How to Know If Your Constipation Requires a Medical Evaluation

Constipation is a common condition that can cause significant gassy discomfort, bloating, and inconvenience, but it’s not typically a serious health concern. However, frequent or long-term constipation sometimes indicates your digestive system is struggling to function normally.

Board-certified gastroenterologist Dr. Prem Chattoo at Hudson River Gastroenterology in New York City answers questions about the causes, potential health complications, and treatments available for chronic constipation. 

Causes of constipation

The many possible causes of constipation, include:

• Low-fiber diet
• Dehydration
• Lack of physical activity
• Changes in routine, such as travel or alteration in your daily schedule
• Medical conditions, including irritable bowel syndrome, hypothyroidism, and diabetes
• Ignoring the urge to have a bowel movement, which causes stool to harden
• Multiple sclerosis, Parkinson’s disease, and other neurological disorders
• Weakened pelvic muscles
• Complications of a stroke
• Colon cancer
• Bowel obstruction or intestinal stricture (narrowing)
• Hormonal imbalances
• Pregnancy

Opioids, antidepressants, and various blood pressure medications can also cause constipation as a side effect.

When it’s time to see a doctor for constipation

Constipation can cause significant distress, whether occurring routinely or once or twice a month. Dr. Chattoo encourages you to schedule a visit whenever you’re concerned about your digestive health.

However, he encourages anyone experiencing chronic constipation to come in for an evaluation since it can lead to or indicate more serious health concerns, including:

• Hemorrhoids
• Fecal (stool) impaction
• Bowel obstruction or stricture
• Underlying health conditions that require further treatment
• Anal fissure or tear
• Rectal prolapse (protruding large intestine)

It’s also possible that chronic constipation may increase your risk of developing colon or rectal cancer.

Symptoms of chronic constipation

Symptoms of chronic constipation can vary but frequently include:

• Having fewer than three bowel movements weekly
• Needing to strain to have a bowel movement
• Passing lumpy or hard stools
• Feeling as though something in your rectum is blocking bowel movements
• Feeling as if you can't completely empty stool from your rectum
• Abdominal bloating and discomfort

Note that the frequency of bowel movements can vary from three times a day to three times a week. So if you usually have a bowel movement every day, you may have constipation if you start having only three or four bowel movements a week.

Treatment for chronic constipation

Dr. Chattoo treats chronic constipation based on its underlying cause and the results of your initial evaluation.

Strategies may include:

• Increased fiber intake
• Improved hydration
• Routine exercise
• Stool softeners or laxatives
• Prescription medications
• Biofeedback therapy to help strengthen pelvic floor muscles

Dr. Chattoo may also consider referring you to another specialist to diagnose or maximize treatment for diabetes, Parkinson’s, and other conditions that can cause chronic constipation. 

You may require a surgical referral if he suspects a bowel obstruction or other structural irregularity.

Schedule an evaluation with Dr. Chattoo at Hudson River Gastroenterology today. Call the office or request an appointment online.