Constipation occurs when stool becomes very difficult to pass from the rectum and out the anus. Stool that remains in the rectum for too long may stretch and weaken the sphincter muscle, allowing watery stools to leak around the lodged stool and then out of the anus – accidental bowel leakage (ABL). Constipation may also cause you to strain. Straining while trying to pass stool may weaken your sphincter muscles, which can also increase your risk of bowel incontinence or ABL.
When lodged stool cannot be passed after a day or two with a mild laxative, this is called fecal impaction. Impacted feces may need an enema and/or a nurse or physician to manually remove the impaction (especially true for those who are bedridden). It is important that you seek immediate medical help if you have an impaction.
If you are suffering from chronic constipation, be sure to discuss this with your physician as there may be a serious underlying medical condition causing your constipation, which needs treating in addition to the constipation.
Chronic constipation can sometimes be helped with dietary changes; through an increase of foods high in dietary fiber and drinking more liquids each day. Eating multiple daily servings of whole grain foods, fresh fruits, yogurt (probiotics) and fresh vegetables helps the gastrointestinal tract stay healthy, so that formed stool is pushed through consistently and easily. Increasing your consumption of fluids helps stool stay soft so that it is more easily passed.
With your doctor’s approval, you may also wish to add over-the-counter products that increase your fiber intake, such as Citracel, or increase the fluid in your digestive tract, such as MiraLAX. Please ask your doctor which products are most appropriate for you.
Exercise is also known to help prevent constipation, but always discuss beginning a new exercise regimen with your physician before beginning any program.
Bowel retraining can also be helpful for some patients with chronic constipation.
Note: In January 2014, the US FDA issued a warning to consumers that some of the over-the-counter (OTC) laxatives they may turn to for relief are potentially dangerous if dosing instructions or warnings on the Drug Facts label are not properly followed or when there are certain coexisting health conditions. For more information on this warning and the OCT products involved, please click here.
Medical Reviewer: Francie Bernier, PhD, RNC
Dr. Bernier completed her PhD at the University of Virginia, School of Nursing in 2008. She is certified in Ambulatory Women’s Health Care by the National Certification Corporation of the Association of Women’s Health, and Neonatal Nursing (AWHONN). Her dissertation research focused on the exploring interventions to assist women to quickly and correctly identify, isolate, contract, and relax their pelvic floor musculature in order to correctly perform Kegel exercises. Over the last 25 years, the focus of Dr. Bernier’s nursing research and clinical practice has been to educate the public as well the nursing and medical professions about the options and outcomes of non-surgical options of care to treat urinary incontinence, the outcomes of non-surgical treatment of urinary incontinence and to assist women to access treatment for their incontinence symptoms and complaints. These quality of life complaints are under-diagnosed, easily treated, and often ignored. Since 2009, Dr. Bernier is an assistant professor at Shenandoah University, Division of Nursing teaching in the Bachelor and Doctoral level programs. Currently her curriculum includes Nursing Research, Multivariate Statistics, and Community Nursing. She is a guest lecturer for urologic system and urogynecologic systems. She serves as the liaison to the American Urologic Association for the Society of Urologic Nursing and Associates (SUNA), is the legislative representative for SUNA, and is the current president of SUNA’s chapter 102 for the Washington DC area. Dr. Bernier has authored and published many research articles reflective of the treatment of incontinence and associated non-surgical interventions. Additionally Dr. Bernier has authored many chapters in Medical–Surgical Textbooks for nursing students focused on the conditions of the urologic system and female reproductive system.