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Constipation is defined as infrequent bowel movements or stool that is difficult to pass.

“Normal” frequency ranges from one bowel movement a day to one per week. If once a week is normal for you, no intervention is needed.

A study of people who thought they had constipation showed that only a third actually fit the
criteria for constipation, while the rest actually had Irritable Bowel Syndrome or other gastrointestinal disorders.

So what are the criteria for constipation?

  • According to ROME IV criteria, if you have two or more of these symptoms, you may have constipation:
  • Fewer than 3 bowel movements per week 
  • During at least 25% of bowel movements do you experience any:
  • Straining
  • Hard or lumpy stools
  • Sensation of incomplete evacuation
  • Sensation of blockage at the level of the anus and rectum
  • The need to use fingers or other manual maneuvers to have a bowel movement If these symptoms last three consecutive months, your constipation may be classified as chronic constipation.

What causes constipation?

Bowel movements are dependent on many things, including regular exercise, fluid intake, high-fiber diet. Occasional constipation can be normal. There are a wide variety of reasons you might become constipated. Diets low in fiber and with low fluid intake can cause constipation, as can a sedentary lifestyle. Constipation is also a side effect of medications including opiates, antacids, and some antidepressants or blood pressure medications. You might become constipated if certain pelvic floor or abdominal muscles aren’t able to relax or
work together properly. Even health conditions including diabetes, Parkinson’s disease, anorexia, and hypothyroidism can cause constipation. Changes in life or daily routine including aging, pregnancy, and travel can all cause constipation, too. Problems with the colon and rectum including scar tissue and diverticulosis. Problems with intestinal function such as Irritable Bowel Syndrome, idiopathic (of unknown origin) constipation, and functional constipation.

Why should I rule out about constipation?

Besides being uncomfortable, complications of chronic constipation can be very serious, even requiring surgery:

  • Swollen veins in your anus, also known as hemorrhoids/piles. Straining to have a bowel movement can cause swelling in the blood vessels in and around your anus. 
  • Ripped or torn skin in your anus, otherwise known as an anal fissure. Large or hard stools can cause little tears in the anus. You may feel a burning or tearing sensation with an anal fissure. Pain can last for days to years and spread or radiate down the legs, even after the bleeding stops.  (3,7,12)
  • Intestine that sticks out or protrudes from the anus, in other words, rectal prolapse. Straining to have a bowel movement can cause part of the rectum to stretch and bulge out from the anus. Rectal prolapse may require surgery.

When to see your doctor.

If you experience any of the following, schedule an appointment to discuss with your doctor :

  • Persistent change to the frequency of bowel movements
  • New or worsening abdominal pain
  • Pain with bowel movements
  • Bloating
  • Piles/Hemorrhoids
  • Blood in stool
  • symptoms longer than three weeks
  • Your stools are black
  • You are found to have low hemoglobin/ anemia, caused by a lack of iron
  • Family history of colon cancer or inflammatory bowel disease in addition to other
  • symptoms
  • You’re losing weight without trying/Unintended weight loss

If you have any of the above feel free to contact

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