Constipation Evaluation and Treatment in Cypress and Katy, TX

When Constipation May Need Urgent Medical Care

Seek prompt medical care when constipation occurs with any of the following:

• Rectal bleeding
• Blood in the stool
• Black or tarry stool
• Constant or severe abdominal pain
• A rapidly swollen abdomen
• Inability to pass gas
• Repeated vomiting
• Fever
• Unexplained weight loss
• Severe weakness, dizziness, or fainting
• New or rapidly worsening symptoms

Call 911 or go to the nearest emergency department for life-threatening symptoms. Do not use an online appointment form for an emergency.

NIDDK advises prompt medical evaluation when constipation is accompanied by rectal bleeding, blood in the stool, constant abdominal pain, inability to pass gas, vomiting, fever, or unintentional weight loss.

What Is Constipation?

Constipation describes bowel movements that are difficult, uncomfortable, incomplete, or less frequent than usual.

You may be constipated even when you have more than three bowel movements per week. Frequency is only one part of the condition. Stool consistency, straining, discomfort, blockage, and incomplete emptying are also important.

Your usual pattern matters. A new change from what is normal for you may need attention, particularly when it occurs with bleeding, anemia, abdominal pain, weight loss, or a family history of colorectal cancer.

Common Symptoms of Constipation

Constipation can cause one or several of the following:

• Fewer bowel movements than usual
• Hard, dry, or pellet-like stools
• Straining to pass stool
• Pain during a bowel movement
• Feeling that stool is stuck
• Feeling that the rectum is blocked
• Feeling that you did not empty completely
• Spending a long time on the toilet
• Abdominal bloating or pressure
• Abdominal cramping
• Excessive gas
• Rectal discomfort
• Hemorrhoid irritation caused by repeated straining
• Needing frequent laxatives, enemas, or suppositories
• Alternating constipation and diarrhea

Constipation may occur by itself or as part of another condition, such as irritable bowel syndrome with constipation, also called IBS-C.

When Should You See a Gastroenterologist for Constipation?

Schedule a medical evaluation when constipation:

• Does not improve with reasonable self-care
• Keeps returning
• Interferes with work, sleep, travel, or daily activities
• Requires frequent or increasing laxative use
• Represents a new change in bowel habits
• Alternates with diarrhea
• Causes ongoing abdominal pain or bloating
• Causes prolonged straining or incomplete emptying
• Makes you feel that stool is blocked
• Begins after starting a new medication
• Occurs with anemia, bleeding, or unexplained weight loss
• Occurs with a personal history of colon polyps
• Occurs with a family history of colorectal cancer
• Has not responded to previous treatment

A primary-care clinician can manage many uncomplicated cases. A gastroenterologist may be helpful when symptoms are persistent, the cause is uncertain, standard treatments have not worked, specialized bowel-function testing may be needed, or colonoscopy must be considered for a separate clinical reason.

Understanding the Causes

What Causes Constipation?

Constipation often has more than one contributing factor. A proper evaluation looks beyond fiber intake alone.

Diet, fluid, activity, and daily routine

Common contributing factors include:

• Not eating enough fiber
• Not drinking enough fluid for your individual health needs
• Low physical activity
• Ignoring the urge to have a bowel movement
• Travel
• Illness
• Changes in eating patterns
• Changes in work or sleep schedules
• Spending insufficient time in the bathroom
• Regularly delaying bowel movements

Medicines and supplements

Some prescription medicines, over-the-counter products, and supplements may contribute to constipation.

Examples may include:

• Opioid pain medicines
• Iron supplements
• Certain antacids
• Some antidepressants
• Anticholinergic medicines
• Some blood-pressure medicines
• Certain allergy medicines
• Some medicines used for neurologic or psychiatric conditions

Do not stop or change a prescribed medicine without speaking with the clinician who prescribed it.

Bring a complete list of your medicines, vitamins, supplements, laxatives, teas, and other products to your appointment.

