Constipation is one of the most common digestive problems in the United States, affecting around 2.5 million people.

It’s defined as having hard, dry bowel movements, or going fewer than three times a week.

Your colon’s main job is to absorb water from residual food as it’s passing through your digestive system. It then creates stool (waste).

The colon’s muscles eventually propel the waste out through the rectum to be eliminated. If stool remains in the colon too long, it can become hard and difficult to pass.

Poor diet frequently causes constipation. Dietary fiber and adequate water intake are necessary to help keep stools soft.

Fiber-rich foods are generally made from plants. Fiber comes in soluble and insoluble forms. The soluble fiber can dissolve in water and creates a soft, gel-like material as it passes through the digestive system.

Insoluble fiber retains most of its structure as it goes through the digestive system. Both forms of fiber join with stool, increasing its weight and size while also softening it. This makes it easier to pass through the rectum.

Stress, changes in routine, and conditions that slow muscle contractions of the colon or delay your urge to go may also lead to constipation.

Common causes of constipation include:

  • low-fiber diet, particularly diets high in meat, milk, or cheese
  • dehydration
  • lack of exercise
  • delaying the impulse to have a bowel movement
  • travel or other changes in routine
  • certain medications, such as high calcium antacids and pain medications
  • pregnancy

Underlying medical problems

The following are some underlying medical problems that can bring on constipation:

Each person’s definition of normal bowel movements may be different. Some individuals go three times a day, while others go three times a week.

However, you may be constipated if you experience the following symptoms:

  • fewer than three bowel movements a week
  • passing hard, dry stools
  • straining or pain during bowel movements
  • a feeling of fullness, even after having a bowel movement
  • experiencing a rectal blockage

Eating a poor diet and not exercising are major risk factors for constipation. You may also be at greater risk if you’re:

  • Age 65 or older. Older adults tend to be less physically active, have underlying diseases, and eat poorer diets.
  • Confined to bed. Those who have certain medical conditions, such as spinal cord injuries, often have difficulty with bowel movements.
  • A woman or child. Women have more frequent episodes of constipation than men, and children are affected more often than adults.
  • Pregnant. Hormonal changes and pressure on your intestines from your growing baby can lead to constipation.

Many people affected by constipation choose to self-treat by changing their diets, increasing exercise, or using over-the-counter laxatives.

However, laxatives shouldn’t be used for more than two weeks without consulting a physician. Your body can become dependent on them for colon function.

You should talk to your primary care provider if:

Your doctor will ask questions about your symptoms, medical history, and any medications or underlying conditions.

A physical examination may include a rectal exam and blood tests to check your blood count, electrolytes, and thyroid function.

In severe cases, additional tests may be required to identify the cause of your symptoms. Tests may include the following:

Marker study

A marker study, also called a colorectal transit study, is used to test how food is moving through your colon. For this test, you’ll swallow a pill that contains tiny markers that will show up on an X-ray.

Numerous abdominal X-rays will be taken over the next few days so the doctor can visualize how the food is moving through your colon and how well your intestinal muscles are working.

You may also be asked to eat a diet high in fiber during the test.

Anorectal manometry

An anorectal manometry is a test used to evaluate anal sphincter muscle function. For this test, your doctor will insert a thin tube with a balloon tip into your anus.

When the tube is inside, the doctor will inflate the balloon and slowly pull it out. This test allows them to measure your anal sphincter’s muscle strength and see if your muscles are contracting properly.

Barium enema X-ray

A barium enema X-ray is a type of test used to examine the colon. For this test, you’ll drink a special liquid the night before the test to clean out the bowel.

The actual test involves the insertion of a dye called barium into your rectum, using a lubricated tube. The barium highlights the rectum and colon area, allowing the doctor to better view them on an X-ray.

Colonoscopy

A colonoscopy is another type of test doctors use to examine the colon. In this test, your doctor will examine your colon using a tube that’s outfitted with a camera and light source (colonoscope).

A sedative and pain medication is often given, so you’ll likely not even remember the examination and should feel no pain.

To prepare for this test, you’ll be on a liquid-only diet for 1 to 3 days, and you may have to take a laxative or enema the night before the test to clean out the bowel.

Changing your diet and increasing your physical activity level are the easiest and fastest ways to treat and prevent constipation. Try the following techniques as well:

  • Every day, drink 1 1/2 to 2 quarts of unsweetened, decaffeinated fluids, like water, to hydrate the body.
  • Limit consumption of alcohol and caffeinated drinks, which cause dehydration.
  • Add fiber-rich foods to your diet, such as raw fruits and vegetables, whole grains, beans, prunes, or bran cereal. Your daily intake of fiber should be between 20 and 35 grams.
  • Cut down on low-fiber foods, such as meat, milk, cheese, and processed foods.
  • Aim for about 150 minutes of moderate exercise every week, with a goal of 30 minutes per day at least five times per week. Try walking, swimming, or biking.
  • If you feel the urge to have a bowel movement, don’t delay. The longer you wait, the harder your stool can become.
  • Add fiber supplements to your diet if needed. Just remember to drink plenty of fluids because fluids help fiber work more efficiently.
  • Use laxatives sparingly. Your doctor may prescribe laxatives or enemas for a short period of time to help soften your stools. Never use laxatives for more than two weeks without talking to your doctor. Your body can become dependent on them for proper colon function.
  • Consider adding probiotics to your diet, like those found in yogurt and kefir with live active cultures. Studies have shown that this dietary change can be helpful for those with chronic constipation.

If you still have trouble with constipation, your doctor may prescribe medications to help.

According to a study, linaclotide (Linzess) is recommended for people with IBS-related constipation.

These medications work by increasing the secretions in your intestines, making the stool easier to pass.

Your doctor may also advise that you stop taking certain medications that may cause constipation.

More severe colon or rectal problems may require manual procedures to clear the colon of impacted stool, therapy to retrain slow muscles, or surgery to remove the problem part of your colon.

Most cases of constipation are mild and easily treated with changes in diet and exercise. If you’re experiencing chronic constipation, or constipation along with other bowel changes, it’s important that you talk to your doctor.