Service
Constipation and defecation disorders
- Section
- Services
- Specialist
- Op. Dr. Dilara Hasanova
- Clinic
- Modern Hospital, Baku
- The doctor's practice — examinations and treatments Dr. Hasanova performs herself
- General information — educational text about diseases and methods
What is constipation?
Short answer
Constipation is a condition marked by infrequent bowel movements (fewer than 3 times a week), hard stool, heavy straining or a feeling of incomplete emptying. If these symptoms last longer than 3 months, it is called chronic constipation. Constipation is not a separate disease but a sign of various causes. To treat it, the cause must first be found.
How many bowel movements are normal?
In healthy people, the frequency of bowel movements can range from 3 times a day to 3 times a week. What matters most is not the frequency but the shape of the stool and how comfortable the bowel movement is: it should happen without heavy straining, pain or a feeling of incomplete emptying.
Types of defecation disorders
- Functional constipation — without any structural change, often related to diet and lifestyle
- Slow transit — slow movement of stool through the colon
- Obstructed defecation — stool reaches the rectum, but passing it is difficult: rectocele, rectal prolapse, impaired coordination of the pelvic floor muscles (dyssynergia)
- Irritable bowel syndrome with constipation
- Secondary constipation — medications, endocrine diseases, neurological diseases, pregnancy
- In some cases, a congenitally long colon (dolichocolon, dolichosigma) can also cause constipation
Overlooked causes
- Medications: diuretics, opioid painkillers, iron and calcium preparations, aluminum-containing antacids, some antidepressants, some blood pressure medications, hormonal preparations
- Endocrine diseases: decreased thyroid function (hypothyroidism), diabetes mellitus
- Low fluid intake and a low-fiber diet
- Regularly suppressing the urge to have a bowel movement (work, travel, avoiding public toilets)
- Low physical activity
- Eating in a hurry and chewing food poorly
- Rectocele and pelvic floor disorders
- Taking laxative teas and pills for a long time without a doctor's supervision
Warning signs (get examined without delay)
- Blood in the stool or black stool
- Unexplained weight loss, anemia
- Constipation that starts for the first time after age 40–45 or changes in character
- Colon cancer or inflammatory bowel disease in the family
- Severe abdominal pain, vomiting, inability to pass gas
- Alternating constipation and diarrhea, thinning of the stool (ribbon-shaped stool)
Diagnosis
- Detailed questioning: frequency of bowel movements, shape of the stool, medications taken, diet
- Proctological examination and digital rectal examination
- Blood tests (for example, for anemia, thyroid function and blood sugar)
- Colonoscopy when indicated
- In obstructed defecation, functional tests: defecography, anal manometry
Treatment
General information
- Diet: vegetables, fruit, whole-grain products. The amount of fiber is increased gradually; otherwise bloating may develop.
- Fluids: enough water during the day (unless the doctor advises otherwise).
- Toilet habits: setting aside regular time after breakfast, not suppressing the urge, placing a small stool under the feet, not spending time on the phone in the toilet.
- Physical activity: daily walks and simple exercises increase bowel motility.
- Medications: the doctor prescribes laxatives, taking the type and duration of use into account.
- Treating the cause: a rectocele, an endocrine disease or a medication effect is addressed. In pelvic floor dyssynergia, physiotherapy and the biofeedback method are used.
The doctor's practice
Examinations and treatments Dr. Hasanova performs herself
- In chronic constipation, she investigates the cause: a proctological examination, assessment of rectocele and pelvic floor problems, and additional tests when needed.
- She provides surgical treatment for obstructed defecation caused by a rectocele.
- When needed, she refers the patient to colleagues — an endocrinologist, a gastroenterologist or a physiotherapist.
- In educational videos on social media, she demonstrates simple physical exercises that increase bowel motility, along with dietary recommendations.
Frequently asked questions
Can you drink senna tea for a long time?
Taking stimulant laxative teas such as senna for months or years without a doctor's supervision is not recommended. Such products do not eliminate the cause of constipation, and the cause is overlooked. If constipation persists, you need to be examined and to choose the appropriate treatment together with a doctor.
Does constipation cause hemorrhoids?
Yes. Chronic constipation and heavy straining during a bowel movement are among the main risk factors for hemorrhoids and anal fissure. That is why the treatment of these conditions starts with resolving the constipation.
Which doctor should you see for constipation?
If constipation is accompanied by hemorrhoids, anal fissure, rectocele or difficulty with bowel movements, see a proctologist. If symptoms such as abdominal pain, bloating and nausea are the main problem, a gastroenterologist can also examine you. In children, an examination by a pediatrician is needed first.