Just about everyone has trouble going to the bathroom at some point. If you're not having bowel movements as often as you used to, usually it's no cause for worry. Often, constipation will go away on its own within a few days or get better after you use laxatives or another constipation treatment.
But what if constipation doesn't go away and becomes a daily problem? When should you stop treating it yourself and call a doctor for help?
What Causes Constipation?
Typically, you become constipated when there either isn't enough water in your stool to soften and move it through your intestines, or the muscle contractions in your intestines are too slow to push the stool through and out of your body.
The most common causes of constipation are pretty easy to remedy, including:
- Too little fiber in your diet -- eat more fruits, vegetables, and whole grains
- A lack of fluids -- drink more water
- Too little exercise -- increase the amount of physical activity you do each day
- Ignoring the urge to go to the bathroom -- schedule a specific time to go each day
- The use of certain medicines, such as antacids, blood pressure medicines, pain relievers, antidepressants, iron and calcium supplements, and anticonvulsants; talk to your doctor about switching to a different medicine.
Sometimes, constipation is a sign of a disease or physical problem in the gastrointestinal tract. Conditions such as multiple sclerosis, Parkinson's disease, stroke, diabetes, thyroid disease, and lupus can all make you constipated. Irritable bowel syndrome is a collection of gastrointestinal symptoms that includes constipation.
A less common possibility is that you have a physical problem in your intestines, such as a blockage or tumor, that's preventing the stool from passing through.
When constipation lingers for three weeks or more, get a check-up just to make sure a medical condition isn't causing the problem. Also see your doctor if:
- You've never been constipated before now
- You have stomach pain
- You've noticed blood in your stools
- You're losing weight without trying
Don’t let constipation go unchecked for too long. When untreated, constipation can lead to unpleasant complications such as hemorrhoids and rectal prolapse, a condition in which part of the intestine pushes out through the anus from too much straining.
What Happens During an Exam?
Your doctor will probably ask for a medical history. They will ask questions about your constipation, including:
- When your constipation started
- How often you normally have bowel movements
- The consistency of your stools and whether you have to strain during bowel movements
- Whether you've noticed blood in your stools
- The results of your last colonoscopy
- What other constipation symptoms you're experiencing (abdominal pain, vomiting, unexplained weight loss)
- What, if anything, seems to relieve your constipation or make it worse
- Your eating habits
- Your family and personal history of colon cancer or digestive problems such as irritable bowel syndrome
- What medicines you're taking
These questions may sound personal, but they're the only way your doctor can learn why you're constipated and find the best constipation treatment for you.
Don't be embarrassed or afraid to also ask your doctor questions, such as:
- How often should I go to the bathroom?
- How much fluid should I drink each day?
- How much fiber do I need to eat?
- Which type of laxative will help my constipation while causing the fewest side effects?
- How soon should my constipation improve?
- Do I need to see a gastroenterologist?
- When should I make an appointment to see you again?
During the exam, the doctor may insert a gloved, lubricated finger into your anus to check for a blockage or blood. You may also have tests to rule out conditions that can cause constipation.
Sometimes, your doctor may recommend that you have tests such as a barium enema X-ray, sigmoidoscopy, or colonoscopy. These diagnostic tests allow your doctor to look for problems in your intestines, colon, and rectum.
Once the cause of your constipation has been determined, your doctor will discuss treatments with you. Common constipation treatments include adding more fiber to your diet and taking laxatives.
Stay in touch with your doctor while following your constipation treatment. You may need to switch treatments if one isn't working. It’s possible to become dependent on laxatives and need them to have a bowel movement. In that case, your doctor may have to wean you off laxatives to get your system back to normal.