When to See a Doctor for Constipation
Oct 30, 2020 Cedars-Sinai Staff
Many people experience constipation—but few talk to their doctor about it.
Recently, a Cedars-Sinai-led study found that three out of five Americans with constipation have never discussed their symptoms with a healthcare provider. While nearly everyone has felt constipated at some point, having chronic constipation can impact your quality of life.
"Constipation is about much more than how many times you go in a day or a week."
"Chronic constipation can affect your productivity at work, your personal life and your social life as well," says Dr. Ali Rezaie, a gastroenterologist with the GI Motility Program at Cedars-Sinai.
What causes constipation?
The cause of chronic constipation is usually a combination of factors.
"Everyone is different, and genetics may play a role in chronic constipation as well as how quickly one's intestines naturally move—and even diet and activity levels," says Dr. Christopher Almario, a gastroenterologist with the Digestive & Liver Diseases Program at Cedars-Sinai who was also the corresponding author on the constipation study.
Both Dr. Almario and Dr. Rezaie say that the frequency of a person's bowel movements can vary widely, depending on the individual.
"Sometimes patients are referred to me because they only have a bowel movement once a week, but it doesn't bother them at all," Dr. Almario says.
"On the other hand, someone can feel constipated and have a bowel movement seven times a day. Constipation is about much more than how many times you go in a day or a week."
For example, those with constipation may strain a lot or feel there is still stool in the rectum even after having a bowel movement, Dr. Almario says.
Understanding the gut microbiome
Dr. Rezaie says one cause of constipation is an imbalance in the gut microbiome. The microbiome is a term used to describe the bacteria, fungi and viruses that live inside our bowels.
In the gut, a type of microorganisms called methanogens (a bacteria that produces methane) can slow down gut motility, which can cause constipation.
"An overgrowth of this type of microbe is essentially an imbalance of the gut microbiome, which can lead to these constipation symptoms," Dr. Rezaie says.
"By manipulating methanogens, we can improve gut transitions and improve constipation."
When is constipation a sign of something more serious?
If someone has constipation along with severe abdominal pain, this could be a sign of a more serious health condition.
Blood in the stool, unintended weight loss, an unexpected new onset of constipation—all of these are signs that you should seek medical attention, says Dr. Almario.
"For someone who has had regular bowel movements all their life, then all of a sudden develops chronic constipation, this can be a red flag as well," Dr. Almario says.
Ways to treat constipation
To treat constipation, diet and lifestyle changes are usually the first step.
Some people may need to increase their fiber intake, but figuring out the right amount of fiber a person needs in their diet can involve a bit of trial and error, Dr. Almario says.
"I usually encourage patients with constipation to increase their physical activity as much as possible," Dr. Almario says.
Are laxatives safe?
Laxatives can be a safe and effective way to treat constipation.
"It's fine to take a gentle laxative every day or on a regular basis, but make sure to read the label and discuss with your doctor," Dr. Almario says.
In addition to over-the-counter therapies, there are also prescription medications that can be effective in treating constipation.
"Sometimes people think that if you're constipated, you pick up the first laxative you see at the drugstore and there's not much else that will help," Dr. Rezaie says.
"That may have been true 30 years ago, but now there are multiple approaches to the management and treatment of constipation, depending on the underlying cause and the severity of your symptoms."