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Constipation: When Is It Time to Tell Your Doctor?

Everyone Poops. It’s a children’s cartoon book by Taro Gomi — ideal for toddlers in the midst of potty training. Beyond that, it’s an important bodily-function that’s seldom discussed among adults — even in the doctor’s office. Even when the patient is worried about not pooping, also known as constipation.

Some eight million visits to healthcare providers each year are the result of constipation, according to a new review of studies [1] in the Journal of American Medical Association (JAMA), even as the study’s author concedes that a majority of people concerned about constipation do not report it to their doctor.

Rozan Razzouk, M.D. [2], a family medicine physician with Baptist Health Primary Care [3] in South Miami, routinely asks her patients about their bowel health. “They say it’s OK,” Dr. Razzouk says. “They don’t talk about it very often, to be honest. Sometimes, [constipation] is really bothering them, but they don’t want to admit it.”

Defining Constipation

Some people may be surprised to learn the definition of constipation. Hint: BMs aren’t a daily requirement for good health. “Patients don’t have to have a bowel movement every day, but that’s what they believe,” Dr. Razzouk says.

Rather, constipation is defined as fewer than three bowel movements per week, or a hard, small stool (even if the bowels move daily). Straining to produce a bowel movement or the inability to empty the bowels during a movement are other signs of constipation.

Sometimes, constipation goes along with another medical problem, including Parkinson’s disease or multiple sclerosis, and endocrine conditions, such as diabetes and thyroid disorders. Constipation may also be a sign of a physical obstruction or tumor in the bowel, so it’s always important to check with your doctor.

Some people, including longtime medical writer Jane Brody [4], the New York Times Personal Health columnist, suffer from chronic constipation, for which lifestyle changes and over-the-counter medications can be very effective. Ms. Brody shared her nearly lifelong experience with constipation, which she described in a recent column [5] as “an all-too-common problem.”

Tips for Preventing Constipation

Constipation also can be a side effect of certain medications, including antidepressants, narcotic painkillers and antihistamines.

Dr. Razzouk offers these tips to prevent and treat occasional constipation.

Talk to your doctor if you have a sudden change in bowel habits, Dr. Razzouk emphasizes. Certain symptoms occurring along with constipation — including weight loss, blood in the stool (known as melena) or a family history of colon cancer — are “red flags” that need to be checked out. “If you have a regular bowel movement all your life and suddenly you start to be constipated,” Dr. Razzouk says, “you need to bring that information to your healthcare provider.”