Constipation occurs when stools are difficult
to pass. Some people are overly concerned with the frequency of their bowel
movements, because they have been taught that a healthy person has a bowel
movement every day. This is not 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 are
Constipation is present if you have 2 or fewer
bowel movements each week or you do not take laxatives
and have 2 or more of the following problems at least 25% of the time:
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, caused by bleeding
hemorrhoids or a slight tearing of the anus (anal fissure) as the stool is pushed through the
anus. This should stop when the constipation is
Constipation can mean the slow movement of stool through the intestines or problems releasing a stool.
Lack of fiber is a common cause of constipation. Other
Constipation is sometimes a sign of another health problem,
Constipation is sometimes
caused by poor muscle tone in the pelvic area (outlet delay). Excessive
straining, 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
increased medicine use. Older adults also often have decreased muscular
activity of the intestinal tract, which 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.
Women report problems with constipation more often
If a stool becomes lodged in the rectum (impacted), mucus
and fluid may leak out around the stool, sometimes leading to leakage of fecal
material (fecal incontinence). You may experience this as constipation
alternating with episodes of diarrhea.
Check your symptoms
to decide if and when you should see a doctor.
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.
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 a medicine that affects the blood's ability to clot, such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix), 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 things can affect how your body responds to a symptom and what kind
of care you may need. These include:
Based on your answers, the problem may not improve without medical
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
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.
Constipation can be treated at
Call your doctor if any of the following occur during home
If you have any of these symptoms, you need to be evaluated
by a doctor.
You can prevent constipation.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your condition by being prepared to answer the
August 1, 2013
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& David Messenger, MD
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