Managing Side Effects of Constipation

By

Chris Iliades, MD

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Almost everyone experiences constipation at one time or another. Constipation is often defined as not having a bowel movement at least three times a week. For most people, constipation is a temporary problem caused by not having enough fiber in the diet, not drinking enough water, not getting enough exercise, or having a change in routine that causes missed bowel movements. Pregnancy and medication side effects are other frequent causes.

Symptoms of constipation include straining to have a bowel movement, feeling like you have to go but can't, and bloating. In most cases constipation is not serious, but it can lead to problems if not managed promptly. Frequent or long-lasting constipation can lead to side effects like painful bowel movements, hemorrhoids, anal fissures, rectal prolapse, and fecal impaction. Fortunately, there are steps you can take to get more "regular" and soothe symptoms.

Painful Bowel Movements

When you go too long without a bowel movement, too much water gets reabsorbed from the stool in your colon and your stool becomes hard and dry. That makes pushing out the stool painful. You may feel bloated, full, and uncomfortable. Here's what you can do to manage mild or frequent constipation:

  • Drink more fluids and add fiber to your diet through fruits, vegetables, beans, and whole grains. Avoid or cut back on low-fiber foods like ice cream, meat, and cheese.

  • Try to set aside a time to have a bowel movement every day.

  • Get regular exercise.

  • Ask your doctor whether you need a laxative or an enema if diet and lifestyle changes don't help.

Hemorrhoids

Hemorrhoids, which are painful, itchy, and swollen veins in the rectal area, are a frequent cause of rectal bleeding, commonly caused by straining to have a bowel movement. If you have hemorrhoids from constipation, you may see bright red blood in the toilet or on the toilet paper after wiping. Managing your constipation is the best way to get rid of hemorrhoids. Here are some other steps to try:

  • Use an over-the-counter cream, spray, or anal pad to reduce pain, swelling and itching.

  • Use an over-the-counter stool softener to reduce straining and irritation.

  • Take a sitz bath by sitting in a shallow tub of warm water for 10 to 15 minutes to soothe irritated tissues.

Be sure to call your doctor about any persistent rectal bleeding.

Anal Fissures

Anal fissures are small cracks or tears in the outer lining of the anal canal. Constipation is a frequent cause, and the symptoms are similar to those of hemorrhoids. Most anal fissures will heal on their own with the same approaches you would take for constipation or hemorrhoids. You can also try cleaning your rectal area gently with warm water and a soft washcloth or a wipe and lubricating your anal canal with petroleum jelly. Call your doctor if home care isn't helping.

Rectal Prolapse

Rectal prolapse is a more serious side effect of constipation. It's a condition in which part of the lining of the rectal canal becomes loose and sticks out through the anal opening. This condition is more common in children and the elderly. The most frequent symptom is a red bulge that protrudes through the rectum and causes bleeding after a bowel movement. If you think you have a rectal prolapse, you need to call your doctor right away.

Fecal Impaction

Having constipation for a long time can result in fecal impaction. This means that your stool has become so hard and dry that it can't come out with a bowel movement. This happens most to people who take laxatives too frequently, are confined to bed rest, or take medications that slow down bowel movements. Symptoms may include abdominal pain, rectal bleeding, and leaking of watery diarrhea. If you think you have a fecal impaction, you need to call your doctor right away.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 19, 2017

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Medical References

  1. Constipation. National Digestive Diseases Information Clearinghouse, NIH http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/
  2. Fecal impaction. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001277/
  3. Hemorrhoids. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001337/
  4. Anal fissure. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002116/?report=printable
  5. Rectal prolapse. PubMed Health. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002118/

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