Information and Treatment for Chronic Constipation

What Is Chronic Constipation?

Chronic constipation means different things to different people. To some, it is defined by having infrequent bowel movements for weeks at a time; to others, it means straining or having difficulty passing stools.

When you are constipated, your bowel movements are painful or too infrequent. Constipation is the most common gastrointestinal (GI) problem.

You may have constipation if:

• you have bowel movements less than three times a week
• your stool is hard, dry, and in small pieces

Normal bowel movements vary depending on the person. They may happen as often as three times a day, or just three times a week.

How Prevalent Is Chronic Constipation?

Chronic constipation is estimated to affect 15 to 20 percent of Americans, accounting for 2.5 million doctor visits annually.

What Are the Common Signs and Symptoms of Chronic Constipation?

Each person’s symptoms may vary, but common ones are:

• difficult and painful bowel movements
• less than three bowel movements a week
• feeling bloated
• a sensation of incomplete evacuation
• abdominal pain
• straining to move your bowels without results

The symptoms of constipation can mirror other health problems. Be sure to talk to your health care provider about your symptoms.

What Causes Chronic Constipation?

The simplest causes are not drinking enough water, not getting enough fiber from the foods you eat, and not getting enough exercise. Stress in your life can be a factor. Many medications used for other conditions cause constipation as a side effect. There may be more serious causes, such as a bowel stricture or a tumor.

What Can I Do about Chronic Constipation?

If you are sedentary, get more exercise. Drink plenty of water to avoid dehydration. Make sure to include lots of fruits, vegetables, whole grain breads and cereals in your diet for fiber (“roughage”). These simple steps will help keep stool softer, easier to pass, and moving through your intestinal tract.

What Treatment Is Available for Chronic Constipation?

Your physician likely will recommend conservative measures, such as adding fiber to your diet, getting more exercise, and taking a mild laxative.

Heeding your body’s signals that you need to have a bowel movement also is important. Don’t delay when you feel the urge to go, and don’t rush the process.

When Should I Make an Appointment with a Gastroenterologist?

Everyone is constipated from time to time. However, you should seek help when:

• constipation lasts longer than three weeks
• constipation pain is stopping you from doing your daily activities
• you experience bleeding or have black stools
• you have symptoms of any of the complications of constipation: hemorrhoids, anal fissures, rectal prolapse, or impacted stool
• your constipation does not respond well to stool softeners or laxatives

A gastroenterologist – a physician who specializes in the digestive system and its disorders – can identify the cause of your constipation and prescribe a plan of action. The Women’s Medicine Collaborative has specialists who can help.

Learn more about treatment for pelvic floor disorders at Brown University Health