Constipation, Age 12 and Older

Constipation occurs when stools are difficult to pass. Some people are overly concerned with the frequency of their bowel movements, because they have been taught that a healthy person has a bowel movement every day. This is not true. Most people pass stools anywhere from 3 times a day to 3 times a week. If your stools are soft and pass easily, you are not constipated.

Constipation is present if you have 2 or fewer bowel movements each week or you do not take laxatives and have 2 or more of the following problems at least 25% of the time:

• Straining
• Feeling that you do not completely empty your bowels
• Hard stools, or stools that look like pellets
• A feeling of being blocked up
• You can't pass stools unless you put a finger in your rectum or use manual pressure to pass a stool.

Constipation may occur with cramping and pain in the rectum caused by the strain of trying to pass hard, dry stools. You may have some bloating and nausea. You may also have small amounts of bright red blood on the stool or on the toilet tissue, caused by bleeding Reference hemorrhoids Opens New Window or a slight tearing of the anus (Reference anal fissure Opens New Window) as the stool is pushed through the Reference anus Opens New Window. This should stop when the constipation is controlled.

Constipation can mean the slow movement of stool through the intestines or problems releasing a stool.

Slow transit constipation

Lack of fiber is a common cause of constipation. Other causes include:

• Reference Irritable bowel syndrome Opens New Window.
• Travel or other change in daily routine.
• Lack of exercise.
• Immobility caused by illness or aging.
• Reference Medicine use.
• Overuse of Reference laxatives.
• Pregnancy.

Constipation is sometimes a sign of another health problem, such as Reference diabetes, Reference hypothyroidism Opens New Window, or Reference hypercalcemia Opens New Window.

Outlet delay constipation

Constipation is sometimes caused by poor muscle tone in the pelvic area (outlet delay). Excessive straining, needing manual pressure on the vaginal wall, or feelings of incomplete emptying may be a symptom of this type of constipation. Outlet delay constipation is caused by:

• Physical disorders that cause loss of function, such as Reference colon cancer Opens New Window, Reference uterine prolapse Opens New Window or Reference rectal prolapse Opens New Window, scarring (adhesions), or injury caused by physical or sexual abuse.
• Nervous system diseases, such as Reference Parkinson's disease Opens New Window, Reference multiple sclerosis Opens New Window, or Reference stroke Opens New Window.
• Spinal cord injury.
• Pain from hemorrhoids or anal fissures.
• Delaying bowel movements because of convenience issues or because having a bowel movement causes pain.

Constipation is more common in people older than 65. People in this age group are more likely to have poor dietary habits and increased medicine use. Older adults also often have decreased muscular activity of the intestinal tract, which increases the time it takes for stool to move through the intestines. Physical problems, such as Reference arthritis Opens New Window, may make sitting on the toilet uncomfortable or painful.

Women report problems with constipation more often than men.

If a stool becomes lodged in the rectum (impacted), mucus and fluid may leak out around the stool, sometimes leading to leakage of fecal material (fecal incontinence). You may experience this as constipation alternating with episodes of diarrhea.

Reference Check your symptoms to decide if and when you should see a doctor.

© 1995-2011, Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.