Digestive and pelvic-floor conditions

Constipation may be related to:

• Irritable bowel syndrome with constipation
• Slow movement of stool through the colon
• Pelvic-floor dysfunction
• Difficulty coordinating the muscles used for bowel emptying
• Anal or rectal narrowing
• Rectocele
• Rectal prolapse
• Inflammation
• Diverticular disease
• Previous pelvic or abdominal surgery
• Less commonly, an intestinal blockage or tumor

Medical and neurologic conditions

Constipation may also be associated with:

• Diabetes
• Hypothyroidism
• Celiac disease
• Pregnancy
• Parkinson’s disease
• Multiple sclerosis
• Spinal cord disease or injury
• Other neurologic conditions
• Changes associated with aging

Testing should be selected according to the patient’s symptoms, history, examination, and response to treatment rather than performed routinely for every person.

Types of Chronic Constipation

Understanding the type of constipation can help guide treatment.

Normal-transit constipation

With normal-transit constipation, stool may move through the colon at a generally expected rate, but bowel movements still feel difficult, hard, painful, or incomplete.

Slow-transit constipation

With slow-transit constipation, stool moves more slowly through the colon.

Possible symptoms include:

• Infrequent bowel movements
• Persistent bloating
• Abdominal discomfort
• Limited response to basic treatments
• Reduced natural urge to have a bowel movement

Pelvic-floor or defecatory dysfunction

The muscles used to empty the rectum may not relax and coordinate correctly.

Possible signs include:

• Prolonged straining
• Feeling blocked
• Feeling incompletely emptied
• Having a strong urge but being unable to pass stool
• Needing unusual positioning or manual assistance
• Repeated failure of laxatives to solve the problem

When pelvic-floor dysfunction is present, simply adding more laxatives may not address the underlying problem.

IBS with constipation

IBS-C commonly involves recurrent abdominal pain associated with bowel movements and changes in stool frequency or form.

Treatment for IBS-C may differ from treatment for chronic constipation without recurring abdominal pain.

Medication-induced constipation

When a medicine contributes to constipation, treatment may require:

• Reviewing the medication
• Adjusting the dose under prescriber supervision
• Changing to another medicine when medically appropriate
• Developing a preventive bowel plan
• Using treatment specifically designed for medication-related constipation

Opioid-induced constipation may require a different approach from constipation caused by diet, routine, or pelvic-floor dysfunction.

How Is Constipation Treated?

Treatment depends on:

• The suspected cause
• How long symptoms have been present
• Stool consistency
• Bowel frequency
• Abdominal pain
• Other medical conditions
• Current medicines
• Previous treatment response
• Whether pelvic-floor dysfunction is present

The goal is not simply to produce one bowel movement. The goal is to create a safe, sustainable plan that improves stool consistency, ease of passage, bowel regularity, and quality of life.

Increase fiber gradually

Fiber can help increase stool bulk and improve stool consistency.

Sources of dietary fiber include:

• Beans
• Lentils
• Whole grains
• Vegetables
• Fruit
• Nuts
• Seeds

Adults generally need approximately 22 to 34 grams of fiber per day, depending on age and sex. Increase fiber gradually because a sudden increase may worsen bloating, gas, or abdominal discomfort.

Fiber is not appropriate as the only treatment for every type of constipation. Patients with severe bloating, suspected obstruction, certain pelvic-floor problems, or slow-transit constipation may need a more individualized approach.

Drink enough fluid

Adequate fluid can help fiber work more effectively and may help when a person is dehydrated.

Drinking excessive amounts of water is not a universal cure for constipation.

Ask your clinician about a safe fluid target if you have:

• Heart failure
• Kidney disease
• Liver disease
• A medical reason to restrict fluid

Improve bowel habits

Helpful habits may include:

• Responding to the urge to have a bowel movement
• Avoiding unnecessary delay
• Allowing unhurried bathroom time
• Trying to use the bathroom after a meal, often after breakfast
• Using a footstool to improve positioning
• Keeping a bowel diary
• Staying physically active as your health allows

NIDDK notes that regular physical activity, consistent bowel training, using the bathroom when the urge occurs, and allowing sufficient time may help relieve constipation.

Over-the-counter treatments

Depending on your health history and symptoms, a clinician may recommend:

• A fiber supplement
• An osmotic laxative
• A stool-softening strategy
• A stimulant laxative
• A short-term rescue treatment
• Another over-the-counter product

These products work in different ways.

