Bowel health
About constipation
What constipation is, what causes it, and how it is treated.
Overview
Constipation is the most common gastrointestinal complaint. About 4 million Americans experience it and make 2.5 million physician visits a year for help. It can occur when the colon absorbs too much water, when the colon’s muscle contractions are slow or sluggish, or when there is delayed transit time through the colon. The result is stool that is hard and dry. Indicators include straining during more than 25 percent of bowel movements, having fewer than three bowel movements per week, or the feeling of incomplete evacuation.
There are established guidelines (Rome II) for defining constipation. A person needs two or more of the following for at least 12 weeks (not necessarily consecutive) in the preceding 12 months:
- Straining in more than 25 percent of bowel movements
- Lumpy or hard stools in more than 25 percent of bowel movements
- A sensation of incomplete emptying in more than 25 percent of bowel movements
- A sensation of anorectal obstruction or blockage in more than 25 percent of bowel movements
- Manual maneuvers to help empty in more than 25 percent of bowel movements (for example, digital evacuation or support of the pelvic floor)
- Fewer than 3 bowel movements per week
- Loose stools are not present, and criteria for irritable bowel syndrome are insufficient
Common causes
Treating constipation
There are several ways to treat constipation, including changes to diet and exercise, use of laxatives, adjustments to the pelvic floor, and scheduled toileting. These include:
- Increasing fiber and fluids in the diet
- Increasing physical activity
- Learning muscle coordination
- Learning proper toileting techniques and toileting modifications
- Designing and sticking to a toileting schedule
This handout is for education and does not replace advice from your own healthcare provider.