Struggling with Constipation: When to Seek Medical Help?

Having bowel movements infrequently?

Since the second year of junior high school, there have been times when I felt the urge to have a bowel movement during class but held it in, often forgetting to go after class.
By the third year of junior high, I stopped having a bowel movement once a day, and now in the second year of senior high, I only go once every 1 to 2 weeks.
Is this a medical issue? How should I address this?

8883523, 10~19 year old female. Ask Date: 2010/01/01

Dr. Chen Qifeng reply Gastroenterology and Hepatology

You should eat plenty of vegetables and fruits, and limit your intake of fried and spicy foods.
Choose a time for bowel movements when you have the opportunity to relax and do not rush in the morning.
During bowel movements, massage your abdomen.
Ensure you are adequately hydrated and engage in sufficient physical activity.
If there is still no improvement, you may consult a gastroenterologist for further evaluation.
Best wishes, Dr.
Chi-Feng Chen, Taoyuan General Hospital, Department of Health.

Reply Date: 2010/01/01

More Info

Constipation is a common digestive issue that can significantly impact one's quality of life, particularly for adolescents like yourself. Based on your description, it seems that you've been experiencing constipation for quite some time, which has progressively worsened. It's important to understand that while occasional constipation can be normal, having bowel movements only once every one to two weeks is not typical and may indicate an underlying issue that requires attention.

When to Seek Medical Help
You should consider seeking medical help if you experience any of the following:
1. Severe Pain: If you have abdominal pain that is severe or persistent, it could indicate a more serious condition.

2. Blood in Stool: The presence of blood can be a sign of various gastrointestinal issues, including hemorrhoids or more serious conditions.

3. Unexplained Weight Loss: If you are losing weight without trying, it could be a sign of a more serious health issue.

4. Changes in Bowel Habits: If you notice a significant change in your bowel habits, such as a sudden increase in constipation or diarrhea, it’s important to consult a healthcare professional.

5. Fecal Impaction: If you are unable to pass stool at all, this could lead to fecal impaction, which is a medical emergency.

Potential Causes of Your Constipation
There are several potential causes of chronic constipation, including:
- Dietary Factors: A diet low in fiber can lead to constipation. Foods rich in fiber, such as fruits, vegetables, and whole grains, help promote regular bowel movements.

- Dehydration: Not drinking enough water can lead to hard stools that are difficult to pass.

- Physical Inactivity: Regular physical activity helps stimulate digestion. A sedentary lifestyle can contribute to constipation.

- Psychological Factors: Stress, anxiety, or even the habit of holding in bowel movements can lead to constipation.

- Medical Conditions: Certain medical conditions, such as hypothyroidism, diabetes, or irritable bowel syndrome (IBS), can cause constipation.

Steps to Manage and Treat Constipation
1. Increase Fiber Intake: Aim for a diet high in fiber. Incorporate fruits, vegetables, whole grains, and legumes into your meals. The recommended daily fiber intake is about 25-30 grams for adolescents.

2. Stay Hydrated: Drink plenty of water throughout the day. Adequate hydration is essential for softening stool and promoting regular bowel movements.

3. Regular Exercise: Engage in regular physical activity. Even simple activities like walking can help stimulate bowel function.

4. Establish a Routine: Try to set aside time each day for a bowel movement, ideally after meals when the digestive system is most active. This can help train your body to have regular bowel movements.

5. Avoid Holding It In: If you feel the urge to go, try not to delay. Holding in bowel movements can lead to constipation.

6. Consider Over-the-Counter Solutions: If dietary changes and lifestyle modifications do not help, you may consider over-the-counter laxatives or stool softeners. However, these should be used sparingly and not as a long-term solution.

7. Consult a Healthcare Professional: If your symptoms persist despite making these changes, or if you have any concerning symptoms, it’s crucial to consult a healthcare provider. They can perform a thorough evaluation, which may include physical exams, blood tests, or imaging studies, to determine the underlying cause of your constipation.

Conclusion
Chronic constipation is not something to ignore, especially given your history of infrequent bowel movements. By taking proactive steps to improve your diet, hydration, and physical activity, you may find relief. However, if these changes do not lead to improvement, seeking medical advice is essential to rule out any serious conditions and to receive appropriate treatment. Remember, your health is important, and addressing these issues early can lead to better outcomes.

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