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Constipation is when a person suffers from infrequent or tough passing of bowels that lasts from several days to several weeks. It is common among adults, and almost everyone experiences it in their lifetime. Although constipation is common, those suffering from chronic constipation may experience excessive straining that interferes with daily life.


Constipation is when stool moves slowly through the digestive tract and cannot be eliminated through the rectum. There are various types of constipation. Some involve sluggish movement through the whole colon whereas others involve the anal sphincter muscles. In some patients with constipation, the anal sphincter muscles do not relax appropriately when bearing down to have a bowel movement. 


Some common causes of constipation are:

  • Changes in diet or exercise
  • Excessive consumption of dairy products
  • Irritable bowel syndrome (IBS)
  • Insufficient water consumption
  • Lack of fiber in diet
  • Prescription medication
  • Stress
  • Colon or rectal cancer


Passing bowels varies from several times daily to a few times weekly, depending on the person. More than 3 days between bowel movements is considered too long. Common symptoms of constipation include:

  • Less than 3 bowel movements weekly
  • Straining to have a bowel movement
  • Hard stools
  • Feeling the stool has not completely emptied from the rectum

If symptoms have occurred for more than 3 months, this may be considered chronic and require medical attention. 


In addition to a digital rectal exam, our specialists may use the following tests to try to determine the cause of chronic constipation:

  • Blood tests to diagnose a systemic condition, e.g., low thyroid, high calcium levels.
  • X-ray to identify a blockage and whether stool is present throughout the colon.
  • Sigmoidoscopy to view the rectum and lower portion of the colon.
  • Colonoscopy to view the entire colon.
  • Anorectal manometry to measure coordination of muscles used to move bowels.
  • Balloon expulsion test to measure the time it takes to push out a balloon filled with water from the rectum.
  • Colonic transit study to view the progress of a swallowed tracking capsule as it progresses through the colon.
  • Defecography (with or without an MRI) to x-ray a barium paste as it passes through the rectum.


Modifying lifestyle habits is the first step to treating constipation. For example, increasing water intake and changing diet should increase the speed stool moves through the intestines. Changes can be made to prevent constipation, such as:

  • Eating a well-balanced diet full of fiber
  • Drinking sufficient water
  • Reducing dairy consumption
  • Being active

If these changes do not ease symptoms, these treatments may be recommended:

  • Biofeedback – To retrain anal sphincter muscles to relax.
  • Laxatives – Fiber supplements, lubricants, stool softeners.
  • Medications – Either to draw water to the intestine or other prescription drugs to treat chronic situations.
  • Surgery – When chronic constipation is caused by a blockage.

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