Constipation: Why Does It Hap... Video Transcript

Participants

, Lucinda A. Harris MS, MD, David R. Marks MD, Mark Pochapin MD, Christine L. Frissora MD, FACP

Summary

As anyone who has experienced it can tell you, constipation can be an uncomfortable and even painful condition. Many people experience it at one time or another and most of the time it goes away on its own. But what causes it in the first place? Join our panel of gastroenterologists as they discuss the causes of constipation and helpful ways to avoid it.

Webcast Transcript

DAVID MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Today we're talking about a topic that most of us don't like to talk about a lot. It's constipation, and at one time or another, almost everyone gets constipated. Usually it's from a poor diet and lack of exercise. Most of the time, it just goes away and it's not serious. But constipation can actually be a warning sign of some serious problems.

Joining us to talk about this are two experts. First is Dr. Lucy Harris. She's a gastroenterologist at Cornell Medical Center. Thank you for being here.

LUCINDA HARRIS, MS, MD: Thank you.

DAVID MARKS, MD: Along with her is Dr. Mark Pochapin. He's also a gastroenterologist, and also at Cornell Medical Center. Welcome.

MARK POCHAPIN, MD: Thanks.

DAVID MARKS, MD: Before we talk about constipation, we have to define what "normal" is. What is normal bowel movements?

LUCINDA HARRIS, MS, MD: The definition that I often use with patients is that normal can be three times a day to about every three days. That can be the range. And also you have to take into consideration what the patient's normal bowel movements have been over their lifetime as well.

DAVID MARKS, MD: With such a broad range, how does one know whether they're actually constipated?

MARK POCHAPIN, MD: I think the most important thing is that it's a change. That something is different. And also that they think about it. People who are not constipated usually don't even think about whether or not they are or they're not. Patients who tend to be constipated spend a lot of time thinking about when they're going to the bathroom, how they're going to go, if they're going to go. And so questioning the patient how much it's important to them, and what type of impact it plays in their life, will tell you pretty much the answer.

LUCINDA HARRIS, MS, MD: The other thing that I think is also important to define is that sometimes patients will say that they're constipated, and that means that they're actually having difficulty straining at a stool, but they're having a bowel movement every day. So it's important to find out the context that the patient views their constipation in as well.

DAVID MARKS, MD: Are there signs like a lot of pain or a lot of straining, more than usual? Does that lead you to think somebody may be constipated even if they're kind of regular?

MARK POCHAPIN, MD: That's a tough question, because straining can be constipation, but can be other problems as well. In fact, people who are progressively straining more to have a bowel movement might actually have more of a blockage problem, rather than a problem with just moving their bowels. That's sometimes a warning sign.

But, actually, when patients say they're constipated, it usually means they can't go, and if it's just a straining problem, they've always had that, that tends to be something easier that we can treat, because at least the body is initiating the sense that they have to go.

DAVID MARKS, MD: Is it more common in certain populations of people? Men, women, older, younger?

LUCINDA HARRIS, MS, MD: I think women sometimes have more problems with constipation. There may be some alteration with the menstrual cycle. I do think that as we grow older, our bowel movements change, and there is a slowing to some extent.

DAVID MARKS, MD: Kids, of course, can have complaints that indicate or possibly indicate constipation. Is it very common in children? I've heard parents say that they think their kids are having a psychological problem, when maybe they are really constipated.