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OVERVIEW

What is constipation?

Constipation is a common condition that makes it difficult to have a bowel movement. A bowel movement occurs when the food you eat passes through your digestive tract.  Your body takes the nutrients and water it needs from that food. What’s leftover is called stool.  Your stool can be hard or soft.  Bowel movements usually happen on a regular basis.

Everyone has a bowel movement schedule (how often, how consistent, and what time of day it occurs). However, if your bowel movements become less frequent (based on your history), are hard (and difficult to pass), and you are physically uncomfortable, you may be constipated. People of all ages experience constipation occasionally. Usually, it goes away and is not serious.  See your healthcare provider if your constipation is chronic (frequent). It may be a symptom of a problem with your diet or a health problem.

SYMPTOMS

Symptoms of constipation

The symptoms of constipation may include:

• Feeling like you still need to have a bowel movement even after you’ve had one
• Feeling like your intestines or rectum (bottom) are blocked
• Having hard, dry stool that is difficult to pass
• Having fewer than 3 bowel movements in a week
• Straining to have a bowel movement

More serious symptoms include:

• Constipation is new and unusual for you
• You have constipation for 3 weeks or more despite dietary changes to help
• You have abdominal (stomach) pain
• You lose weight without trying
• You notice any blood or white mucous in your stool
• You cannot pass the stool on your own

Complications of chronic constipation include:

• Anal fissure (a tear in the skin around the anus)
• Fecal impaction (when stool becomes too large for you to pass on your own)
• Hemorrhoids
• Rectal prolapse (when a small piece of your intestine comes out of your anus from straining to have a bowel movement)
• Encopresis (when your bowels are so backed up that only liquid can pass through). Many people mistake this for diarrhea take anti-diarrheal medicine, making constipation even worse

Complications of constipation can become serious if left untreated. They may require surgery.

CAUSES & RISK FACTORS

What causes constipation?

Constipation can be caused by your diet (too many processed foods and not enough fiber), certain medications (opioid medicines given for pain and even too many laxatives, which usually help you have a bowel movement), dehydration (especially not enough water), too little physical activity, intestinal problems, and major life changes, such as pregnancy. Constipation becomes more common as you age. Certain diseases and disabilities also can cause constipation. These include multiple sclerosis, stroke, diabetes, hypothyroidism, and lupus.

Dehydration (not enough fluids) and dietary changes are the most common causes of constipation in babies. For example, changing from breast milk to cow’s milk or from baby food to solids can cause constipation.

DIAGNOSIS AND TESTS

How is constipation diagnosed?

Your healthcare provider will ask about your symptoms and medical history.  This will include asking you about any medicines you take.

Depending on the frequency and severity of your symptoms, your healthcare provider may also want to do other tests, such as a rectal exam, blood tests, X-rays, or colonoscopy.

Can constipation be prevented or avoided?

There are things you can do to reduce constipation. These include:

• Add more fibre to your diet.  Health Canada recommends that women eat 25 grams of fibre and men eat 38 grams of fibre each day. Foods, such as beans, whole grains, fruits, and vegetables are high in fiber.
• Drink more water.   Being dehydrated causes your stool to dry out. This makes having a bowel movement more difficult and painful.
• Don’t wait. When you have the urge to have a bowel movement, don’t hold it in. This causes the stool to build up.
• Get physical. Exercise is helpful in keeping your bowel movements regular.
• Beware of medicines. Certain prescription medicines (especially pain medicines) can slow your digestive system.
• Talk to your healthcare provider if you are being treated for certain diseases that are related to constipation. He or she may have additional guidance for lowering your risks

TREATMENT

How is constipation treated?

The treatment depends on what is causing your constipation. For most people, eating a healthy diet, getting enough fibre, exercising regularly, and drinking enough fluids are the keys to clearing up constipation

Laxatives are over-the-counter medicine that helps you have a bowel movement. Laxatives should only be used in rare instances. Do not use them on a regular basis. If you have to use a laxative, bulk-forming laxatives are best (two brands: Metamucil and Benefiber). These work naturally to add bulk and water to your stools so they can pass easily. Bulk-forming laxatives can cause some bloating (when your stomach feels full) and gas.

Living with constipation

Living with constipation can be uncomfortable and miserable. This is true when it’s just for just a couple of days. Routine (chronic) constipation can be so uncomfortable that it influences how your clothes fit, what foods you eat, and your everyday activities. Keep a journal of your bowel movements to see what a normal bowel movement schedule is for you or your child. A normal schedule is between 3 times per day to 3 times per week. Try to keep your diet and lifestyle as routine as possible to prevent constipation.

FOR MORE INFORMATION

Health Canada website at:
https://www.canada.ca/en/services/health/food-nutrition.html
https://www.canada.ca/en/services/health/healthy-eating.html