When You Should See a Doctor for Constipation

Constipation is when a person strains to defecate, has small hard stools, and or cannot totally empty their bowels. It is often uncomfortable.

Constipation warrants seeing a doctor if it occurs for three weeks or more. Usually, lifestyle changes — drinking more water, exercising, and increasing fiber intake — can alleviate the symptoms in a timely fashion. (Learn More — Constipation Overview)

In addition to the three-week cutoff, you should see a doctor right away if you experience severe symptoms, see blood in your stool, are having stomach pains, or your body is changing in unexplained ways. This could be a sign that something more serious is wrong. (Learn More — When to See a Doctor)

There are many treatments a doctor might potentially prescribe, depending on your particular symptoms. First, they will try and determine if you are suffering from fecal impaction, where a hard stool is essentially blocking part of your intestines. If you are, the fecal impaction usually needs to be washed out or broken up.

If this is not the issue, your doctor will likely prescribe a medication that suits your needs. They may even just prescribe lifestyle changes if you have not yet tried them. (Learn More — Possible Treatments for Constipation)

Constipation Overview

Constipation is when a person often feels as though their bowels are not totally empty, must strain to defecate, and/or passes small hard stools. It can be an uncomfortable condition that many find embarrassing to discuss with their doctor. But if you are constipated for three weeks or more, it usually means the issue warrants a consult with a medical professional.

Constipation is often thought of as a decrease in the frequency of stools, but the American College of Gastroenterology emphasizes that this is not exactly true. Some people have bowel movements as few as three times a week but are still healthy. A big component of constipation is discomfort and strain when you do feel an urge to defecate.

Some ways to treat mild to moderate constipation include:

• Drink plenty of liquids.
• Eat a diet high in fiber.
• Get enough exercise.
• Take time to have a bowel movement when you get the urge rather than holding it or trying to force it out quickly.

When to See a Doctor

If you have been constipated for more than three weeks, been unable to effectively control your symptoms with the above recommendations, or experience what are particularly uncomfortable or otherwise severe symptoms, you should see a doctor.

While there is debate about whether people should have access to OTC laxatives (which carry their own risks), talk to a doctor if you considering laxatives or other measures, such as enemas.

You should see a doctor right away if you experience:

• Blood in your stool.
• Unexplained weight loss.
• Stomach pain.
• Hemorrhoids.
• Rectal prolapse (when part of the intestines pushes out through the anus).

In medicine, there is a genuine problem as a result of many cultures having a stigma surrounding “bathroom” functions. People tend to find talking about their bowel movements embarrassing, and they sometimes hide important facts and symptoms as a result.

Your doctor is not going to judge you for being constipated, and it is important to give them as much information as you can. There is no need to be embarrassed. It is a medical professional’s job to listen to you with respect, maintain a proper level of patient confidentiality, and do their best to help you live a healthier life.

Possible Treatments for Constipation

First, your doctor is likely to suggest the lifestyle changes previously mentioned if you have not already embraced them. They carry little, if any, risks or downsides, and they will help most people gain control of their symptoms.

A doctor will first attempt to determine if your stool is impacted. Fecal impaction is when a lump of hard, dry stool is stuck in the rectum, causing constipation. It is most common among those who have suffered from constipation for a long time.

Generally, this is treated in one of two ways.

• Enemas: By using tap water or mineral oil, an enema is inserted into the patient’s rectum as they lay on their side with their knees bent. The liquid can help soften and lubricate the stool, alleviating the problem.
  
  This is usually the first course treatment for fecal impaction. For large, hardened impaction, it may be necessary to perform a manual removal.
• Manual removal: Done in small steps to avoid injuring the rectum, a doctor will insert one or two fingers into the rectum and manually break up the stool. Suppositories are sometimes given in between steps, helping to clear out stool.

While treatment can be uncomfortable for fecal impaction, the prognosis for recovery is generally good with treatment. Patients usually need bowel training after treatment. This involves talking with a nurse or other medical professional about your diet and lifestyle to help you regain control of your bowel movements and maintaining a healthy routine.

If your stool isn’t impacted, and lifestyle changes alone are proving ineffective, recommended treatments can include:

• • Fiber supplements (FiberCon, Benefiber). Fiber supplements add bulk to your stool, which can jumpstart healthy bowel movements. They can sometimes cause stomach pain and bloating.
    
    Fiber supplements are available over the counter. They are generally safe to use, as long as you do not take more than recommended.

• Osmotics (Miralax). Osmotics helps to soften stool by drawing water into your large intestine. They can cause cramping, nausea, diarrhea and potentially more serious problems in older people with certain health conditions. These sorts of risks are why it can be a good idea to talk with a doctor before using osmotics, even though they are available over the counter.

• Stimulants (Correctol, Ducodyl, Senexon). Stimulants stimulate the muscles in your bowels. They generally should only be used for severe constipation, when other drugs prove ineffective.
  
  While available over the counter, many advise speaking to a doctor about stimulants before taking them as they can be overused and cause damage.
• Prescription osmotics (Cephulac, Kristalose). These drugs are similar to osmotics, but they have a more powerful effect and greater risk of symptoms like diarrhea, cramps, gas, and stomach pain.
• Linaclotide (Linzess). Used to treat irritable bowel syndrome (IBS) and chronic idiopathic constipation (CIC), this medication draws water into the intestines but has a different mechanism than osmotics, which makes it good for treating certain conditions.
  
  It is generally used if other treatments aren’t working. It can cause diarrhea. This drug is available by prescription only.
• Polyethylene glycol (PEG) (GoLYTELY, NuLYTELY). This drug comes in a powder form and is added to water, which you then drink. It helps draw a great deal of water into your intestines, but it can commonly cause bloating, cramping, nausea, and even vomiting.
  
  Contact your doctor right away if you experience shortness of breath, severe stomach pain, a significantly elevated heart rate, or if your vomit contains material that looks like coffee grinds or blood. This drug is available by prescription only.
• Prucalopride (Motegrity). Specifically meant to treat chronic idiopathic constipation (CIC), this drug stimulates the colon to help with bowel movements. While it can assist users, it has a host of side effects that need to be understood before you take it.
  
  Contact your doctor right away if you experience any kind of mood change, especially if there is an unexplained and quite extreme change to your mood (even if it doesn’t immediately feel like a negative change).

References

Constipation. (May 2019). MedlinePlus.

Constipation and Defecation Problems. (March 2016). American College of Gastroenterology.

When to Get Help for Constipation. (May 2018). WebMD.

Concerned About Constipation? (December 2018). National Institute on Aging.

Over-the-Counter Laxatives for Constipation: Use With Caution. (June 2017). Mayo Foundation for Medical Education and Research (MFMER).

Medicines to Treat Constipation. (May 2019). WebMD.

Fecal Impaction. (July 2019). MedlinePlus.