Constipation: Causes, Symptoms, and When to Seek Help

Unable to achieve a bowel movement?

Hello, I previously experienced occasional constipation, but recently it has been relatively smooth.
I have seen a doctor before for issues related to anal fissures and also have some hemorrhoids.
After the doctor prescribed hemorrhoid ointment, there weren't any significant problems.
However, in the past few weeks, I had a day when I experienced abdominal pain and rushed to the bathroom, but I couldn't pass anything.
It felt like my anus was blocked.
Subsequently, I was unable to have a bowel movement for 4-5 consecutive days, so I went to see a traditional Chinese medicine practitioner for treatment.
After taking the herbal medicine, I was able to pass a small amount, but the stool was round and hard like stones.
In the following days, I only passed a little bit, which was covered in mucus and dark brown in color.
After that, I started taking probiotics, but there hasn't been much improvement.
I still feel the urge to go to the bathroom, but I can only pass a small amount each time, leaving me with a feeling of incomplete evacuation.
Additionally, I have been experiencing a sensation of urgency to urinate at night, even after just using the bathroom.
My abdomen has felt bloated for the past few days.
Could you please advise what this issue might be? I am very concerned it could be colon cancer.
PS: I have anxiety disorder and have been taking "Yongkangxu"; I wonder if this is related.

Miss Hsu, 20~29 year old female. Ask Date: 2023/06/01

Dr. Hu Guozheng reply Gastroenterology and Hepatology

It is recommended to visit the colorectal surgery outpatient clinic for evaluation.
Thank you.

Reply Date: 2023/06/01

More Info

Constipation is a common gastrointestinal issue that can significantly affect one's quality of life. It is characterized by infrequent bowel movements, difficulty passing stool, or a feeling of incomplete evacuation. Understanding the causes, symptoms, and when to seek medical help is crucial for managing this condition effectively.

Causes of Constipation
1. Dietary Factors: A diet low in fiber, which is found in fruits, vegetables, and whole grains, can lead to constipation. Insufficient fluid intake can also contribute to hard, dry stools.

2. Lifestyle Factors: Sedentary lifestyles, lack of physical activity, and irregular bowel habits can exacerbate constipation. Stress and anxiety can also play a significant role, as they may affect gut motility.

3. Medical Conditions: Certain medical conditions, such as hypothyroidism, diabetes, and neurological disorders, can lead to constipation. Additionally, conditions like irritable bowel syndrome (IBS) can cause alternating patterns of constipation and diarrhea.

4. Medications: Some medications, including opioids, antacids containing aluminum, and certain antidepressants, can cause constipation as a side effect.

5. Psychological Factors: Anxiety and depression can lead to changes in bowel habits. Your mention of having anxiety disorder and taking medication for it could potentially be linked to your current symptoms.

Symptoms of Constipation
Common symptoms include:
- Infrequent bowel movements (fewer than three times a week)
- Hard or lumpy stools
- Straining during bowel movements
- A feeling of blockage or obstruction in the rectum
- Abdominal discomfort or bloating
- A sensation of incomplete evacuation after a bowel movement

When to Seek Help
It is essential to consult a healthcare professional if you experience:
- Severe abdominal pain or cramping
- Blood in your stool or rectal bleeding
- Unexplained weight loss
- Persistent constipation lasting more than three weeks
- Changes in bowel habits that are not typical for you
Given your symptoms, such as the feeling of blockage, the presence of hard stools, and the anxiety you are experiencing, it is advisable to seek medical attention. While it is understandable to worry about serious conditions like colorectal cancer, it is essential to remember that many cases of constipation are due to benign causes.

Recommendations
1. Dietary Changes: Increase your fiber intake gradually by incorporating more fruits, vegetables, and whole grains into your diet. Aim for at least 25-30 grams of fiber per day. Additionally, ensure you are drinking plenty of water to help soften stools.

2. Physical Activity: Regular exercise can help stimulate bowel movements. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Routine: Establish a regular bowel routine by setting aside time each day to try to have a bowel movement, especially after meals when the urge is often stronger.

4. Medications: If dietary changes and lifestyle modifications do not help, over-the-counter laxatives may be considered. However, it is essential to consult with a healthcare provider before starting any new medication, especially since you are already taking medication for anxiety.

5. Mental Health: Since you have a history of anxiety, consider discussing your mental health with a professional. Anxiety can significantly impact gastrointestinal function, and addressing it may improve your symptoms.

In conclusion, while your symptoms may be concerning, they are often manageable with lifestyle changes and medical guidance. It is crucial to consult a healthcare professional to rule out any serious conditions and to receive personalized treatment options. Remember, taking proactive steps towards your health is essential, and seeking help is a sign of strength.

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