Severe Constipation in Teens: Causes, Symptoms, and Solutions

Severe constipation

I am a high school student and I haven't had a bowel movement for several months.
Every time I try to poop, the stool gets stuck at the anal opening and it is very thick and hard.
It takes a long time, usually over an hour! I feel like the stool is right at the anal opening, but I can't pass it.
I can only manage to pass a little bit at a time (it's not small pieces, but rather a thick and hard log) and it often breaks in half, with one half getting stuck at the anal opening.
I have to exert a lot of effort to push out that hard stool, and sometimes I can't get it out at all and have to give up.
Once, I even passed a stool that was about 5 centimeters in diameter.
Before each bowel movement, I check the anal area (it often protrudes) and I can feel the hard stool stuck there.
The stool in front hasn't come out, and the stool behind keeps pushing, causing a lot of abdominal pain.
What should I do? My stomach hurts a lot.

Xiao Yang, 10~19 year old female. Ask Date: 2015/06/14

Dr. Chen Bozhang reply Family Medicine

Dear Xiao Yang,
I understand that you have been experiencing difficulties with bowel movements for quite some time.
Given your symptoms of constipation and fecal impaction, I recommend that you visit a gastroenterologist or a family medicine clinic for further evaluation and management.

In the long term, symptoms of bowel discomfort can be improved with adequate hydration and a high-fiber diet.
Additionally, it is advisable to take sufficient time to relax and walk for about 20 to 30 minutes after each meal, as this can help stimulate bowel reflexes.
I hope these suggestions are helpful to you.

Reply Date: 2015/06/14

More Info

Severe constipation in teenagers can be a distressing and uncomfortable condition that can significantly affect daily life. Based on your description, it sounds like you are experiencing a severe form of constipation, characterized by hard, large stools that are difficult to pass, prolonged straining, and abdominal pain. Here’s a comprehensive overview of the potential causes, symptoms, and solutions for severe constipation in teens.

Causes of Severe Constipation
1. Dietary Factors: A diet low in fiber can lead to constipation. Fiber is essential for adding bulk to the stool and facilitating its passage through the intestines. If your diet consists mainly of processed foods, dairy products, and low-fiber options, this could be a significant factor.

2. Dehydration: Insufficient fluid intake can lead to hard stools, making them difficult to pass. Water is crucial for softening the stool and promoting regular bowel movements.

3. Physical Inactivity: A sedentary lifestyle can contribute to constipation. Regular physical activity helps stimulate intestinal function and promotes bowel regularity.

4. Psychological Factors: Stress, anxiety, or changes in routine (such as starting high school) can affect bowel habits. Some individuals may also develop a fear of bowel movements due to previous painful experiences, leading to avoidance and further constipation.

5. Medical Conditions: Certain medical conditions, such as hypothyroidism, diabetes, or gastrointestinal disorders (like irritable bowel syndrome), can contribute to constipation. Medications, particularly those that are pain-relievers or antacids containing aluminum, can also cause constipation.

Symptoms of Severe Constipation
- Infrequent bowel movements (fewer than three times a week)
- Hard, dry stools that are difficult to pass
- Straining during bowel movements
- Abdominal pain or discomfort
- A sensation of incomplete evacuation after a bowel movement
- Bloating or discomfort in the abdomen

Solutions for Severe Constipation
1. Increase Fiber Intake: Aim for a diet rich in fruits, vegetables, whole grains, and legumes. Foods high in fiber can help soften the stool and promote regular bowel movements. Gradually increase fiber intake to avoid gas and bloating.

2. Stay Hydrated: Drink plenty of water throughout the day. Aim for at least 8-10 cups of fluids daily. Hydration is key to preventing hard stools.

3. Regular Exercise: Engage in regular physical activity, such as walking, jogging, or sports. Exercise helps stimulate the digestive system and can improve bowel function.

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

5. Over-the-Counter Remedies: If dietary changes are not effective, over-the-counter laxatives may provide relief. Options include fiber supplements, stool softeners, or osmotic laxatives. However, it’s essential to consult with a healthcare provider before starting any medication.

6. Consult a Healthcare Provider: Given the severity of your symptoms, it’s crucial to speak with a healthcare professional. They can evaluate your condition, rule out any underlying medical issues, and provide tailored treatment options. If necessary, they may refer you to a gastroenterologist for further evaluation.

7. Address Psychological Factors: If stress or anxiety is contributing to your constipation, consider talking to a counselor or therapist. They can help you develop coping strategies and address any fears related to bowel movements.

Conclusion
Severe constipation can be uncomfortable and may require a multifaceted approach to treatment. By making dietary changes, staying hydrated, exercising regularly, and seeking professional help, you can improve your bowel health and alleviate your symptoms. Remember, it’s essential to consult with a healthcare provider to ensure that you receive appropriate care tailored to your specific needs. Don’t hesitate to reach out for help; managing constipation is important for your overall health and well-being.

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