Possible side effects may include:

• Bloating
• Gas
• Cramping
• Diarrhea
• Dehydration
• Electrolyte changes
• Medication interactions

Do not assume that a product is safe simply because it is labeled “natural.”

Frequent, increasing, or long-term laxative use should be reviewed with a healthcare professional.

Prescription constipation treatment

Prescription treatment may be considered when appropriate lifestyle measures and over-the-counter options have not provided adequate relief.

The choice of medication depends on:

• Whether the diagnosis is chronic idiopathic constipation or IBS-C
• Other health conditions
• Kidney function
• Previous treatment response
• Possible adverse effects
• Cost
• Insurance coverage
• Patient preferences

Joint AGA–ACG guidance includes evidence-based prescription and nonprescription options for adults with chronic idiopathic constipation, particularly after appropriate over-the-counter treatments have not worked.

Pelvic-floor biofeedback

When testing identifies a defecatory disorder, pelvic-floor retraining with biofeedback may be more useful than repeatedly adding laxatives.

Biofeedback helps patients learn to coordinate the muscles and nerves involved in bowel emptying.

AGA guidance recommends anorectal testing for selected patients who do not respond to basic treatment and recommends pelvic-floor biofeedback rather than laxatives alone for defecatory disorders.

Treating an underlying cause

Treatment may involve:

• Addressing hypothyroidism or another medical condition
• Reviewing a contributing medication
• Treating IBS-C
• Managing opioid-induced constipation
• Treating a structural problem
• Addressing pelvic-floor dysfunction
• Improving diet and routine
• Updating colorectal cancer screening

Surgery is uncommon and is generally reserved for carefully selected patients after thorough specialist evaluation.

Experience the Difference in Digestive Care.

How to Prepare for a Constipation Appointment

Bring or record the following information:

• How often you have bowel movements
• What your stool usually looks like
• Whether you strain
• Whether bowel movements are painful
• Whether you feel blocked
• Whether you feel incompletely emptied
• How long symptoms have been present
• Whether symptoms alternate with diarrhea
• A list of all prescription medicines
• A list of vitamins and supplements
• Fiber products you have tried
• Laxatives, enemas, teas, or cleanses you have tried
• Previous colonoscopy reports
• Previous laboratory or imaging reports
• History of abdominal or pelvic surgery
• Family history of colorectal cancer or polyps

A one- or two-week bowel diary may be helpful.

This information can help distinguish among medication-related constipation, IBS-C, slow-transit constipation, pelvic-floor dysfunction, and other possible causes.

Constipation Care in Cypress, Katy, and Greater Houston

United Gastroenterology Associates offers adult gastroenterology consultations at locations in Cypress and Katy.

Cypress gastroenterology office

21216 Northwest Freeway, Suite 640
Cypress, TX 77429

View the Cypress gastroenterology office.

Katy gastroenterology office

23920 Katy Freeway, Suite 555
Katy, TX 77494

View the Katy gastroenterology office.

Appointments

Telephone: (346) 340-4414

Request a non-emergency appointment.

Review insurance information.

Compassionate Digestive Care

Why Choose United Gastroenterology Associates?

Patients with constipation may benefit from an evaluation that considers more than stool frequency alone.

United Gastroenterology Associates offers:

• Evaluation by a gastroenterologist
• Adult digestive and liver care
• Cypress and Katy office options
• Assessment of medicines, diet, bowel habits, and medical conditions
• Evaluation for IBS-C
• Evaluation for slow-transit constipation
• Evaluation for pelvic-floor dysfunction
• Diagnostic testing when clinically appropriate
• Coordination of colorectal screening when indicated
• Individualized treatment recommendations

Request a Constipation Evaluation

Persistent constipation should not be managed indefinitely with repeated laxatives without understanding why it is occurring.

A gastroenterology evaluation may help identify whether symptoms are related to diet, medication, IBS-C, slow colon transit, pelvic-floor dysfunction, another medical condition, or a need for additional testing.

Call (346) 340-4414 or request a non-emergency appointment at our Cypress or Katy office.

Your Questions, Answered

Frequently Asked Questions