Constipation is infrequent and/or uncomfortable bowel movements. Stool is often hard and dry. It is the most common gastrointestinal complaint in the United States and accounts for 2 million annual visits to the doctor.
Constipation has many causes, including:
A risk factor is something that increases your chance of getting a disease or condition.
Symptoms include:
There are over-the-counter medications to treat constipation called laxatives. However, changes in bowel habits, such as constipation, may indicate a more serious medical condition.
Consult a doctor if you have:
Tests to rule out other medical conditions include:
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 accustomed to these products and require them in order 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 after breakfast and coffee. 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.
Biofeedback works by attaching sensors to the body. A therapist helps you understand your body’s signals and then you use them to help you move your bowels.
Work with your doctor to treat other conditions that may be causing your constipation.
If you're taking medication that causes constipation, ask your doctor for an alternative.
If you are taking opioids to relieve pain, you may have constipation. A study found that the medication methylnaltrexone (Relistor) can rapidly relieve this side effect. *
If you are diagnosed with constipation, follow your doctor's instructions .
To reduce your chance of getting constipation:
RESOURCES:
American Gastroenterological Association
http://www.gastro.org
National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html
Healthy U
http://www.healthyalberta.com/
References:
American Gastroenterological Association website. Available at: http://www.gastro.org . Accessed June 25, 2008.
Botox, not just for wrinkles. Johns Hopkins Health Alerts website. Available at: http://www.johnshopkinshealthalerts.com/alerts/digestive_health/JohnsHopkinsHealthAlertsDigestiveDisorders_2898-1.html . Accessed March 31, 2009.
Camilleri M, Kerstens R, Rykx A, and Vandeplassche L. A placebo-controlled trial of prucalopride for severe chronic constipation. N Engl J Med . 2008;358:2344-2354.
Cephulac. Drugs.com website. Available at: http://www.drugs.com/mtm/cephulac.html . Accessed March 31, 2009.
Cisapride. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/drug-information/DR600429 . Accessed March 31, 2009.
Constipation. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/ . Accessed March 31, 2009.
Goroll AH, Mulley AG. Primary Care Medicine . 4th ed. Lippincott, Williams, and Wilkins; 2000.
Professional Guide to Diseases , 9th ed. Ambler, PA: Lippincott Williams & Wilkins; 2009.
Treatment of constipation. International Foundation for Functional Gastrointestinal Disorders website. Available at: http://www.aboutconstipation.org/site/about-constipation/treatment/ . Accessed March 31, 2009.
What I need to know about constipation. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation_ez/ . Published December 2003. Accessed June 25, 2008.
*6/25/2008 DynaMed Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Thomas J, Karver S, Cooney GA, et al. Methylnaltrexone for opioid-induced constipation in advanced illness. N Engl J Med. 2008;358:2332-2343.
Last reviewed April 2009 by Rosalyn Carson-DeWitt, 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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