Constipation Symptoms: Signs & Possible Related Conditions

 

Constipation is a term that people sometimes use casually, but do they know if they are actually experiencing this gastrointestinal issue?

The technical definition of constipation is having fewer than three bowel movements a week. But the norm for each individual can vary widely from having a bowel movement several times a day to only going one or two times a week. Whatever your bowel movement pattern is, it’s unique to you, and as long as you don’t get too far away from that pattern, there may not be any reason to be concerned about constipation. It's important to listen to your body's signals and respond promptly to your bowel's natural pattern to help maintain regularity.

Constipation is common and can affect people of all ages. In fact, around 1 in every 7 adults and up to 1 in every 3 children in the UK has constipation at any one time.

So what issues can pop up, and when should you be concerned?

Several risk factors can increase your chances of developing constipation, including age, gender, diet low in fibre, not getting enough exercise, low fluid intake, and certain medications. Keeping active and mobile will greatly reduce your risk of getting constipation. Certain medications, such as opioids, blood pressure medicines, pain medications, antidepressants, antacids, and iron pills, can cause constipation as a side effect. Medical conditions like neurological diseases, digestive disorders, diverticular disease, bowel cancer, Parkinson's disease, stroke, and other illnesses can also contribute to constipation. Mental health conditions, such as depression or eating disorders like bulimia nervosa and anorexia nervosa, may also play a role. Your medical history is important for healthcare professionals to assess and diagnose constipation accurately.

Eating high-fiber foods is recommended to help prevent constipation. You should aim to have about 30g of fibre a day, and it's best to gradually increase your fibre intake to avoid discomfort. Make sure you drink plenty of fluids to avoid dehydration, which can lead to constipation.

A daily walk or run can help you poo more regularly and prevent constipation.

Constipation is usually not serious and can often be treated with simple changes to diet and lifestyle. Most cases are temporary and will clear up with simple lifestyle measures. There is no evidence that long-term constipation increases the chance of bowel cancer.

Chronic constipation can sometimes lead to complications, such as faecal impaction. Long-term constipation should be managed promptly to prevent worsening health issues.

The key features of constipation include infrequent bowel movements, hard or lumpy stools, and difficulty or pain when passing stools. You may also notice the following symptoms: abdominal pain, bloating, straining, rectal pain, nausea, reduced appetite, and unexplained weight loss.

How & why constipation occurs

As food moves through your digestive tract normally, your body absorbs nutrients. The partially digested food (waste) that remains moves from the small intestine to the large intestine (also known as the colon or large bowel). The colon absorbs water from this waste, which creates a solid matter called stool.

If you experience constipation, food may move too slowly through the digestive tract. This gives the colon more time – too much time – to absorb water from the waste. The stool becomes dry, hard, and difficult to pass. Certain medical conditions, including neurological diseases affecting the brain and spinal cord, as well as digestive disorders, can cause constipation.

Generally speaking, the longer time period between each of your bowel movements, the more difficult it will likely be to pass the stool. Here are a few key features that we usually see in a patient who is experiencing constipation:

• Dry, hard stool
• Bowel movement is painful, and stools are difficult to pass
• Feeling that you have not fully emptied your bowels
• Common symptoms of constipation include abdominal pain, bloating, and the need to strain during bowel movements. In some cases, people may need to press on their belly or use a finger to remove stool if they are constipated.

If you experience any of these issues due to constipation, you are not alone. Constipation is one of the most frequent gastrointestinal complaints in the United States. People of all ages can have an occasional bout of constipation, but sometimes people may experience chronic constipation. It’s more likely in these situations:

• Older age. Older people tend to be less active. They typically have a slower metabolism and less muscle contraction strength along their digestive tract.
• Being a woman, especially while pregnant and after childbirth. Changes in a woman’s hormones during and after pregnancy can make constipation more common. The baby inside the womb may compress the intestines, which can also slow down the passage of stool.
• Not eating enough high-fiber foods. High-fiber foods keep everything moving through the digestive system.
• The role of the digestive system in constipation

The digestive system is at the heart of how and why constipation occurs. When you eat, food travels through your digestive tract, where nutrients are absorbed and waste is formed. The large intestine, or colon, plays a key role in this process by absorbing water and electrolytes from the waste material. If the colon absorbs too much water, the stool becomes hard, dry, and difficult to pass—classic symptoms of constipation.

