Constipation at a Glance

• Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week.
• Constipation usually is caused by the slow movement of stool through the colon.
• There are many causes of constipation including low fiber diets, abuse of laxatives, hormonal disorders, medications, poor bowel habits,and diseases primarily of other parts of the body that also affect the colon.
• The two disorders limited to the colon that cause constipation are colonic inertia and pelvic floor dysfunction.
• Medical evaluation of constipation may include a history, physical examination, blood tests, abdominal x-rays, barium enema, colonic transit studies, defecography, ano-rectal motility studies, and colonic motility studies.
• Medical evaluation for the cause of constipation should be done when constipation is of sudden onset, severe, worsening, associated with other worrisome symptoms such as loss of weight, or is not responding to simple, safe treatments.
• Treatment of constipation may include dietary fiber, non-stimulant laxatives, stimulant laxatives, enemas, suppositories, biofeedback training, and surgery.
• Changes in diet and exercise usually eliminate the problem.
• Stimulant laxatives should be used as a last resort because of the possibility that they may permanently damage the colon and worsen constipation.
• Most herbal laxatives contain stimulant-type laxatives and should be used, if at all, as a last resort.
• The goal of therapy for constipation is one bowel movement every 2 to 3 days without straining.