Constipation symptoms, causes, and treatments including laxatives and an approach to the evaluation and treatment of constipation.

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Constipation

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Medical Author: Jay W. Marks, MD
Medical Editors: William C. Shiel, Jr., MD, FACP, FACR and Dennis Lee, MD

Featured constipation patient discussions on effective treatments experienced

"My eleven year old daughter has suffered constipation since she was born. It gradually got worse. I tried many things that the doctor recommended but I find the most effective to be a regular (every couple of days) dose of bisacodyl (Dulcolax) and if that doesn�t work a nice warm bath can sometimes get things moving. "

"My problems with constipation were medically related (NSAIDs, trazodone, etc.) Flax seed oil capsules work great for me. My mother, however, had a stroke. Flax seed oil helped a little, but not much. Lactulose was reasonably effective for her; however, lactulose also speeds up the need to go pee. (If you have had a stroke, rushing to the bathroom, well, takes way too long.) So the latest treatment I�m trying with her is magnesium citrate. I'm starting to do research on this. It does seem to be effective. I imagine it must be better than using laxatives long-term, but the medical info says not to use it long-term without consulting a doctor. "

"I am 43 years old and have suffered from severe constipation since I was a teenager. I am in need for what is the current treatment, other than, Amitiza. This medication does nothing to help with my chronic constipation. I have used everything new on the market and have found nothing to help. The one and only drug that every helped me was Zelnorm. Was told recently you could get it on a case by case study. Today, I found out that this study has been canceled. "

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Patient Discussions are not a substitute for professional medical advice, or treatment.
See the disclaimer at the bottom of the comments page.

What is constipation?

Constipation means different things to different people. For many people, it simply means infrequent stools. For others, however, constipation means hard stools, difficulty passing stools (straining), or a sense of incomplete emptying after a bowel movement. The cause of each of these "types" of constipation probably is different, and the approach to each should be tailored to the specific type of constipation.

Constipation also can alternate with diarrhea. This pattern commonly occurs as part of the irritable bowel syndrome (IBS). At the extreme end of the constipation spectrum is fecal impaction, a condition in which stool hardens in the rectum and prevents the passage of any stool.

The number of bowel movements generally decreases with age. Ninety-five percent of adults have bowel movements between three and 21 times per week, and this would be considered normal. The most common pattern is one bowel movement a day, but this pattern is seen in less than 50% of people. Moreover, most people are irregular and do not have bowel movements every day or the same number of bowel movements each day.

Medically speaking, constipation usually is defined as fewer than three bowel movements per week. Severe constipation is defined as less than one bowel movement per week. There is no medical reason to have a bowel movement every day. Going without a bowel movement for two or three days does not cause physical discomfort, only mental distress for some people. Contrary to popular belief, there is no evidence that "toxins" accumulate when bowel movements are infrequent or that constipation leads to cancer.

It is important to distinguish acute (recent onset) constipation from chronic (long duration) constipation. Acute constipation requires urgent assessment because a serious medical illness may be the underlying cause (for example, tumors of the colon). Constipation also requires an immediate assessment if it is accompanied by worrisome symptoms such as rectal bleeding, abdominal pain and cramps, nausea and vomiting, and involuntary loss of weight. In contrast, the evaluation of chronic constipation may not be urgent, particularly if simple measures bring relief.