The muscles lining the digestive tract, especially the bowel muscles, are responsible for moving stool along its journey. When these muscles are weakened or their movement slows down, stool can linger in the colon, giving it more time to lose moisture. This is why chronic constipation is more common in people with sluggish bowel muscles or certain medical conditions, such as irritable bowel syndrome, which can disrupt the normal rhythm of the digestive system.

Understanding how the digestive system works can help you make effective diet and lifestyle changes to treat constipation and prevent complications like rectal prolapse. Eating more high fiber foods, staying hydrated, and keeping active all support the digestive system’s natural function. By supporting your digestive health, you can help your colon absorb just the right amount of water and keep your bowel movements regular.

---

Pelvic floor and constipation

The pelvic floor muscles are essential for healthy bowel movements, yet they’re often overlooked when it comes to constipation. These muscles, including the puborectalis, help control the release of stool through the anus. If the pelvic floor muscles are weakened or damaged—sometimes due to aging, childbirth, or certain medical conditions—it can make passing stools difficult and lead to painful bowel movements.

On the other hand, if the pelvic floor muscles are too tight, they can prevent stool from passing smoothly, making constipation worse. This can disrupt your normal bowel habits and lead to symptoms of constipation, such as straining or feeling like you haven’t fully emptied your bowels.

To prevent constipation and promote regular bowel movements, it’s important to keep your pelvic floor muscles strong and flexible. Pelvic floor exercises, like Kegels, can help, as can maintaining a healthy diet and lifestyle. Eating high fiber foods, drinking plenty of water, and exercising regularly all support both your digestive system and pelvic floor health. It’s also important to remember that digestive and kidney diseases can affect these muscles, so if you experience ongoing constipation or painful bowel movements, consult a healthcare professional to rule out underlying conditions. By caring for your pelvic floor and overall health, you can help prevent constipation and keep your digestive system functioning smoothly.

When constipation may be more concerning

There are some complications that may occur if you don’t have soft, regular bowel movements, including:

• Hemorrhoids – These are swollen, inflamed veins in your rectum, which can cause rectal bleeding, pain, and itching.
• Anal fissures – These are tears in the lining of your anus caused by hardened stool trying to pass through. Anal fissures can result in pain, tearing, and rectal bleeding during bowel movements.
• Diverticulitis – An infection in pouches that sometimes form off the colon wall from stool that has become trapped and infected.
• Fecal impaction – This is a pile-up of too much stool in the rectum and anus. Faecal impaction can cause overflow diarrhoea, where liquid stool leaks around the obstruction.
• Bowel obstruction is another serious complication of severe constipation. It can cause symptoms such as inability to pass gas, abdominal bloating, and pain, and may require hospital treatment.

We commonly treat these conditions at Alabama Colon & Rectal Institute, but you can go a long way in eliminating them by doing all you can to keep your bowels healthy and moving.

Symptoms of constipation may also include a sensation of blockage in the rectum.

Another concern with constipation is that while it may simply be a sign of slow bowels, it can also be a symptom of serious anal and rectal disorders and diseases. These may include colorectal cancer, irritable bowel syndrome (IBS), or diverticular disease. Especially in situations when constipation is recurring or chronic, it is very important that you see your doctor to rule out these conditions or catch them if you are in the early stages.

Long-term constipation can lead to a condition called megacolon, where the bowel becomes abnormally large.

You should consult a doctor if you experience severe symptoms such as severe abdominal pain, rectal bleeding, or a sudden persistent change in bowel habits lasting longer than six weeks, particularly if you are over 50. Sudden changes in bowel habits lasting longer than six weeks warrant medical consultation, especially for individuals over 50. The presence of blood in the stool or rectal bleeding requires medical evaluation.

