Constipation is a common gastrointestinal problem, and an estimated 2.5 million people visit their doctor for the condition each year, according to Cleveland Clinic. Constipation is technically defined as having fewer than three bowel movements a week. Bowel movements may be painful, and your stools may be dry, hard, and difficult to pass. You may also feel like you need to empty your bowels. It’s important to note, though, that everyone’s pooping habits are a little bit different, explains Dr. Nathan Landesman, DO, an osteopathic gastroenterologist in Grand Blanc, Michigan, who’s affiliated with multiple hospitals in the area. Many people mistakenly believe they need to poop daily. “Everyone has a unique natural bowel rhythm, so what constitutes normal bowel habits for one may drastically differ from another,” he says. “When I ask patients what constipation means to them, they may focus on pain, exhausting efforts to have a bowel movement, irregular or unpredictable bowels, or a sense of small or incomplete bowel movements.” Constipation can range from mild to severe, and it has several causes. Parade.com asked gastroenterologists to explain when constipation becomes a legit emergency and you need to seek immediate care.
When is constipation an emergency?
Constipation can be caused by a number of factors, including lack of physical activity, poor hydration or diet, food allergies and intolerances, stress, medications, genetic conditions, altered anatomy such as a birth defect or hernia, diabetes, thyroid disease, and disorders of the digestive system, Landesman says. Pay attention to any abrupt changes in bowel habits or the need to take over-the-counter medications, such as fiber or stool softeners, he adds, as you likely need to get it checked by a physician. “Constipation becomes an emergency when it becomes so severe that one becomes nauseated and starts vomiting, unable to keep anything down by mouth, or if it becomes obstructive,” says Dr. Christine Lee, MD, a gastroenterologist at Cleveland Clinic. Any mild constipation can reach an emergency level when it’s not adequately treated or ignored for too long, she adds. Severe constipation can also be caused by:
Volvulus, when the intestines twists and causes an obstruction Intussusception, a condition in which part of the intestine telescopes into itself, causing a blockageAcute neurologic disorder that causes a loss of peristalsis, which is the constriction and relaxation of the muscles of the intestines creating wave-like movements that push the contents of the intestines forwardTumors that block the intestinesStrictures in the intestines that cause partial or complete blockages
“Failure to recognize constipation and to correct it quickly leads to continued stool backup, a ‘logjam’ as some patients delicately describe,” Landesman says. “In rare cases, this may rapidly progress into a complicated situation, especially if the patient has other health issues.”
When should you head to the emergency room?
Constipation becomes an emergency—and, you need to go to the emergency room—when you can’t poop despite multiple attempts and you experience other symptoms, including:
Severe abdominal painFeverRectal bleeding Vomiting and being unable to keep anything downInability to pass gasChest painsShortness of breathDizzinessLightheadednessChanges in mental statusLoss of consciousness
The emergency room will perform an evaluation to first rule out conditions that would be surgical emergencies, like volvulus, intussusception, and bowel obstruction, and conditions such as pancreatitis, Lee says. Bloodwork and imaging may also be done to identify the cause. Depending on what’s causing constipation, ER treatments may include removing the stool from the rectum, enemas, laxatives, suppositories, or oral medications. Constipation can become a serious condition, and Landesman says you should never feel embarrassed about talking about your poop with your doctor. It’s the best way for a physician to understand your symptoms and recommend the best treatment.
How to prevent constipation
Constipation can sometimes be prevented by exercising regularly, avoiding a sedentary lifestyle, not sitting for too long, staying away from narcotics and pain medications, eating a high-fiber diet, staying hydrated, and avoiding taking excessive amounts of vitamins and supplements, Lee says. If you struggle with constipation, she recommends talking to your doctor about taking psyllium husk fiber or polyethylene glycol 3350 or adding bran or prune juice to your diet. Warm baths, gentle abdominal massage, yoga, stretching, sitting on the toilet after meals, and some types of physical therapy may also help with constipation, Landesman says. And, he adds that positioning the body properly while sitting on the toilet can create the best angle for stool to pass—for example, resting your feet on a footstool or thick book. Still, constipation sometimes persists, especially if it’s combined with other health issues and even with over-the-counter and prescription treatments, Landesman says, “In these instances, multiple hospital visits can occur, and surgery may be needed for the best long-term results.” Next, read about the foods that could make you poop.
Sources
Dr. Nathan Landesman, DO, osteopathic gastroenterologist Dr. Christine Lee, MD, a gastroenterologist at Cleveland ClinicCleveland Clinic:“Constipation” Cleveland Clinic: “Intussusception” MedlinePlus:“Polyethylene Glycol 3350”
