Bowel movement form and frequency vary from person to person. Constipation occurs when bowel movements are less frequent or stool becomes hard or difficult to pass. Constipation may exist as part of a diagnosis of Irritable Bowel Syndrome (IBS). Changes in diet or routine often affect bowel movements. If bowel movements become difficult or painful or there has been an extended period of time since your last bowel movement, your constipation should be treated by a gastroenterologist.
Some signs of constipation may include:
- Dry and/or hard stool
- Feeling like your bowel is not fully emptied
- Lower abdominal pain
- Painful and difficult to pass bowel movements
- Using maneuvers to evacuate stool, such as pressure or digital manipulation
Constipation can be caused by many different factors and is not the same for everyone. It is important to note that constipation can occur from infancy to geriatric age groups, but may get worse due to pregnancy, when taking certain medications or by having a digestive disorder. Typical causes are:
- Anorectal (outlet) blockage
- Changes in routine (traveling, time you eat, sleep pattern)
- Getting little to no exercise
- Inadequate fiber intake
- Improper functioning of pelvic floor muscles
- Not drinking enough water
- Resisting or withholding bowel movements
- Slow transit of stool within your intestines
- Stress, anxiety, depression, etc.
If you are experiencing issues with bowel movements or have pain, talk to your doctor. They will ask about your medical history, routine, diet and bowel movement history. A physical examination that includes a thorough rectal examination may be done to see if there are any underlying causes. Your doctor will review any current medications or supplements you are taking to see if the dosage or medication needs to be changed. Other tests such as diagnostic lab testing, imaging including X-rays or MRI defecography as well as anorectal manometry may be performed.
In some cases, constipation is manageable at home with proper eating and drinking habits, including the appropriate amount of fiber in your diet. There are a number of over the counter and prescription medications available to treat constipation. If certain causes of constipation are found, like pelvic floor dyssynergia, working with our advanced practice providers and physical therapists for biofeedback and pelvic floor retraining will be helpful.