When Does Constipation Become an Emergency?

Constipation is anything but comfortable. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), you may be constipated if you pass less than three bowel movements per week. The bloating and cramping that can come with inconsistent bowel movements are enough to make anyone want to sit on the couch and stay there until those feelings pass.

For the most part, constipation is not an uncommon occurrence. The NIDDK estimates that 16 out of 100 adults experience symptoms of constipation. But sometimes, it is anything but normal. If your inability to pass stool is accompanied by debilitating abdominal pain, fever, and vomiting—among other severe symptoms—you may want to consult your healthcare provider.

So, how do you know if your constipation is an emergency? Here's what to know about the more alarming symptoms of constipation and what treatment looks like.

What Is Constipation?

Knowing what happens inside your body when you experience constipation may be helpful. Per the NIDDK, the digestive system is essentially one long tube, starting at your mouth and ending at your anus.

The digestive system includes several vital organs, like the stomach, small and large intestines, liver, pancreas, and gallbladder. Specifically, when you consume food, your large intestine absorbs the water from that food, creating waste products—or stool.

Normally, stool evacuates through your anus. But if you become constipated, stool slowly moves through and builds up inside your colon, according to the NIDDK.

"All the gases and air are really backing up," Rudolph A. Bedford, MD, a gastroenterologist at Providence Saint John's Health Center in Santa Monica, Calif., told Health. Per the Johns Hopkins Medicine Health Library, an excess of gas can make you feel bloated until you can pass the backed-up stool.

According to the NIDDK, you may be constipated if you notice any of the following symptoms:

• Having less than three bowel movements during one week
• Experiencing pain or difficulty while passing stool
• Stool that appears lumpy or hard—caused by your colon absorbing water from backed-up stool
• Feeling like stool has not completely passed after having a bowel movement

When Should You See a Doctor for Constipation?

While backed-up stool eventually passes, constipation may sometimes turn into a serious situation. It can be part of an underlying condition—like irritable bowel syndrome (IBS)—or even lead to serious problems for your colon. According to the NIDDK, you should consult a healthcare provider as soon as possible if you experience any of the following symptoms.

Severe Abdominal Pain

Constipation can cause feelings of discomfort. However, if your situation bypasses uncomfortable and becomes debilitatingly painful, it is time to seek help.

"[Constipation] can sometimes feel worse than labor pain," Elana Maser, MD, assistant professor of gastroenterology at the Icahn School of Medicine at Mount Sinai and gastroenterologist at the Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai in New York City, told Health. "The emergency is the pain."

In 2017, published in the journal International Journal of Surgery Case Reports, researchers found that chronic constipation may cause bowel perforation—or holes that form in the lining of your colon—due to lumpy and hard stool.

Those holes may be the culprit of severe abdominal pain. The researchers noted that although bowel perforation as a result of chronic constipation is rare, it is a situation that requires immediate medical attention.

Blood in Your Stool

Dr. Bedford added that you should consult your healthcare provider if you manage to pass stool and notice that it contains blood.

"Everyone thinks they're hemorrhoids, but that could be the first manifestation of colorectal cancer," said Dr. Bedford. Colorectal cancer occurs when polyps—or abnormal growths—become malignant, per the Centers for Disease Control and Prevention (CDC). Bleeding is one sign that those polyps may be cancerous.

Of course, noticing some blood in your stool does not automatically mean cancer. Various other conditions—including inflammatory bowel disease (IBD), anal fissures, or hemorrhoids—could be the reason you see blood. But regardless, it is essential to consult your healthcare provider to receive the necessary treatment.

No Bowel Movements for More Than One Week

If you do not pass any bowel movements for over one week, Dr. Bedford added that is an additional reason to seek medical attention. After seven days, your constipation may not necessarily be an emergency, but a healthcare provider can prevent the situation from becoming one.

Too many days with no bowel movements could lead to fecal impaction, in which stool hardens and bulks up so much that you cannot pass it, Dr. Bedford explained.

Although fecal impaction is more common among older adults and people with underlying conditions complicating their constipation, it can still be a threat.

"The key is to never get to that position," said Dr. Bedford. Per the National Library of Medicine, healthcare providers can stop fecal impaction from becoming serious by issuing an enema to soften your stool. They may also insert a finger into your rectum to separate large waste products so that it is easy to pass.

Fever

Constipation itself does not cause a fever. But if you are constipated and develop a fever, that may be a sign of diverticulitis. Diverticulitis occurs when diverticula, or small pouches, form in the colon. Those pouches usually do not cause problems but can sometimes become inflamed or infected.

"That certainly will cause a fever along with abdominal pain," noted Dr. Bedford.

Even in mild cases, you will likely need to complete a round of antibiotics to treat bouts of diverticulitis. In serious cases of the condition, the colon may bleed or tear, according to the National Library of Medicine.

Vomiting

Vomiting while experiencing constipation may indicate that impacted stool has seriously blocked your colon.

"Vomiting and inability to keep food down would be concerning," added Dr. Maser. Several conditions can cause nausea and vomiting—including fecal impaction—so you should consult your healthcare provider.

The Bottom Line on Constipation

Beyond performing a physical and obtaining your medical history, a healthcare provider may also order tests to see if there is an underlying condition causing your constipation, said Dr. Bedford. Those conditions may include diabetes, hypothyroidism, or anemia.

Depending on your age, after you completely pass the impacted stool, the healthcare provider may suggest a colonoscopy or sigmoidoscopy, added Dr. Bedford. Those procedures use small tools that have cameras to observe your colon closely. Meanwhile, they might indicate an enema or laxative to soften your stool and help you have a bowel movement.

But even if your constipation does not cause severe symptoms indicative of an emergency, you should not ignore it.

"There's no such thing as normal constipation," Dr. Bedford said. "Constipation in itself is an abnormal condition, which you should do whatever you need to do to avoid."