Constipation means bowel movements that are infrequent, hard, or difficult to pass. It is one of the most common digestive complaints, and it becomes more frequent as people get older.
In most cases constipation is not caused by a serious disease. Diet, fluid intake, physical activity, and certain medicines — including some pain, blood pressure, and iron medicines — are frequent contributors. Even so, a persistent change in your bowel habits deserves an evaluation.
Common symptoms
People with constipation may have fewer bowel movements than usual, strain to pass stool, or pass stools that are hard and lumpy. Some feel unable to empty completely, or notice bloating and a sluggish, uncomfortable abdomen. Symptoms that build gradually and vary with diet are common; a sudden, unexplained change in bowel habits is more concerning.
How constipation is evaluated
Your gastroenterologist will review your bowel pattern, diet, medicines, and overall health, and examine your abdomen. Blood tests can check for thyroid problems and other contributing conditions. If there are warning signs — bleeding, anemia, unintended weight loss, a family history of colon cancer, or a new change after age forty-five — a colonoscopy may be recommended to examine the colon directly. Specialized tests of colon and pelvic-floor function are available for difficult cases.
Treatment approaches
Treatment usually starts with simple measures: more fiber from fruits, vegetables, and whole grains; enough fluids; and regular physical activity. Fiber supplements and gentle over-the-counter laxatives can help when diet alone is not enough.
For persistent constipation, prescription medicines that draw water into the bowel or stimulate its movement are available. Pelvic-floor physical therapy helps when the muscles used to pass stool do not coordinate properly. Your care team can help you build a plan that is safe alongside your other medicines.
When to contact a gastroenterologist
See a doctor promptly if constipation begins suddenly without explanation, or if it comes with blood in the stool, black stools, unintended weight loss, severe pain, or vomiting. Also make an appointment if constipation lasts more than a few weeks despite home measures, or if you regularly depend on laxatives to have a bowel movement.
Take-home information sheet
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Questions about your care?
This page is general education, not personal medical advice. Your care team is happy to talk through what it means for you.