Causes of Severe Constipation

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Causes of Severe Constipation

Question:

I get very constipated, to where I don't have a bowel movement for up to two weeks. I look like I could be seven months pregnant. (I'm not.) The pain gets so bad that it runs down my legs to my knees. I'm 26 and very active, but this has been going on for a few years. What can I do?

Answer:

The most important thing you can do is see a gastroenterologist. This specialist can evaluate your constipation.

The severe constipation you describe can have many causes. Some medications can cause severe constipation.

Other reasons include:

• An abnormally sluggish colon that cannot empty in a regular manner

• A metabolic problem, such as hypothyroidism, diabetes or an abnormally high blood calcium level

• A problem with the function of the nerves that coordinate bowel movements

• A partial obstruction of the bowel

• A failure of the external sphincter of the anus to relax when stool is ready to be evacuated

Your gastroenterologist may order some tests, including:

• Blood studies

• An x-ray to follow the progress of swallowed markers through your colon

• A procedure to measure pressures within your anal canal

• An imaging study to view the internal workings of your rectum and anus during defecation

Once the results are in, your doctor should have the information needed to start treatment and get you some relief.

Stephen Goldfinger, M.D., is a professor of medicine at Harvard Medical School. He is a graduate of Columbia College of Physicians and Surgeons, and his clinical base is at the Massachusetts General Hospital.

Last updated:	July 20, 2009