Constipation can be an uncomfortable problem. In severe cases, constipation can be painful or even life-threatening. Because normal bowel frequency can vary greatly from person to person, many people may not be entirely sure whether or not they are constipated.

Constipation is a medical condition in which bowel movements become less frequent than normal, and/or difficult to produce. While clinically defined as not producing bowel movements for three days or longer, if a person's regular bowel schedule is two or three times a day, that person might be constipated if he or she hasn't produced a single bowel movement after only one day.

Patients may be constipated if they are experiencing one or more of the following symptoms:

Abdominal pain and bloating. Constipated patients may feel tightness in their abdomen, or a sharp, cramping pain deep in their gut. They may also feel full all the time—as if they've just eaten a large meal—even when they haven't eaten for several hours. Patients may also feel gassy, but passing gas does not relieve discomfort.

Nausea and/or vomiting. It may seem counterintuitive, but nausea and vomiting can be a symptom of constipation. While constipation affects the intestines and not the stomach, being constipated slows down the entire digestive system, which can delay or prevent food in the stomach from reaching the intestines. When this happens, constipated patients may feel nauseous or even vomit. Diarrhea may also result if the body’s overall digestive process is impaired by partial stool blockages.


Hard stools or inability to have a bowel movement. Constipation causes stools to dehydrate and harden, which makes bowel movements difficult. Sometimes it can be hard for people to determine whether or not their stools are hard, however. To help educate patients about stools, a British hospital developed the Bristol Stool Chart, 1 Bristol Stool Chart. Continence Foundation of Australia. Accessed January 2015. sometimes called the Bristol Stool Scale, as a simple visual guide for assessing stool hardness. The chart illustrates seven types of stools. When patients consult their doctor about possible constipation, they can reference the chart to explain their recent stools.

Small stools followed by a feeling of not emptying the bowels. Constipation may cause people to produce only tiny bowel movements. These tiny bowel movements are often followed by frequent and continued urges to "go," but constipated patients may find they are unable to produce another bowel movement despite the constant urges.

Infrequent bowel movements. Patients who are producing fewer bowel movements per day or week than is normal for them may be constipated. While the medical definition of constipation is producing fewer than three bowel movements per week, some patients may still feel constipated even if they are producing five or six bowel movements per week.


Straining during a bowel movement. Constipated patients may have to push and strain their entire lower bodies to produce a bowel movement. They may even develop sore abdominal muscles or feel as if they are engaging in hard physical labor every time they go to the bathroom. Despite these straining efforts, patients still may not be able to produce a bowel movement, or do so only with great discomfort.

Rectal bleeding due to the development of anal fissures and/or hemorrhoids caused by hard stools. The strain of passing hard stools can cause the development of varicose veins in the rectum, which are known as hemorrhoids. Hemorrhoids can be painful, itchy, or both. They can make sitting for long periods uncomfortable or painful, and may make bowel movements more difficult. Anal fissures are small tears to the anus and surrounding tissue that can cause bleeding, burning, and pain, especially during bowel movements.

Anyone who experiences unusual or more serious symptoms, such as severe abdominal cramping, bloating, blood in the stool, or dizziness, should consult a physician immediately.

Dr. Erich Widemark is a faculty member of the Nurse Practitioner program and the Director of Simulation Education for the University of Phoenix, College of Health Sciences and Nursing. He has held various roles with the University of Phoenix, including Director of Nursing, Lead Faculty Area chair, and Subject Matter Expert for Curriculum Development within the Nurse Practitioner Program.