Have you ever felt a little backed up—complete with bloating or abdominal pain? Most people have, experiencing constipation from a change in diet, a new medication, stress, or reduced activity. Whatever the cause, constipation is one of the most common gastrointestinal complaints, affecting millions of people in the United States.

Generally, constipation is easy to treat and doesn’t require a doctor visit. Sometimes, however, constipation is a sign of a more serious medical condition that requires a doctor’s care. The following can help you understand when it’s time to seek treatment.

What is constipation?

It’s important to understand that the definition of constipation isn’t the same for everyone. Healthy bowel habits can vary from person to person­­—from multiple daily bowel movements to just one bowel movement every two to three days.

To know if you’re constipated, it’s important to watch for changes in your normal bowel habits. If you notice you’re passing stool less frequently or are having difficulty with it, it’s likely constipation.

When do I need to see a doctor for constipation?

Most people experience occasional, short-term constipation and don’t need to see a doctor. But, it can be sign you have an underlying condition that requires medical attention, especially if you have any of these symptoms:

• Significant changes in bowel habit or frequency
• Fewer than 3 bowel movements per week
• Significant weight loss
• Constant straining to pass stool

Major warning signs include:

• Blood in the stool (black or red stool or blood visible in the water around the stool)
• Severe abdominal pain
• No bowel movements or fewer than 2 bowel movements per week

If you have any of these symptoms, and especially if you have any major warning signs, visit your primary care doctor or see a gastroenterologist. If it’s a significant issue, the doctor might refer you to a colorectal surgeon.

What causes constipation?

The causes of constipation can be separated into two categories: mechanical and non-mechanical. Mechanical issues are usually structural or due to other medical problems, and non-mechanical issues are related to diet, activity, medical conditions, or medication use.

Non-mechanical issues are most common and include:

• Lack of fiber in diet
• Sedentary lifestyle
• Dehydration

To avoid constipation, doctors suggest drinking two liters of water per day, exercising daily, and consuming an appropriate amount of fiber—25 grams per day for women and 35 grams per day for men. Fiber supplements can help you reach your daily fiber goal.  

Other non-mechanical causes of constipation include:

• Medical conditions such as hypothyroidism, diabetes, scleroderma, lupus, and depression
• Medications such as narcotics, blood pressure medications, psychiatric medications, and opioids, which can harden your stool to the point it can cause a dangerous colon perforation

Mechanical causes of constipation include:

• Bowel dysfunction
• Colon, rectal, or anal cancer
• Anatomic abnormalities where the walls of the intestines or rectum weaken and bulge into other organs (rectocele, enterocele) or when organs descend (prolapse) in the pelvis and put pressure on the colon or rectum
• Stricture, a narrowing of the colon, rectum or anus due to disease, surgical scarring or certain cancer treatments
• Anal pain from fissures or infection

If you have constipation, and the advice above doesn’t relieve it, make an appointment with your doctor for diagnosis and treatment. If further action is needed, Virtua’s colorectal surgeons are expert in diagnosis and minimally invasive and robotic surgical treatment, if necessary.

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