Constipation Specialists

Our gastroenterologists have undergone extensive training in the evaluation of digestive diseases and are constipation management experts. Our mission is to provide safe and effective therapies in a warm and welcoming environment.

What Is Constipation?

If you have difficulty moving your bowels, you may be suffering from constipation. Constipation occurs when a person’s bowel movements are infrequent, less than once every three days, or when passing stool requires straining. Constipation should always be evaluated by a physician with a thorough consultation and examination to establish an accurate diagnosis and constipation treatment plan and to rule out a serious illness or condition.

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What Is Chronic Constipation?

Chronic constipation is the presence of two or more of the following:

  • Straining during at least 25% of bowel movements;
  • Lumpy or hard stools in at least 25% of bowel movements;
  • The sensation of incomplete evacuations for at least 25% of bowel movements;
  • The feeling of anorectal blockage for at least 25% of bowel movements;
  • Manual maneuvers to facilitate at least 25% of bowel movements;
  • Fewer than three bowel movements each week.

What Causes Constipation?

There are many causes of constipation. The most common is simply poor eating habits. Many people don’t realize it, but they eat a low fiber diet, don’t take in enough fluids, and don’t exercise enough. Constipation can affect people of all ages, from newborns to the elderly. Although the problem is seen more in females than in males, the cause of constipation is multifactorial. The issue may arise in the rectum or colon or because of an external factor.

External causes include:

  • Lack of fluid consumption
  • Poor dietary habits
  • Overuse of certain medications
  • Emotional disorder

Changes in your routine, stress, and conditions that slow colon muscle contractions or delay the urge to urinate can all lead to constipation.

The most common causes of constipation are:

  • Dehydration
  • Low-fiber diet
  • Lack of physical activity
  • Changes to your daily routine
  • Pregnancy
  • Delaying the need to have a bowel movement
  • Caffeine abuse
  • Overuse of alcohol
  • Psychological issues
  • Neurological disorders

Several underlying medical conditions lead to constipation. These include stroke, Parkinson’s disease, diabetes, irritable bowel syndrome (IBS), and an underactive thyroid gland. Your constipation may also result from Irritable Bowel Syndrome (IBS).

IBS has recurrent abdominal pain plus two or more of: (diagnostic criteria can change over time)

  • Pain better from defecation
  • Altered stool at the onset of pain
  • Abdominal bloating
  • Increased or decreased stools at the onset of pain
  • A ‘never empty’ sensation after passing stool
  • Passing mucus from the rectum
  • Morning cluster of motions
  • Constipation alternating with diarrhea

Other symptoms reported by patients with IBS:

  • Fatigue (some IBS patients also have Chronic Fatigue Syndrome)
  • Nausea
  • Unexplained insomnia or disturbed sleep patterns
  • Susceptibility to colds, flu, sinusitis, or post-nasal drip
  • Headaches
  • Allergic sensitivity
  • Restless leg syndrome
  • Gastric reflux

What Are the Signs and Symptoms of Constipation?

The definition of a normal bowel movement can be different for every individual. Some people go three times a day, while others go three times a week.

You might need to consult a specialist if you experience any of the following signs of constipation:

  • Fewer than three bowel movements a week
  • Pain or straining during bowel movements
  • Dry stool
  • A feeling of fullness after a bowel movement

How Is the Condition Diagnosed?

Many people exposed to this health condition decide to self-treat by modifying their diets, using over-the-counter laxatives, or exercising more frequently. However, many people forget that using laxatives for more than two weeks without preliminary consultation with a physician is prohibited.

Constipation diagnosis starts with a preliminary consultation with your medical practitioner. The specialist will inquire about your symptoms, medical history, medications, and any underlying medical conditions. Your specialist may perform blood tests and a rectal exam as part of your physical evaluation to check your electrolytes, thyroid function, and blood count.

In more serious cases, you may need more tests to determine the cause of your symptoms. These tests include:

  • Marker study. We use this test to determine how food is moving through your colon.
  • Anorectal manometry. We use this test to examine the muscle function of your anal sphincter.
  • Barium enema X-ray. A test designed to examine the colon.
  • Colonoscopy. We use this test to evaluate the colon.

What Does Constipation Treatment Entail?

