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Constipation is most often defined as having a bowel movement less than 3 times per week. It is often associated with hard stools or problems passing stools. You may have pain while passing stools or may be unable to have a bowel movement after straining or pushing.
Irregularity of bowels; Lack of regular bowel movements
Normal bowel movements are different for each person. Some people do not have a bowel movement every day. Also, some healthy people always have very soft stools. Other have firm stools, but are able to pass them without problems.
When you do not have frequent bowel movements, or it takes a lot of effort to pass stool, you have constipation. Passing large, wide, or hard stools may tear the anus, especially in children. This can cause bleeding and may lead to an anal fissure.
Constipation is most often caused by:
Stress and travel can also contribute to constipation or other changes in bowel habits.
Other causes of constipation may include:
Constipation in children often occurs if they hold their bowel movements. This may happen when the child is not ready for toilet training or is afraid of it.
Lifestyle changes can help you avoid constipation. These changes can also be used to treat it.
Things you can do include:
For infants with constipation:
Regular exercise may also help establish regular bowel movements. If you are confined to a wheelchair or bed, change position often. Also do abdominal exercises and leg raises. A physical therapist can recommend exercises that you can do.
Stool softeners (such as those containing docusate sodium) may help. Bulk laxatives such as psyllium may help add fluid and bulk to the stool. Suppositories or gentle laxatives, such as milk of magnesia liquid, may help you have regular bowel movements.
Enemas or stimulant laxatives should only be used in severe cases. These methods should be used only if fiber, fluids, and stool softeners do not provide enough relief.
Do NOT give laxatives or enemas to children without first asking your doctor.
Call your doctor right away if you have sudden constipation with abdominal cramps and you cannot pass gas or stool. Do NOT take any laxatives.
Also call your doctor if you have:
Call your child's doctor right away if:
Also call your child's doctor if:
Your doctor will perform a physical exam. You will be asked questions such as:
The following tests may help find the cause of constipation:
Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 138.
Lembo AJ, Ullman SP. Constipation. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 18.
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.