Constipation is infrequent and/or uncomfortable bowel movements. Stool is often hard and dry. This is a very common gastrointestinal complaint.
Constipation has many causes, including:
Risk factors include:
Call your doctor if you:
Changes in bowel habits, such as constipation, may indicate a more serious condition. Your doctor may order tests to rule out other conditions. Tests may include:
Treatment may include:
Talk to your doctor about what is a normal frequency of bowel movements for you. The range of normal is quite broad. Some people have several stools a day. Others have one stool every several days.
Regularly using laxatives or enemas can be habit forming. Your bowels can become accustomed to these products and require them in order to produce a stool. Stool softeners, though, are not habit-forming. Ask your doctor about how often and for how long to use these products.
Examples of medicines include:
Set aside the same time each day to move your bowels. Typically, this works best after breakfast and coffee. Sit on the toilet for 15-20 minutes. Over time, your body will learn to have regular bowel movements at the same time each day.
Biofeedback works by attaching sensors to the body. These sensors give you information about your muscles. By working with a therapist, you learn how to control certain muscles that can help you to move your bowels.
Work with your doctor to treat other conditions that may be causing your constipation.
If you are taking medicine that causes constipation, talk to your doctor to find out if you can take another drug.
If you are taking opioids to relieve pain, you may have constipation. A medicine called methylnaltrexone (Relistor) may help to reduce this side effect.
To reduce your chance of getting constipation:
American Gastroenterological Association
National Institute of Diabetes and Digestive and Kidney Diseases
Botox, not just for wrinkles. Johns Hopkins Health Alerts website. Available at: http://www.johnshopkinshealthalerts.com/alerts/digestive_health/JohnsHopkinsHealthAlertsDigestiveDisorders_2898-1.html. Published January 2009. Accessed July 9, 2009.
Camilleri M, Kerstens R, Rykx A, Vandeplassche L. A placebo-controlled trial of prucalopride for severe chronic constipation. N Engl J Med. 2008;358(22):2344-2354.
Cephulac. Drugs.com website. Available at: http://www.drugs.com/mtm/cephulac.html. Updated March 2008. Accessed July 9, 2009.
Cisapride. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/drug-information/DR600429. Updated June 2009. Accessed July 9, 2009.
Constipation. AGA Patient Center, American Gastroenterological Association website. Available at: http://www.gastro.org/patient-center/digestive-conditions/constipation. Updated April 2008. Accessed July 9, 2009.
Constipation. Family Doctor.org website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/constipation.printerview.all.html. Updated July 2010. Accessed January 12, 2012.
Constipation. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation. Updated July 2007. Accessed January 31, 2012.
Constipation. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation. Published July 2007. Accessed July 9, 2009.
Goroll AH, Mulley AG. Primary Care Medicine. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000.
Professional Guide to Diseases. 9th ed. Ambler, PA: Lippincott Williams & Wilkins; 2009.
Treatment of constipation. International Foundation for Functional Gastrointestinal Disorders website. Available at: http://www.aboutconstipation.org/site/about-constipation/treatment. Updated May 2009. Accessed July 9, 2009.
What I need to know about constipation. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/constipation_ez. Published December 2008. Accessed July 9, 2009.
6/25/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Thomas J, Karver S, Cooney GA, et al. Methylnaltrexone for opioid-induced constipation in advanced illness. N Engl J Med. 2008;358:2332-2343.
11/30/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Arebi N, Kalli T, Howson W, Clark S, Norton C. Systematic review of abdominal surgery for chronic idiopathic constipation. Colorectal Dis. 2010 Oct 22. [Epub ahead of print]
6/20/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther. 2011;33(7):822-828.
Last reviewed October 2012 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.