Lifestyle changes to fight constipation

Again, making sure you are not constipated can be a first line of defense in eliminating or reducing colorectal diseases and disorders. To avoid constipation or if you think you are exhibiting symptoms, keep these tips in mind:

• Eat plenty of healthy, high fiber foods. Gradually increase your fibre intake, aiming for about 30g per day to help prevent constipation.
• Drink plenty of water. Make sure you drink enough fluids to avoid dehydration, which can lead to constipation.
• Stay active, and exercise regularly. Keeping active and mobile will greatly reduce your risk of getting constipation. A daily walk or run can help you poo more regularly and prevent constipation.
• Don’t eat or drink too much dairy.
• Try to eliminate as much stress from your life as possible.
• If you feel the urge to have a bowel movement, don’t fight it. Respond promptly to your bowel's natural pattern and avoid delaying the urge to go.
• Continue to follow the above tips even when out of your regular routine, such as when you are on vacation.
• Most cases of constipation are temporary and can be managed with these simple lifestyle measures.

Frequently Asked Questions

What is considered constipation?

Constipation is typically defined as having fewer than three bowel movements per week. It's important to listen to your body's signals and respond promptly to your bowel's natural pattern to help maintain regularity and comfort. However, normal bowel habits can vary from person to person. It becomes a concern when there is a noticeable change in your regular pattern, especially if stools are hard, dry, or difficult to pass. Sudden changes in bowel habits lasting longer than six weeks should prompt medical consultation, especially for individuals over 50.

What are the common signs and symptoms of constipation?

Common symptoms include dry and hard stools, difficulty or pain during bowel movements, and a feeling of incomplete evacuation. You may also experience the following symptoms: abdominal pain, bloating, the need to strain during bowel movements, rectal pain, nausea, reduced appetite, unexplained weight loss, and a sensation of blockage in the rectum. These symptoms may indicate that stool is moving too slowly through the digestive tract, allowing excess water absorption.

What causes constipation?

Constipation occurs when stool moves slowly through the digestive system, causing it to become hard and dry. Certain medications, such as opioids, blood pressure medicines, pain medications, antidepressants, antacids, and iron pills, can cause constipation as a side effect. Medical conditions, including neurological diseases, digestive disorders, diverticular disease, bowel cancer, Parkinson's disease, and stroke, may also contribute to constipation. Mental health conditions, such as depression or eating disorders, can affect bowel movements, and disordered eating behaviors seen in conditions like bulimia nervosa and anorexia nervosa can lead to constipation. Contributing factors include low fiber intake, dehydration, lack of physical activity, hormonal changes (such as during pregnancy), and aging, which can slow metabolism and digestive function.

What complications can arise from chronic constipation?

If left untreated, constipation can lead to complications such as hemorrhoids, anal fissures, diverticulitis, and faecal impaction. Faecal impaction is a serious condition where hard stool becomes stuck in the rectum, and it can cause overflow diarrhoea, where liquid stool leaks around the obstruction. Long-term constipation can also result in megacolon, a condition where the bowel becomes abnormally large. In some cases, constipation may also be a symptom of more serious conditions like colorectal cancer, irritable bowel syndrome (IBS), or diverticular disease.

How can constipation be prevented or managed?

Constipation can often be prevented through lifestyle changes such as eating a high-fiber diet—aim for about 30g of fibre a day, but increase your fibre intake gradually to avoid stomach cramps and bloating—staying well-hydrated by drinking plenty of fluids, exercising regularly, and keeping active and mobile. A daily walk or run can help you poo more regularly and greatly reduce your risk of getting constipation. Reducing excessive dairy intake, managing stress, and responding promptly to the bowel's natural pattern when you feel the urge to have a bowel movement are also important. Maintaining these habits consistently can support healthy digestion.

If you have any concerns related to constipation, let us know!

Alabama Colon & Rectal Institute specializes in diseases of the colon, rectum, and anus. Our free-standing practice located in Birmingham, Alabama, includes three doctors known regionally for their expertise. Visit our website for more information, give us a call to make an appointment at (205) 537-8639, or email us at [email protected].

• Previous
• Next