Constipation: what can it be a symptom of? + Causes and treatment

Constipation: what can it be a symptom of? + Causes and treatment
Photo source: Getty images

Constipation is an unpleasant condition that almost everyone encounters during their lifetime. With constipation, there is a decrease in the frequency of defecation. It is often accompanied by abdominal pain, discomfort and harder stools. What can constipation signal?

Constipation is technically called obstipation. In constipation, the stool is harder and the frequency of defecation is significantly lower. The etiology of constipation is quite diverse. From dietary errors, diet, stress, drug therapy to various, not only gastrointestinal diseases.

Causes of constipation, symptoms, diagnosis, treatment, diet and much more interesting information can be found in the article.


Constipation is a condition in which the frequency of defecation is less than 3 times per week. The stool has a harder consistency. Defecation itself can be uncomfortable.

Constipation is often accompanied by abdominal pain, a feeling of pressure, bloating, or discomfort and soreness when defecating alone.

Constipation is a disorder of intestinal peristalsis in which emptying is impaired.

Possible associated symptoms in constipation:

  • Heavy, hard and bulky stools
  • Painful uncomfortable defecation
  • Feeling of increased pressure and tension in the intestinal tract
  • Pain and discomfort in the abdominal cavity
  • Bloating, flatulence
  • Feeling of incomplete emptying of the rectum

According to the duration, they are divided into:

  • Acute constipation (short-term)
  • Chronic constipation (long-term)

Acute constipation (short-term)

Acute constipation is short-term. It lasts a few days and is most often the result of dietary errors and lack of fluids. It may be related to psychology, stress, a change in environment or new drug therapy.

Acute constipation can be a manifestation of an ongoing disease. Most often it is a disease of the gastrointestinal system.

One of the serious causes of sudden constipation can be intestinal obstruction - ileus. Severe pain and abdominal distention occurs. This condition requires acute professional intervention and the release of the intestinal passage obstruction.

Chronic constipation (long-term)

Long-term constipation is a health problem in most cases. If constipation persists, the cause of the constipation should be investigated by a doctor.

It does not have to be a serious health problem, but regular constipation can be a symptom of various diseases, not only gastrointestinal. Constipation can also be a side effect of medication.

When to seek professional help from a doctor?

  • If the constipation does not subside after a few days
  • If constipation returns regularly
  • If there is blood or mucus in the stool
  • If the stool has a strange colour
  • If constipation is accompanied by vomiting and nausea
  • If you have severe abdominal pain
  • If your abdomen is swollen and sensitive to touch
  • If you have fever, chills, shivering
  • If you suspect poisoning, infection and other illnesses

What can be a symptom of constipation?

The etiology of constipation varies. Factors affecting its occurrence can be divided into external and internal. Causes are also divided into functional and organic.

On the one hand, constipation can be caused by improper diet, stress, travel, minimal physical activity and similar external influences.

On the other hand, constipation can be a manifestation of a specific disease - digestive, neurological, psychological and other internal systems of the body.

Possible causes of constipation:

  • Inappropriate unhealthy lifestyle
  • A diet low in fibre
  • Sudden change of diet and change of raw materials
  • Excessive meat intake
  • Diet without leftovers
  • Insufficient fluid intake (dehydration of the body)
  • Lack of regular physical activity
  • Insufficient compensation for sedentary work
  • Change of environment, habits and travel
  • Psychogenic factor (stress, emotional strain)
  • Pregnancy and postpartum period

Diseases as possible causes of constipation:

  • Diseases of the intestinal tract (ulcerative colitis, diverticulosis, intestinal obstruction, celiac disease, Crohn's disease)
  • Diseases of the digestive system (pancreatitis, hemorrhoids)
  • Food allergies and intolerances (celiac disease, lactose intolerance)
  • Neurological diseases (Parkinson's disease, myopathy, nerve supply disorders)
  • Endocrine diseases (thyroid disease, hypothyroidism, amyloidosis, hyperparathyroidism)
  • Metabolic diseases (diabetes mellitus, hypokalaemia)
  • Mental illness (depression, anxiety, behavioural disorders, eating disorders)
  • Adverse side effect of pharmacological treatment (drugs and medicines)

Inappropriate lifestyle and eating habits

Constipation can be the result of a diet that is not varied enough for a long time, poor drinking patterns, inappropriate combinations, irregular or excessive consumption of food. Digestive processes are slowed down.

A common cause of abdominal bloating is the consumption of large amounts of carbohydrates and substances contained in legumes or other specific foods. Constipation is a frequent consequence of insufficient fibre intake.

Lack of regular physical activity combined with a sedentary lifestyle can cause slow digestion and defecation. The consequence is a reduced frequency of defecation. This is particularly true for individuals with sedentary jobs and insufficient compensatory physical activity.

Diseases of the digestive system

Constipation is the most common manifestation of a disorder of the digestive system.

Constipation often accompanies chronic inflammatory bowel diseases, such as ulcerative colitis or Crohn's disease. It can be a signal of food allergies and intolerances. The most common intolerances are gluten (gluten), lactose (milk sugar) and milk protein.

Constipation can occur with inflammation, infections and disorders of various organs of the digestive system.

However, in various diseases of the digestive tract, constipation may alternate with diarrhea. Vomiting, nausea, and abdominal tenderness may also be present. Intestinal viruses and influenza often occur.

One of the acute causes of constipation may be intestinal obstruction (ileus). In this case, severe colicky pain and abdominal distention occur. This condition requires acute medical intervention.

Other diseases

In the context of metabolic and endocrine diseases, constipation may be present with reduced thyroid function, reduced blood calcium and potassium levels, or diabetes.

