Occasional constipation: definition
Occasional constipation negatively impacts on your quality of life: it is characterized by uncomfortable or irregular bowel movements. It refers to bowel movements that occur less than three times each week. The stool is often dry and/or small, making it difficult or even painful to pass1. Other symptoms can be pain, discomfort or bloating in the abdomen, and feeling sluggish2.
The symptoms of constipation may resemble other medical conditions or problems or may be a symptom of another medical problem2. If you experience constipation symptoms for more than a week or notice a sudden change in your bowel habits, we would advise you to consult your doctor.
How your digestive system works
Your digestive system is a complex group of organs that work in harmony to transform food into energy and nutrients because your body needs nutrients from food and drink to work properly and stay healthy. Proteins, fats, carbohydrates, vitamins, minerals, and water are nutrients. Your digestive system breaks nutrients into parts small enough for your body to absorb and use for energy, growth, and cell repair. Your large intestine absorbs water, and the waste products of digestion become stool. Nerves and hormones help control the digestive process3.
Digestion begins in the mouth. Once food is chewed and mixed with saliva, it moves down into the esophagus and then to the stomach. After food enters your stomach, the stomach muscles mix the food and liquid with digestive juices. The stomach slowly empties its contents, called chyme, into your small intestine.
The food bolus then passes through the small intestine, where it is broken down into simple molecules. The walls of the small intestine absorb water and the digested nutrients into the bloodstream. Non-absorbed waste products of the digestive process move into the large intestine.
The last stage of digestion takes place in the large intestine (also called the colon). The large intestine further absorbs water and electrolytes, changing the waste from liquid into stool. Then the compacted residue is transported to the rectum where it is stored until sufficient volume triggers the receptors for evacuation.
Constipation can occur when the waste in the rectum is too dry to trigger the ejection reflex or contractions of the colon are too weak to drive the stool out of your body. This, in turn, can make the stool harder because it stays in the rectum. This can also cause pain, flatulence and bloating.
Frequently asked questions
When you start talking about constipation, the same questions often pop up.
Primary constipation is characterized by difficult, infrequent, and/or incomplete defecation without any known cause or identified underlying illness. This is by far the most common condition when it comes to constipation. It means that even after a thorough medical examination including diagnostic tests, no organic causes can be detected which can be held responsible for causing the constipation symptoms and underlying physical abnormalities as the cause of their symptoms.
This type of constipation is associated with factors, impacting your body’s poop routine. Examples of possible organic causes include bowel blockage or narrowed areas. Numerous common medical conditions may affect the muscles or nerves used for normal bowel movements and can be the cause of constipation, including4:
- Drug effects
- Mechanical obstruction (e.g. due to colon cancer, external compression from malignant lesion
- Narrowing of the large intestine
- Postsurgical abnormalities
- Abnormal dilation of the large intestine (megacolon)
- Anal fissure (a tear or open sore that develops in the lining of the large intestine)
- Disorders of metabolism, such as Diabetes mellitus, hypothyroidism, hypercalcemia, hypokalemia, hypomagnesemia, uremia
- Heavy metal poisoning
- Chronic diseases of the muscles and nerves, including Parkinson disease, multiple sclerosis, dementia, spinal cord injury or tumor
- Other conditions, including depression, degenerative joint disease and immobility, cardiac disease
In conclusion, this type of constipation could be caused by medication or it could be due to a side effect from a disease. A doctor can test to see if the problem is medical. Medical problems can often be treated. In that case, you know what caused your body’s reaction, you and your doctor then can act on it!
Acute versus chronic constipation
It is important to distinguish between acute (days to weeks) or chronic (months to years) onset of constipation because this information in the context of accompanied symptoms helps physicians discover the cause of constipation.
Most frequently, chronic constipation is the result of a primary disturbance of bowel function due to dietary factors (such as insufficient fiber intake), lifestyle factors (for example, lack of mobility or sedentary lifestyle) or a disorder of stool transport through the large intestine or rectal emptying5.
Constipation may cause you troublesome complications, these can interfere with your daily life and affect your happiness and effectiveness. They may include6:
- Swollen veins in your anus (hemorrhoids). Straining to have a bowel movement may cause swelling in the veins in and around your anus.
- Torn skin in your anus (anal fissure). A large or hard stool can cause tiny tears in the anus.
- Stool that can't be expelled (fecal impaction). Constipation may cause an accumulation of hardened stool that gets stuck in your intestines.
- Intestine that protrudes from the anus (rectal prolapse). Straining to have a bowel movement can cause a small amount of the rectum to stretch and protrude from the anus.
- U.S. Department of Health and Human Services National Institutes of Health (NIH) – National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Constipation. 2018 https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/definition-facts
- John Hopkins Medicine. Health conditions and diseases – Constipation. 2021. https://www.hopkinsmedicine.org/health/conditions-and-diseases/constipation
- U.S. Department of Health and Human Services National Institutes of Health (NIH) – National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Your Digestive System & How it Works. 2017 https://www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works
- Bharucha AE, Lacy BE. Mechanisms, Evaluation, and Management of Chronic Constipation. Gastroenterology. 2020 Apr;158(5):1232-1249.e3. doi: 10.1053/j.gastro.2019.12.034. https://doi.org/10.1053/j.gastro.2019.12.034
- Camilleri M, Ford AC, Mawe GM, Dinning PG, Rao SS, Chey WD, Simrén M, Lembo A, Young-Fadok TM, Chang L. Chronic constipation. Nat Rev Dis Primers. 2017 Dec 14;3
- MayoClinic 2019.