Constipation is defined as having infrequent bowel movements, typically fewer than three times a week, or experiencing difficulty passing stools. When stool moves too slowly through the large intestine, the colon absorbs excessive water, resulting in hard, dry, and difficult-to-pass feces. Constipation can make a person feel unwell, but most uncomfortable symptoms are secondary effects caused by the pressure and discomfort of retained stool in the lower digestive tract.
Systemic Symptoms of Constipation
The accumulation of stool in the colon causes abdominal distension, putting pressure on surrounding organs and the nervous system, leading to systemic discomfort. This pressure often manifests as a feeling of being unwell, which is a reaction to internal stress. Fatigue is commonly reported, potentially linked to continuous abdominal discomfort or alterations in the gut microbiome.
Loss of appetite and nausea often accompany constipation, as the backed-up waste slows the digestive process and creates a sense of fullness. Tension headaches are also common, possibly triggered by the strain associated with passing difficult stools. These systemic symptoms are usually temporary and diminish after the constipation is resolved.
Acute Physical Complications
While general symptoms are unpleasant, chronic or severe constipation can lead to physical complications. The most recognized complication is the development of hemorrhoids, which are swollen, inflamed veins around the anus. Hemorrhoids often result from the straining required to push out hard stools.
Straining and the passage of hard feces can also cause small tears in the tissue lining the anus, known as anal fissures. These fissures cause pain and bleeding during bowel movements, making defecation more difficult and perpetuating the cycle of withholding.
In severe cases, constipation can progress to fecal impaction, where a hardened mass of stool becomes lodged in the rectum or colon. Impaction can lead to severe abdominal pain, nausea, and vomiting. Prolonged impaction can cause a complete bowel obstruction or stercoral perforation, where the hardened stool creates a tear in the colon wall, requiring surgery.
Primary Causes of Constipation
Constipation is caused by a combination of dietary, lifestyle, and medical influences. A common cause is a diet lacking fiber. Fiber adds bulk to the stool, helping it retain water and promoting smooth movement through the colon.
Inadequate fluid intake is a contributor because the colon absorbs water from waste. When the body is dehydrated, the colon absorbs too much water from the stool, causing it to become dry and hard. A sedentary lifestyle slows down the movement of the intestines.
Certain medications are also known to slow intestinal motility. These include opioid pain relievers, some antidepressants, and specific antacids containing calcium or aluminum. Ignoring the urge to defecate can train the body to suppress the reflex, which over time can lead to chronic constipation.
Resolution and When to Consult a Doctor
The initial approach to resolving mild constipation involves lifestyle adjustments. Increasing water intake helps rehydrate the stool. Gradually adding high-fiber foods or using a fiber supplement restores bulk to the stool and encourages peristalsis.
Over-the-counter options, such as bulk-forming laxatives, provide temporary relief but should be used cautiously. Prolonged reliance on stimulant laxatives can lead to dependency, making it harder for the bowel to function without them. Regular physical activity stimulates the muscles of the intestines, helping to move waste along the digestive tract.
It is important to recognize symptoms that indicate a medical emergency. Consult a doctor if constipation is accompanied by severe abdominal pain that does not subside, or if you experience vomiting. Warning signs include blood in the stool, unexplained weight loss, or an inability to pass gas. If constipation lasts longer than one week despite home treatment or if you notice a sudden, persistent change in your typical bowel habits, seek medical attention.