The easiest and fastest ways to manage constipation include:

  • Dietary changes
  • Medical supervision
  • Behavioral changes
  • Normal fiber and fluid consumption
  • Increased physical activity

Laxatives represent the first-line treatment for constipation. An adequate intake regimen usually results in symptomatic improvement. Patients with refractory to medical interventions require surgical treatment of the condition. The primary goal of surgery is to alleviate symptoms.

The anal procedure, colorectal resection, antegrade enemas, and intestinal diversion are among surgical options. Most pediatric patients are treated with medical therapy, and the majority of them improve. However, approximately 30% remain symptomatic until adulthood.

Factors linked to the worse prognosis include:

  • Age
  • Female gender
  • Longer colonic transit time
  • Longer time between the first signs of the condition and the start of the treatment

Constipation has a poor prognosis in adults. This disease can have a negative impact on one’s quality of life, and in many cases, treatments are ineffective. Even if they provide results, the benefits will be short-term. Once the condition is confirmed, it is essential to comply with the diet and medical therapy to reverse the disorder. Although, the reoccurrence of the condition is common among many people. It occurs chiefly because of the lack of compliance with the diet.

Chronic constipation can make many people disabled and impact the quality of their lives. Patients who fail to respond to medical treatment might need to undergo a total abdominal colectomy. Keep in mind that managing constipation can be difficult if you are addicted to laxatives and unwilling to change your lifestyle.

When To See a Doctor?

Causes Constipation
Causes Constipation

If there is a change in bowel habits or new development of constipation, it’s essential to seek medical advice from the team of GI doctors for a thorough evaluation. Depending on your specific condition, you will most likely need to be tested for the presence of blood in your stool and may require a colonoscopy to rule out colon cancer.

However, with dietary and lifestyle modifications (such as adequate fiber and fluid intake and physical activity), you can usually manage constipation symptoms successfully. Laxatives and prescription drugs are sometimes required, and some people with extremely severe constipation may require further medical investigations and treatments. Your gastroenterologist can develop an effective constipation treatment plan for you.

Frequently Asked Questions

What Are the Risk Factors for Constipation Disease?

Major constipation risk factors are eating a poor diet and not exercising. You can also be at greater risk if you are:

  • Confined to bed. People with certain medical conditions, like spinal cord injuries, often struggle with bowel movements.
  • Pregnant. Constipation can be caused by pressure on your intestines from your baby, as well as hormonal changes.
  • 65 or older. Older adults are less physically active, eat poorer diets, and have underlying health conditions that lead to constipation development.
  • A woman. Women experience constipation more frequently than men.

Are There Any Complications or Side Effects of Constipation?

Damage that can arise as a result of severe constipation includes:

  • Hemorrhoids
  • Anal fissures
  • Damage to the pelvic floor
  • Fecal incontinence
  • Urinary retention
  • Rectal prolapse
  • Volvulus
  • Abdominal discomfort or cramps

Other complications that may develop include depression and a decrease in quality of life. If you do not want to be exposed to the complications of this disorder, it is critical that you seek medical advice.

How To Prevent Constipation?

You can use the following techniques to help prevent constipation:

  • Drink 11/2 to 2 quarts of plain water every day to hydrate the body;
  • Minimize the consumption of alcohol and caffeine;
  • Include fiber-rich foods in your diet;
  • Limit the consumption of low-fiber foods such as milk, cheese, and processed foods;
  • Exercise for at least 30 minutes every day, five times per week;
  • Do not delay a bowel movement;
  • Consider adding fiber supplements and probiotics to your diet.

Before implementing any of the above recommendations, you should first consult with your healthcare provider.

Should You Take Laxatives for Chronic Constipation?

If you have chronic constipation that occurs on a daily basis or more than once a week, you should consult a doctor before self-treating with over-the-counter laxatives.

Important Reminder: The only intent of this information is to provide guidance, not definitive medical advice. Please consult a doctor about your specific condition. Only trained physicians can determine an accurate diagnosis and proper treatment.

Our leading gastroenterologists in NYC have more than enough competencies to provide highly comprehensive and personalized care. For more information about constipation treatment or to schedule a consultation with one of our NYC specialists, please contact our NYC gastroenterology office.

Updated on Oct 13, 2023 by Dr. Shawn Khodadadian (Gastroenterologist) of Manhattan Gastroenterology