Most people would have experienced constipation at least once or more in their lives. Being unable to pass stools for more than a few days, or needing to strain to pass stools is a common issue that is usually easily resolved with home remedies or an over-the-counter laxative.
Most cases of constipation have causes that can be easily addressed. For example, lack of fibre, lack of fluids, lack of exercise, or ignoring the urge to go to the bathroom can all lead to constipation. However, chronic constipation or constipation that is accompanied by other worrying symptoms can also be a sign of more troubling problems, such as physical conditions in the gastrointestinal tract.
Thus, the question is, how does one tell apart the innocuous bout of constipation from constipation as an indicator of something more serious? Here are some clues you should look out for:
1. Persistent or intense abdominal pain
Constipation symptoms often include some abdominal pain. This pain is usually due to a build-up of gas or the need to pass stools. However, if the pain is debilitating or persistent, it could signal other issues with the gastrointestinal tract. If this occurs with the inability to pass gas or stools, you should seek medical help immediately.
Some possible causes of persistent, intense abdominal pain accompanied by constipation are:
- intestinal obstruction
- perforated intestine or stomach
- mesenteric ischemia (blockage of blood flow to the intestine)
2. Blood in your stool
Finding bright red blood in your stools seems like a worrying sign, but it is not always the case. Small bright red stains are often due to a scratch in the rectal area from straining or wiping too hard, or sometimes due to haemorrhoids (piles). These symptoms and conditions are relatively minor and you can find relief with home and over-the-counter remedies.
However, having large amounts of bright red stains or spots, or dark red or black stools may indicate problems in your intestinal tract itself. For these cases, it is best to consult a doctor to examine the source of bleeding.
Some possible causes for blood in stools are:
- ulcerative colitis
- Crohn’s disease
- colorectal cancer
If constipation and vomiting come together, you should suspect a case of faecal impaction or other forms of bowel obstruction. Faecal impaction is when a large, dry mass of stool becomes stuck in the colon or rectum. The blockage causes a build-up of waste, and is highly dangerous and potentially life-threatening. Learning to recognise the signs of faecal impaction can allow the sufferer to get prompt help and save them from this medical emergency.
When constipation is accompanied by bloated stomach symptoms, it can be a sign of bowel obstruction. Bowel obstruction can also present itself with vomiting. Most cases of bowel obstruction require immediate attention, as it can become dangerous and life-threatening if left untreated. Obstructions in the small or large intestine can be caused by a variety of factors, including:
- Scar tissue from previous surgery
- Inflammation (e.g. due to Crohn’s disease, inflammatory bowel disease, etc.)
What to expect when seeing a doctor for constipation
If you experience any of the above symptoms, you know it’s time to visit your doctor or a gastroenterology specialist. The doctor will typically ask you a series of questions about your bowel movements, diet, lifestyle, and family history of digestive issues. Don’t feel embarrassed about answering them, but try your best to be as accurate as possible, as this will help your doctor pinpoint the cause of your constipation.
The doctor may conduct a physical examination by inserting a gloved, lubricated finger into your anus to check for blockage or bleeding. If further diagnostic tests are required, the doctor may advise you to undergo procedures like a colonoscopy, CT scan, or barium enema X-ray.