Rosalyn Carson-DeWitt, MD
Constipation is infrequent and/or uncomfortable bowel movements. Stool is often hard and dry. This is a common gastrointestinal complaint.
Constipation has many causes, including:
Constipation is more common in people of increased age.
Risk factors include:
Call your doctor if you:
You will be asked about your symptoms and medical history. A physical exam will be done. It may include a digital rectal exam of the rectum with the doctor's gloved, lubricated finger inserted into your rectum.
Your bodily fluids may be tested. This can be done with blood tests.
Your bodily structures may need to be viewed. This can be done with:
Treatment may include:
Talk to your doctor about what is a normal frequency of bowel movements for you. The range of normal is quite broad. Some people have several stools a day. Others have one stool every several days.
Regularly using laxatives or enemas can be habit forming. Your bowels can become used to these products and require them to produce a stool. Stool softeners, though, are not habit-forming. Ask your doctor about how often and for how long to use these products.
Examples of medications include:
Set aside the same time each day to move your bowels. Typically, this works best first thing in the morning. Sit on the toilet for 15-20 minutes. Over time, your body will learn to have regular bowel movements at the same time each day.
may be effective in certain conditions. By working with a therapist, you learn how to control certain muscles that can help you to move your bowels.
Work with your doctor to treat other conditions that may be causing your constipation.
If you are taking medication that causes constipation, talk to your doctor to find out if you can take a different medication.
If you are taking opioids to relieve pain, you may have constipation. A medication called
methylnaltrexone may help to reduce this side effect.
If you have severe, chronic constipation, your doctor may recommend surgery.
If you are diagnosed with constipation, follow your doctor's
To reduce your chance of getting constipation:
American Gastroenterological Association
National Institute of Diabetes and Digestive and Kidney Diseases
Camilleri M, Kerstens R, Rykx A, Vandeplassche L. A placebo-controlled trial of prucalopride for severe chronic constipation.
N Engl J Med.
AGA Patient Center, American Gastroenterological Association website. Available at:
http://www.gastro.org/patient-center/digestive-conditions/constipation. Updated January 2013.
Accessed December 12, 2013.
Constipation. American Academy of Family Physicians' Family Doctor website. Available at:
http://familydoctor.org/familydoctor/en/diseases-conditions/constipation.printerview.all.html. Updated October 17, 2012. Accessed December 12, 2013.
Constipation. National Digestive Diseases Information Clearinghouse website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/constipation. Updated September 18, 2013. Accessed September 18, 2013.
Treatment of constipation. International Foundation for Functional Gastrointestinal Disorders website. Available at:
http://www.aboutconstipation.org/site/about-constipation/treatment. Updated November 22, 2013. Accessed December 12, 2013.
What I need to know about constipation. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
Published September 11, 2013. Accessed December 12, 2013.
6/25/2008 DynaMed Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Thomas J, Karver S, Cooney GA, et al. Methylnaltrexone for opioid-induced constipation in advanced illness.
N Engl J Med.
11/30/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Arebi N, Kalli T, Howson W, Clark S, Norton C.
Systematic review of abdominal surgery for chronic idiopathic constipation.
2010 Oct 22. [Epub ahead of print]
6/20/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation.
Aliment Pharmacol Ther.
Last reviewed December 2013 by Peter Lucas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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