Constipation is when you have stools that are hard to pass, you don't feel like you pass all of your stool, or there are four or more days between one bowel movement and the next.
Constipation can make you feel constantly bloated or uncomfortable. You may also experience harmful side effects, such as bowel obstructions, due to chronic constipation.
An estimated 15 percent of Americans experience problems with constipation.
This article will explore what constipation can feel like and things you can do for it, including if you're pregnant or have hemorrhoids.
It might help to first look at the path your food takes when it’s being digested.
The digestive tract extends from your mouth to your rectum. Some of the main organs involved in digestion are the:
- small intestine
- large intestine, where stool ultimately exits via the rectum
Along each point of the gastrointestinal tract, nutrients are absorbed and the wastes from food breakdown are ultimately released from the body.
Special motions including churning in the stomach and peristalsis (a rhythmic movement) in the intestines help to propel food material forward through the digestive tract.
The softer and bulkier the stool is, the more likely it is to activate the movements of the intestines and move forward. When it’s time for you to go to the bathroom, muscles in your pelvic floor work together to help push stool out of the rectum.
Constipation can happen due to one or more breakdowns of the expected pathway where stool is excreted.
These can include slow-moving stool, hard stools, or experiencing a problem with the muscles and nerves needed to pass a bowel movement.
As a result, constipation can “feel” like many symptoms. Examples include:
- fullness in the stomach or pelvic region
- cramping of the bowels
- feeling like stool remains in the rectum but cannot pass
- feelings of heaviness or discomfort in the stomach and abdominal regions
- aching feeling in the back
Sometimes it’s difficult to distinguish between discomfort in your stomach and intestines. You might feel cramping or bloating in your intestines that pushes upward on your stomach.
As a result, you could feel stomach discomfort while the area of constipation is really in your intestines.
Sometimes constipation can be a medical emergency.
Go for medical treatment right away if you experience any of the following:
- blood in the stool that is more than a small amount
- dark or tar-colored stools
- severe abdominal pain
Seek immediate medical advice and treatment if you experience the following:
- symptoms don’t get better or they become worse even after trying self-care measures at home, including laxatives
- continued pain after trying to have bowel movements or pain that gets worse
- constipation that alternates with diarrhea
These symptoms can be a sign of bleeding in the digestive tract or that you are experiencing an intestinal blockage. These can be life-threatening emergencies.
Constipation treatments can range from lifestyle to medication treatments. If you have an obstruction or scarring that is blocking the movement of your stool, you may require surgery.
Some at-home, self-care measures you can use to reduce the incidence of constipation include:
- Drinking plenty of water to where your urine should be pale yellow in color.
- Eating at least 25 grams of fiber a day through sources such as vegetables, whole grains, and fruits.
- Engaging in regular physical activity, such as walking, riding a bicycle, or dancing. These physical activity elements can mimic the natural movement of the stool and help stool move more quickly.
- Talking to your doctor about medications you may be taking that affect constipation. However, you shouldn’t stop taking your medicines without talking to your doctor first.
There are also over-the-counter (OTC) medications that can ideally reduce constipation, such as fiber supplements.
Pregnant women experience constipation at a higher rate than the general population. An estimated 11 to 38 percent of pregnant women have problems with constipation.
Some of the factors that make it more likely pregnant women will have constipation include:
- increased progesterone levels and reduced hormones called motilin that slow intestinal movement
- increased water absorption in the intestines that causes stool to dry out
- increased calcium and iron supplements that can increase constipation risk
- enlarged uterus that presses on the intestines, slowing their movement
- decreased physical activity
Constipation may be difficult to recognize initially if you're pregnant because you may be uncertain your symptoms are related to pregnancy. Examples could include bloating or feelings of abdominal fullness and pressure.
When you're pregnant, you can’t take the same medications you did when you weren’t expecting, due to concerns the medicines could affect the baby.
Also, there isn’t a lot of data about the safety of using laxatives to promote bowel movements during pregnancy.
However, some treatments that do not seem to be associated with adverse side effects include:
- bulk-forming agents (although these can cause gas, cramping, and bloating in some pregnant women)
- lubricant laxatives, such as mineral oil
- stool softeners, such as docusate sodium (Colace)
Sometimes laxatives can lead to electrolyte imbalances that could cause you to feel ill and potentially affect your baby.
For this reason, it’s important that if you're pregnant you take these medications for a short time and try lifestyle techniques, such as more fiber, increased water intake, and more physical activity (if tolerated).
Hemorrhoids are swollen blood vessels that occur inside or outside the rectum. They can bleed and make bowel movements painful to pass.
This can be especially difficult if you have hemorrhoids with constipation because your bowel movements already may pass more slowly or be hard to pass. The combination of the two conditions can make going to the bathroom an extremely unpleasant experience.
However, if you’re constipated and have hemorrhoids, you shouldn’t try to put off going to the bathroom when the urge hits. Doing so can put further strain on the bowels and worsen hemorrhoids when you ultimately do pass the stool.
When you have hemorrhoids, changing the position of your body when you use the bathroom may help reduce pressure on the rectum. An example could be planting your feet on a small step stool as you go to the bathroom. This may make stool easier to pass.
Treating constipation with hemorrhoids
Taking steps to treat both your constipation and hemorrhoids can help reduce the incidence of both conditions. Examples include:
- Cleansing the anal area gently and thoroughly after going to the bathroom. Some people may find using baby wipes or rinsing the area may help.
- Drinking plenty of water to make stool less hard.
- Applying anti-inflammatory creams (e.g. steroids like OTC Preparation H) to the area to reduce itching and skin irritation.
- Eating a high-fiber diet, such as fruits, vegetables, and cereals to help add bulk to stool naturally and make it easier to pass.
If you continue to have problems with hemorrhoids, including blood in your stool, talk to your doctor.
Constipation can result from several underlying reasons. These can include:
- dietary changes, such as lower fiber or not drinking enough fluids
- history of colon surgery
- history of gastrointestinal disorders, such as irritable bowel syndrome
- history of pelvic floor disorders
- intestinal obstructions
It can also result from taking certain medications, such as:
- aluminum- and calcium-containing antacids
- calcium channel blockers
- iron supplements
- narcotic pain medications
- medicines used to treat Parkinson’s disease
Sometimes, the movement of the colon slows for no known reason and constipation results.
Whether temporary or chronic, constipation can be an unpleasant occurrence whose symptoms don’t always happen where and when you think they will.
Fortunately, most instances of constipation can resolve with at-home, self-care measures. If your symptoms don’t resolve or you experience pain and bleeding, call a doctor.
If you have fewer than three bowel movements a week combined with difficulty with your bowel movements or other discomfort, it may be worthwhile to talk to a doctor.
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