Constipation is often present in some psychiatric disorders. It is common in eating disorders (bulimia, anorexia nervosa), depression or anxiety disorders.

Constipation can be a manifestation of neurological diseases such as Parkinson's disease, multiple sclerosis or disorders of nerve transmission and nerve supply.

Constipation is a relatively common side effect of some medications such as antidepressants, chemotherapy drugs, narcotics, some antibiotics, antacids or antiepileptics.

Constipation in children

Conscious regulation of defecation occurs at approximately 28 months of a child's life.

Irregular frequency of defecation during the first few weeks of a newborn's life is considered to be a physiological condition. Newborns and infants may experience an increased frequency of stool followed by constipation.

Constipation in an infant is most often manifested by dry, hard or gritty stools. The child is slow and difficult to empty. Constipation in young children is manifested primarily by crying or arching the child's back in an attempt to help emptying.

Switching from breast milk to regular cow's milk can lead to constipation, including hard stool consistency. Cow's milk protein intolerance is quite common.

Toddlers defecate approximately 2-5 times a day. During adolescence, the frequency of defecation gradually decreases to 1-2 times a day.

In the childhood period, a change in defecation can also occur with various febrile illnesses, dehydration, dietary errors, lack of fiber, food allergies and intolerances.

Constipation in a child should always be consulted with a pediatrician or pediatric gastroenterologist. The doctor will rule out intestinal abnormalities, food allergies, diseases of the digestive tract, as well as metabolic or endocrine disorders.

Constipation in women during pregnancy and after childbirth

Women have problems with obstipation more often than men. Constipation can affect women short-term before menstruation due to changes in hormones, but also long-term during pregnancy.

Constipation in pregnancy is caused by two main factors, namely hormonal changes and the growing fetus.

Due to higher levels of the hormone progesterone, the activity of the intestinal tract is slowed down. The growing uterus also puts pressure on the bowel and rectum. This again slows down bowel movement (motility).

Other factors may include a change in diet, restriction of physical activity, drug therapy or the use of various dietary supplements.

Constipation after childbirth can be caused by temporary disruption of the anal sphincter and disturbances of the pelvic floor muscles. Due to the action of strong pressure during childbirth, swelling of the rectum or hemorrhoids can occur.

Examination of the symptom of constipation

The initial diagnosis of obstipation consists of an assessment of clinical symptoms, taking a general history and a basic examination of the abdomen by palpation and listening.

In addition to other diagnoses, the doctor is particularly interested in the patient's lifestyle, eating habits and current drug therapy.

Further diagnostic procedure depends on the doctor's suspicion of a certain disease. The patient may be sent to another department.

Ultrasound examination of the abdominal organs, blood or stool sampling may be indicated. In addition, imaging endoscopic examinations of the digestive tract (gastroscopy, colonoscopy...) and others are used.

In the case of short-term constipation without suspicion of other diseases and chronicity, advanced diagnostics is not performed in most cases.

Help and treatment of constipation

The basis of the treatment of constipation is the diagnosis of the exact cause.

In most cases, minor, short-term constipation can be dealt with at home.

The treatment of chronic regular constipation always belongs in the hands of a doctor.

The treatment plan consists of determining and then eliminating the cause of the constipation. Depending on the etiology, the obstipation is treated by the respective doctor.

Conservative treatment of constipation involves a change in lifestyle.

Conservative treatment includes, in particular, a change in dietary habits in the form of an increased intake of dietary fibre, sufficient fluid intake and an increase in regular physical activity.

Whole-grain cereals, oatmeal, fresh fruit (apples, pears, plums, berries), vegetables, nuts and seeds (linseed) are suitable. Conversely, it is advisable to exclude products made from white flour, chocolate or black tea.

A supportive treatment is the use of prebiotics and probiotics. They support the balance of the bacterial gut microbiome, healthy digestion and intestinal peristalsis.

Pharmacotherapy for constipation offers prokinetics, which improve the patency of the digestive tract. Spasmolytics are indicated especially in the spastic form of constipation and relieve increased tension in the digestive tract.

In the short term, laxatives with different mechanisms of action (osmotic, irritant...) may be indicated. They must always be used under the professional supervision of a physician.

Currently, over-the-counter dietary supplements and drugs are available to support digestion and peristalsis of the intestinal tract.

Preventive advice against constipation:

  • Regular balanced diet
  • Intake of all 3 macronutrients (protein, carbohydrate and fat)
  • A diet rich in fibre
  • Adequate daily fluid intake (plain water, mineral water, tea...)
  • Adequate intake of fruit and vegetables
  • Adequate intake of natural sources of probiotics in the diet
  • Regular physical activity during the day
  • Compensation for sedentary work
  • Not controlling the urge for great need
  • Compliance with food allergies and intolerances
  • Taking probiotics and probiotics to aid digestion
A natural source of probiotics and prebiotics in the diet to support a healthy intestinal bacterial balance.
A natural source of probiotics and prebiotics in the diet to support a healthy gut bacterial balance. Source: Getty Images
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Interesting resources

  • - Solving obstipation in the GP's office for adults. Solen. MUDr. Ahmadullah Fathi, Mgr. Zuzana Gavalierová
  • - What is obstipation? Healthline: What is obstipation? Rachel Nall, MSN, CRNA
  • - Obstipation in children - Part 1. Solen. Jana Kosnáčová, MD, prof. MUDr. Ľudmila Podracká, CSc.
  • - What to know about constipation. Medical News Today. Stacy Sampson, D.O.
  • ZAVORAL, Miroslav, ed. Mařatkova gastroenterologie: pathophysiology, diagnostics, treatment. Prague: Institute for Public Health Care: Charles University, Karolinum Publishing House, 2021. ISBN 978-80-246-5002-9.
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