Healthcare: Gastroenterology & Digestive Health



What is Constipation?


Constipation means that you have a hard time passing stools (bowel movements). People pass stools from 3 times a day to once every 3 days. What is normal for you may be different. Constipation may occur with pain in the rectum and cramping. The pain may get worse when you try to pass stools. Sometimes there are small amounts of bright red blood on toilet paper or the surface of stools. This is because of enlarged veins near the rectum (hemorrhoids).


What Causes Constipation?


Slow transit constipation

Lack of fiber is a common cause of constipation. Other causes include:

  • Irritable bowel syndrome.
  • Travel or other changes in daily routine.
  • Lack of exercise.
  • Immobility caused by illness or aging.
  • Medicine use.
  • Overuse of laxatives.
  • Pregnancy.

Constipation is sometimes a sign of another health problem, such as diabetes, hypothyroidism, or hypercalcemia.

Outlet delay constipation

Constipation is sometimes caused by poor muscle tone in the pelvic area (outlet delay). Straining too much, needing manual pressure on the vaginal wall, or feelings of incomplete emptying may be a symptom of this type of constipation. Outlet delay constipation is caused by:

  • Physical disorders that cause loss of function. These include colon cancer, uterine prolapse or rectal prolapse, scarring (adhesions), and injury caused by physical or sexual abuse.
  • Nervous system diseases, such as Parkinson's disease, multiple sclerosis, or stroke.
  • Spinal cord injury.
  • Pain from hemorrhoids or anal fissures.
  • Delaying bowel movements because of convenience issues or because having a bowel movement causes pain.

Constipation is more common in people older than 65. People in this age group are more likely to have poor dietary habits and take more medicines. Older adults also often have less muscular activity of the intestinal tract. This increases the time it takes for stool to move through the intestines. Physical problems, such as arthritis, may make sitting on the toilet uncomfortable or painful.


What Diagnostic Tests Are Available?


We have a wide variety of diagnostic tests available, including: 

  • In-office balloon expulsion testing
  • Anorectal manometry
  • Sitzmarker studies
  • SmartPill.

We offer a range of medication options for constipation. In addition, our gastroenterologists work closely with a multidisciplinary team – Registered Dietician, local pelvic floor physical therapists, and colorectal surgeons – to serve your care needs.