medical care.
Constipation that is associated with bloody stool, major rectal bleeding, dizziness, fainting, or severe abdominal pain can be a symptom of a serious, potentially life-threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms.
What other symptoms might occur with constipation?
Constipation may be accompanied by other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms frequently affect the digestive tract but may also affect other body systems.
Digestive symptoms that may occur with constipation
Constipation may accompany other symptoms affecting the digestive tract including:
Abdominal cramping or pain
Abdominal swelling, bloating or distention
Change in bowel habits
Flatulence, gas or indigestion
Full bowel sensation
Leaking of small amounts of liquid stool without having a full bowel movement
Nausea and vomiting
Rectal pain or burning
Straining during bowel movement
Other symptoms that may occur with constipation
Constipation may accompany symptoms related to other body systems including:
Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches, and pains)
Stress or anxiety
Unexplained weight loss
Serious symptoms that might indicate a life-threatening condition
In some cases, constipation may occur with symptoms that might indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:
Bloody, black or tarry stool
Change in level of consciousness or alertness, such as passing out or unresponsiveness
High fever (higher than 101 degrees Fahrenheit)
Major rectal bleeding
Rapid heart rate (tachycardia) or rapid breathing (tachypnea)
Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking
Rigid, board-like abdomen
Severe abdominal pain
Weakness (loss of strength)
Yellow skin and whites of the eyes (jaundice)
What causes constipation?
Normally, the colon absorbs excessive water from food during digestion. When food moves too slowly, the colon absorbs too much water, resulting in hard, dry stool and constipation.
In young children, constipation can result from being afraid or unwilling to use the restroom, or delaying a bowel movement when the urge is felt, which can also occur in adults. Other conditions that affect digestion and cause constipation include dehydration, malignancy (cancer) and inflammation.
Gastrointestinal or digestive conditions, such as irritable bowel syndrome, colon cancer, anal fistula, and ileus (bowel paralysis) or obstruction can cause constipation. Constipation often results from consumption of a low-calorie or low-fiber diet. Chronic laxative use can cause the bowel to become dependent on laxatives in order to pass stool and lead to constipation when laxatives are stopped. Constipation with no known cause is called idiopathic constipation.
Constipation can also result from conditions that occur in other body systems, such as pregnancy and certain types of spinal cord injury. In some cases, an underlying condition, such as bowel obstruction, is life threatening.
Lifestyle and dietary causes of constipation
Constipation can be caused by lifestyle, diet or other conditions including:
Delaying bowel movements (ignoring the urge to have a bowel movement)
Lack of physical activity
Not drinking enough fluids
Stress or anxiety
Travel (travel-related constipation)
Gastrointestinal causes of constipation
Constipation may occur due to conditions of the digestive tract including:
Anal fistula (abnormal connection or tunnel between the anus and the buttocks)
Bowel (intestinal) obstruction
Colonic inertia (abnormal nerve and muscle function in the colon)
Dehydration from excessive vomiting or diarrhea
Digestive tract surgery
Diverticulosis or diverticulitis (inflammation of an abnormal pocket in the colon)
Food intolerances or allergies such as to milk products
Hirschsprung’s disease (caused by a neurological birth defect that leads to severe constipation and intestinal obstruction in newborns and infants)
Irritable bowel syndrome (IBS; digestive discomfort that does not cause intestinal damage or serious disease)
Pelvic floor dysfunction
Other causes of constipation
Constipation can be caused by neurological, metabolic and other conditions including:
Diabetes (chronic disease that affects your body’s ability to use sugar for energy)
Hypercalcemia (high blood calcium)
Hypothyroidism (underactive thyroid)
Multiple sclerosis (disease that affects the brain and spinal cord causing weakness, coordination, balance difficulties, and other problems)
Parkinson’s disease (brain disorder that impairs movement and coordination)
Spinal cord injury
Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues)
Uremia (high levels of nitrogen-type waste in the blood due to impaired kidney function)
Medications that cause constipation
Constipation can also be caused by certain medications including:
Antacids that contain calcium and aluminum
Calcium channel blockers for high blood pressure
Parkinson’s disease medications
What are the potential complications of constipation?
In some cases, constipation can be caused by a serious condition of the gastrointestinal tract, such as bowel obstruction. It is important to contact your health care provider if you develop persistent constipation that lasts more than a few days. Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can lower your risk of potential complications including:
Peritonitis and shock from intestinal obstruction