Constipation means having a hard time passing stools and passing fewer stools. Some people are overly concerned with how often they have bowel movements. That's because they've been taught that a healthy person has a bowel movement every day. But this isn't true. Most people pass stools anywhere from 3 times a day to 3 times a week. If your stools are soft and pass easily, you aren't constipated.
You have constipation if you have 3 or fewer bowel movements each week. And you may have some of the following problems:
Constipation may occur with cramping and pain in the rectum caused by the strain of trying to pass hard, dry stools. You may have some bloating and nausea. You may also have small amounts of bright red blood on the stool or on the toilet tissue. This is caused by bleeding hemorrhoids or a slight tearing of the anus (anal fissure) as the stool is pushed through the anus. It should stop when the constipation is controlled.
Constipation can also mean the slow movement of stool through the intestines or problems releasing a stool.
Lack of fiber is a common cause of constipation. Other causes include:
Constipation is sometimes caused by poor muscle tone in the pelvic area (outlet delay). Straining too much, needing manual pressure on the vaginal wall, or feelings of incomplete emptying may be a symptom of this type of constipation. Outlet delay constipation is caused by:
Constipation is more common in people older than 65. People in this age group are more likely to have poor dietary habits and take more medicines. Older adults also often have less muscular activity of the intestinal tract. This increases the time it takes for stool to move through the intestines. Physical problems, such as arthritis, may make sitting on the toilet uncomfortable or painful.
If a stool can't pass through the rectum (impacted), mucus and fluid may leak out around the stool. This can sometimes lead to leakage of fecal material (fecal incontinence). So you may go back and forth between having constipation and diarrhea.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.
A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.
A large amount of blood in the stool may mean a more serious problem is present. For example, if there is a lot of blood in the stool, not just on the surface, you may need to call your doctor right away. If there are just a few drops on the stool or in the diaper, you may need to let your doctor know today to discuss your symptoms. Black stools may mean you have blood in the digestive tract that may need treatment right away, or may go away on its own.
Certain medicines and foods can affect the color of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food coloring can turn the stool black.
If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.
Pain in adults and older children
Many prescription and nonprescription medicines can cause constipation. A few examples are:
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Based on your answers, the problem may not improve without medical care.
Here are some things you can do to help relieve constipation.
This will help flex your hips and place your pelvis in a more normal "squatting" position for having a bowel movement.
If your teen has constipation problems, talk to your teen's doctor before trying laxatives.
Your doctor may need to check your symptoms or may suggest a different way to treat your constipation.
There are many ways to treat chronic constipation, depending on what's causing it. Many people need to combine treatments. You may have already tried increasing activity or changing your diet.
Your doctor may also suggest some of these treatments.
Fiber helps keep water in your stool, making it softer and easier to pass.
Your body needs water to be able to pass stool.
Some foods have a natural laxative effect, like prunes. There are also laxative medicines. One type (osmotic) holds water in the intestine to make it easier to pass stool. The other type (stimulant) increases movement in the intestine.
These keep stool soft.
Some medicines may help with your bowels. But others can make constipation worse. Talk with your doctor about everything you take. You may be able to switch to a different medicine that will not cause constipation.
This can help retrain your pelvic floor muscles to know when to relax and when to push.
There are four types of products for preventing or treating constipation.
Food such as bran or products such as Citrucel, Metamucil, Fibercon, or Perdiem ease constipation by absorbing more fluid in the intestines. This makes the stool bigger, which gives you the urge to pass the stool. Regular use of bulking agents is safe and often lets you have more stools.
Products such as Colace lubricate and soften the stool in the intestine, making it easier to pass. Stool softeners do not often cause problems but they don't work as well if you don't drink enough water during the day.
Products such as Fleet Phospho-Soda, Milk of Magnesia, or Miralax and nonabsorbable sugars such as lactulose or sorbitol hold fluids in the intestine and draw fluids into the intestine from other tissue and blood vessels. This extra fluid in the intestines makes the stool softer and easier to pass. Drink plenty of water when you use this type of laxative.
Products such as Correctol, Dulcolax, Ex-Lax, bisacodyl, or Senokot speed up how fast a stool moves through the intestines by irritating the lining of the intestines. Regular use of stimulant laxatives is not recommended. Stimulant laxatives change the tone and feeling in the large intestine and you can become dependent on using laxatives all the time to have a bowel movement.
Call a doctor if any of the following occur during self-care at home:
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