Constipation

Constipation is one of the most common digestive problems. It's more common in women, older adults and during pregnancy.

• Occasional constipation: short-term, often from changes in diet, travel or routine.
• Chronic constipation: lasts for several weeks or longer.
• Slow-transit constipation: stool moves slowly through the colon.
• Pelvic floor problems (outlet constipation): muscles that help you pass stool don't work together well.
• Constipation-predominant IBS (IBS-C): constipation with belly pain and bloating.
• Constipation caused by medicines or other medical conditions.

• Not enough fiber or fluids
• Not much physical activity
• Ignoring the urge to go
• Medicines such as opioid pain relievers, iron, calcium, some blood pressure medicines, antihistamines and antidepressants
• Pregnancy and getting older
• Low thyroid, diabetes, or high calcium
• Nerve conditions such as Parkinson's disease or spinal cord problems
• Rarely, a blockage such as colon cancer

• Fewer bowel movements than normal
• Hard, dry or lumpy stools
• Straining or pain when passing stool
• Feeling that you haven't fully emptied
• Bloating or belly discomfort
• Needing to press on your belly or use a finger to help pass stool
• At your visit, your provider examines your belly for tenderness, swelling or stool that can be felt, and may do a rectal exam to check for hemorrhoids, fissures, a mass, or how your pelvic floor muscles work.

Constipation is usually diagnosed from your symptoms and exam.

Lab tests your provider may order include: a complete blood count (CBC), thyroid tests (TSH), a comprehensive metabolic panel including calcium and glucose, and sometimes a stool test for hidden blood.

A colonoscopy may be recommended if you have warning signs or are due for colon cancer screening. Some people need special tests of bowel and pelvic floor function. We don't do imaging or procedures at our office; we refer you to a trusted gastroenterology partner or center and review the results with you.

• Fiber: slowly add more fruits, vegetables, beans and whole grains, or a fiber supplement such as Metamucil (psyllium). Aim for about 25 to 35 grams a day.
• Fluids: drink enough water, especially when adding fiber.
• Move more: walking and regular activity help the bowels move.
• Routine: try to go at the same time each day, often after breakfast, and don't ignore the urge. Putting your feet on a small stool can help.
• Over-the-counter options: stool softeners such as Colace (docusate), or gentle laxatives such as MiraLAX (polyethylene glycol) or Senokot (senna). Ask your provider which is right for you and how long to use them.
• If you take opioid pain medicine, constipation is very common. Start a bowel plan when you start the medicine, and tell us if it isn't working; there are prescription medicines made for opioid-induced constipation.
• Reviewing medicines that may cause constipation.
• Prescription medicines or pelvic floor physical therapy for chronic constipation.

Most constipation improves with diet, fluids and activity changes. Chronic constipation can usually be managed with a long-term plan.

Results vary depending on the cause.

Your primary care team at Moaddel Medical looks for causes, reviews your medicines, orders labs and builds a step-by-step plan.

We refer you to a gastroenterology partner for colonoscopy or specialized testing when needed.

We're at 7230 Medical Center Dr, Suite 100, West Hills, CA 91307.