When Is Constipation Pain Normal, and When Is It an Emergency?
So it's been a few days since you had a good poop, and your stomach doesn't feel great—maybe it's even passed from just uncomfortable into downright painful. But how much constipation pain or discomfort is normal? And when is constipation an emergency?
Some level of constipation pain is par for the course, Niket Sonpal, MD, an internist and gastroenterologist in New York tells Health. "Pain from normal constipation should feel like slight discomfort in the abdominal area from stool that cannot be passed," he says. "You may feel like your stomach is 'full' from the cramping and bloating in your intestines."
If you're just having a normal run-in with constipation, which happens to many people from time to time, then you can expect the constipation to resolve itself within a few days to a couple of weeks, Dr. Sonpal says. "Normal constipation may be uncomfortable, but it should not interfere with the quality of a person's daily life," he adds.
Home treatments for constipation include drinking a cup of coffee, drinking a lot of water, getting some exercise, or using an over-the-counter laxative, Rudolph Bedford, MD, gastroenterologist at Providence Saint John's Health Center in Santa Monica, CA tells Health.
If you're dealing with constipation on a regular basis, it's worth making changes to your lifestyle to try to get yourself more regular. Namely, increase your fiber intake by eating more fruits and vegetables, consider a high-fiber bran-based cereal, drink lots of water, and try to get regular exercise, Dr. Bedford says. If that doesn't work, you'll want to talk with your doctor to figure out what else might be going on and get into a schedule that works for your body. You don't want to be regularly using laxatives without your doctor's insight, as laxative overuse can actually lead to more constipation.
Once you do manage to have a complete bowel movement, it may take a bit of time before your gut is totally comfortable again—typically within 24 hours, Dr. Bedford says. "You've just finished stretching the bowel walls. It doesn't just come back to a normal caliber immediately," he says. "There may even be some underlying spasming that's going on as you are relieving yourself."
However, there are some symptoms that take constipation from the occasional nuisance to get-to-a-doctor emergency.
If you haven't pooped in more than two weeks, even after you've tried over-the-counter options like stool softeners and laxatives, you might want to make an appointment with a specialist like a gastroenterologist, Dr. Sonpal says.
And there are more concerning symptoms, too. If you spike a fever (anything over 100 to 101 degrees Fahrenheit) while constipated, you'll want to see a doctor ASAP, as it likely means there's something else going on. Namely, diverticular disease. Diverticula are little pockets within the colon that are more common after age 40. Often, they don't cause problems, but they can get inflamed if they break open. "Diverticular disease is usually caused by constipation itself where little pockets develop within the colon and if those pockets break open that will cause diverticulitis," Dr. Bedford explains. This can cause a fever along with abdominal pain, and it won't resolve on its own without treatment, Dr. Bedford says.
Blood is another reason to see your doctor immediately. Whether you have dark blood in the stool itself or bright red blood on the toilet paper, get it checked out. Some people might assume that seeing bright blood on toilet paper is "just" hemorrhoids, but that's a mistake, Dr. Bedford says. "Never assume that it's hemorrhoids. That could be the first sign of a colorectal cancer," he cautions.
Lastly, if you're in terrible pain that's affecting your ability to live your life, see a doctor. "Severe abdominal pain is one of the number one drivers of emergency room visits, and people are often surprised that the cause of this pain—which can sometimes feel worse than labor pains—is actually due to constipation," Elana Maser, MD, assistant professor of gastroenterology at the Icahn School of Medicine at Mount Sinai and gastroenterologist at the Feinstein IBD Center at Mount Sinai Hospital in New York City, tells Health.
In extreme cases, severe constipation could lead to something called obstipation, where the colon is almost completely blocked. Left for long enough, the buildup can cause the colon to perforate, allowing the contents of the bowel to spill into the abdomen. "When we see constipated people who have abdominal pain and they're doubled over, you're worried the colon, like a balloon, might pop," Dr. Bedford says. "Typically they're in quite a bit of pain before that happens and that is an emergency."
The constipation pain itself is an emergency, too. "Pain isn't a defining feature of severity," Dr. Maser says. Someone might be more constipated but in less pain, or vice versa. But the fact that it's extremely painful is absolutely a reason to get help from a doctor.
But again, even if you're not experiencing these severe symptoms, that doesn't mean you shouldn't try to manage your constipation. "If you have any sort of discomfort of any severity level, you should try to empty your bowels," Dr. Maser says. "If you have trouble emptying your bowels on your own or the pain doesn't go away, you should see your doctor."
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