Constipation – symptoms and causes

Key takeaways

Constipation is a common gastrointestinal issue, affecting approximately 14% to 20% of the global population at any given time.
Constipation is more common in older adults, with prevalence rates increasing with age. However, it can occur at any age, including in children and adolescents.
Women are more likely to experience constipation than men, with studies suggesting that women are twice as likely to report constipation symptoms.
Chronic constipation, defined as experiencing symptoms for at least three months, affects approximately 2% to 27% of the population worldwide.
Certain medications, such as opioids, antidepressants, antacids containing calcium or aluminum, and iron supplements, are known to cause constipation as a side effect.
Low-fiber diets, inadequate fluid intake, and a lack of physical activity are common dietary factors contributing to constipation.
Sedentary lifestyles, lack of exercise, and ignoring the natural urge to have a bowel movement can contribute to the development of constipation.
Stress, anxiety, and depression can affect gastrointestinal function and contribute to constipation in some individuals.

Constipation, a widespread gastrointestinal issue, manifests through symptoms like infrequent bowel movements and difficulty passing stool. This article explores the symptoms and causes of constipation, shedding light on the various factors contributing to this common ailment and offering insights into effective management strategies.

Overview of constipation

Constipation is a common digestive issue characterized by infrequent bowel movements or difficulty passing stool. It can lead to discomfort, bloating, and abdominal pain. Factors contributing to constipation include diet, lack of physical activity, dehydration, medications, and certain medical conditions. Treatment typically involves lifestyle changes such as increasing fiber intake, staying hydrated, exercising regularly, and using over-the-counter remedies when necessary. Persistent or severe constipation may require medical evaluation to identify underlying causes and appropriate management strategies.

Constipation stands as one of the most prevalent gastrointestinal problems worldwide, impacting a considerable portion of the global population. Studies indicate that approximately 14% to 20% of individuals worldwide experience constipation at some point in their lives.

Symptoms of constipation

Symptoms of constipation can vary from person to person, but common signs and symptoms include:

Infrequent Bowel Movements: Having fewer than three bowel movements per week is often considered a sign of constipation.
Difficulty Passing Stool: Straining during bowel movements or feeling like you can’t completely empty your bowels.
Hard, Dry Stools: Stools that are dry, lumpy, or difficult to pass.
Abdominal Discomfort: Pain, cramping, or bloating in the abdomen, often relieved after passing stool.
Feeling of Incomplete Evacuation: Sensation that you haven’t fully emptied your bowels after a bowel movement.
Rectal Bleeding: Straining during bowel movements can sometimes cause small tears in the skin around the anus, leading to bleeding.
Anal Fissures: Small tears or cracks in the skin around the anus, often accompanied by pain or itching.
Rectal Prolapse: Protrusion of the rectum through the anus, which may occur due to straining during bowel movements.
Decreased Appetite: Loss of appetite or feeling full quickly, particularly if constipation is accompanied by abdominal discomfort.
Feeling Unwell: General feelings of discomfort, fatigue, or irritability, often associated with prolonged constipation.

Causes of constipation

Constipation can be caused by a variety of factors, including:

Low Fiber Diet: Diets low in fiber can lead to constipation because fiber adds bulk to stool and helps it pass more easily through the digestive tract.
Lack of Fluid Intake: Inadequate hydration can contribute to constipation by causing stools to become hard and difficult to pass.
Inactivity: Lack of physical activity can slow down the movement of stool through the intestines, leading to constipation.
Ignoring the Urge to Defecate: Ignoring the natural urge to have a bowel movement can disrupt the body’s natural rhythm and lead to constipation over time.
Certain Medications: Some medications, such as certain pain relievers (opioids), antacids containing calcium or aluminum, antidepressants, and iron supplements, can cause constipation as a side effect.
Medical Conditions: Certain medical conditions can contribute to constipation, including irritable bowel syndrome (IBS), hypothyroidism, diabetes, neurological disorders, and pelvic floor dysfunction.
Changes in Routine: Traveling, changes in routine, or disruptions to regular eating and sleeping patterns can disrupt the digestive system and lead to constipation.
Pregnancy: Hormonal changes and pressure on the intestines from the growing uterus can lead to constipation during pregnancy.
Aging: As people age, muscle tone in the intestines may weaken, leading to slower bowel movements and an increased risk of constipation.
Psychological Factors: Stress, anxiety, and depression can affect digestion and contribute to constipation.

Frequently asked questions

How often should I have a bowel movement?

The frequency of bowel movements can vary from person to person. However, having fewer than three bowel movements per week is often considered a sign of constipation.

When should I see a doctor for constipation?

You should see a doctor if constipation persists for more than a few weeks, is accompanied by severe abdominal pain, rectal bleeding, unintended weight loss, or if you have a family history of colorectal cancer.

Is constipation a sign of a serious medical condition?

In most cases, constipation is not a sign of a serious medical condition and can be managed with lifestyle changes and over-the-counter remedies. However, persistent or severe constipation may indicate an underlying medical issue and should be evaluated by a doctor.

Sources

Diaz S, Bittar K, Hashmi MF, et al. Constipation. [Updated 2023 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513291/

Jani, B., & Marsicano, E. (2018). Constipation: Evaluation and Management. Missouri Medicine, 115(3), 236-240. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140151/

Włodarczyk, J., Waśniewska, A., Fichna, J., Dziki, A., Dziki, Ł., & Włodarczyk, M. (2020). Current Overview on Clinical Management of Chronic Constipation. Journal of Clinical Medicine, 10(8), 1738. https://doi.org/10.3390/jcm10081738

Forootan, Mojgan MDa; Bagheri, Nazila MDb; Darvishi, Mohammad MDc,*. Chronic constipation: A review of literature. Medicine 97(20):p e10631, May 2018. | DOI: 10.1097/MD.0000000000010631