Constipation

How common is it?

Constipation affects about 15% of Americans. Most cases are simple, safe, and treatable, but sometimes it can signal a more serious problem.

What is Constipation?

Constipation can mean:

• Infrequent stools (less than 3/week)
• Hard stools
• Straining
• Incomplete emptying

What’s “normal” varies — some people go daily, others every 2–3 days.

How Normal Bowel Function Works

After food moves through the small intestine, the colon:

• Absorbs water
• Forms stool
• Passes it to the rectum for storage until a bowel movement occurs

Good bowel function depends on:

• Stool consistency
• Ease of passing
• Feeling completely empty

Fiber helps by making stools bulkier and easier to move.

Common Causes

Constipation is often due to:

• Low fiber intake
• Poor hydration
• Lack of physical activity

Other causes include:

• Medical conditions (diabetes, hypothyroidism)
• Medications (pain meds, antidepressants, BP meds)
• Pelvic floor dysfunction
• Structural blockage
• Cancer (rare but important to rule out)

When to Seek Medical Attention

See a healthcare provider if constipation:

• Is persistent or worsening
• Comes with nausea, vomiting, severe pain
• Causes blood in stool
• Involves pencil-thin stools
• Does not improve after lifestyle changes

Treatment Basics

Start with lifestyle changes, which help most people:

1. Fiber: 25–35g/day from fruits, vegetables, whole grains
2. Fluids: 6–8 glasses of water daily
3. Exercise: Regular activity stimulates the bowel

Laxatives

Available types include:

• Stimulant (senna, bisacodyl) — occasional use only
• Osmotic (MiraLAX®, lactulose, magnesium) — draws water in
• Stool softeners (Colace®)
• Enemas/suppositories — avoid routine use

Always talk to a provider before long-term laxative use.

Prescription Medications

Used when conservative measures fail. Examples:

• Lubiprostone (Amitiza®)
• Linaclotide (Linzess®)
• Medications for opioid-induced constipation

Cost and insurance coverage may vary.

Evaluation Tools (If Symptoms Persist)

Tests may include:

• Colonoscopy
• Transit study (Sitzmarks®)
• Anorectal manometry
• Defecography

Used to check for blockage, slow motility, or pelvic floor dysfunction.

Specific Disorders & Advanced Care

• Pelvic floor dyssynergia can be treated with biofeedback physical therapy
• Slow-transit constipation is rare and requires specialized evaluation
• Surgery is rare and only used for select cases

  Bottom Line: Most constipation improves with fiber, fluids, and exercise, but persistent symptoms — especially with bleeding, pain, or weight loss — deserve medical evaluation.