Everybody poops, but not everybody poops well. Constipation is a condition that means you're not having a healthy number of bowel movements every week. It can be quite uncomfortable and even frustrating, as you'll sometimes sit on the toilet knowing you need to poop but just can't seem to.
You certainly wouldn't be alone in getting constipation every now and again. In fact, some 2.5 million people visit the hospital via ambulance due to constipation pain every year, according to the American Gastroenterological Association. And while most symptoms of constipation aren't that severe, they're still largely uncomfortable—and downright annoying. Here's what you should know about the most common constipation symptoms and what you can do about them.
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Infrequent bowel movements
Everybody has a different poop schedule. It might be once a day, a few times a day, or once every couple of days. But if you haven't had at least three bowel movements in a week, that's when doctors start to consider you as having constipation, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
If you had to aim for a healthy "target," having one poop a day that is both the size and consistency of a large banana is good, 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. If you're a larger person or you eat a lot, you might have more like two of those a day.
Straining
If pooping isn't near-effortless, and instead you're finding yourself bearing down, rocking back and forth, pushing, or otherwise straining in order to have a bowel movement, there's a good chance you're constipated.
If you're backed up, attempting to use your muscles to push out stool is a natural response, Rudolph Bedford, MD, gastroenterologist at Providence Saint John's Health Center in Santa Monica, CA tells Health. For some people, continued straining can lead to problems with leaking urine and developing urinary incontinence over time, he says.
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Bloating
You know that feeling when your stomach just feels distended and full? That's bloating—and it can be a sign of constipation. The reason is because the stool ends up blocking air in your digestion, according to Dr. Maser. "If you don't have a complete evacuation of stool, you're going to get air buildup in front of that stool," she says.
The good news: Once you manage to have a full bowel movement, that feeling should subside, since the air will be able to move through your system.
Hard, lumpy stools
As digested food moves through your colon, the colon absorbs the water content from your food. Again, remember the goal is for a soft, banana-sized and textured bowel movement. If your digestion is moving slowly, the colon can absorb too much water, leading to hard, lumpy stools.
The stool you do manage to pass may also start looking like round little deer poops. "If you start to see lumps stuck together or just small kibble sized stools, you're getting to more severe constipation," Dr. Maser says.
If they're in your colon long enough, these hard, lumpy stools can clump together and grow in thickness, making them difficult to pass, says Dr. Bedford, since your colon can expand larger more comfortably than the rectal muscles can. In especially severe cases, that can lead to fecal impaction—where you won't be able to pass the stool on your own and will require a doctor's help.
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Feeling like you don’t poop everything out
So you're on the toilet, and you manage to poop, but you just feel like you're not getting everything out. That's constipation, too. And there's a good chance it's because there is still more stool to pass in the last part of the colon called the sigmoid colon, which is attached to the rectum.
It is possible, for some people who are having normal bowel movements or who are dealing with diarrhea, that a bowel movement will feel incomplete even though there's no more stool to pass. There's a special term for this, called tenesmus, and experts aren't sure what causes the sensation.
But for people experiencing constipation, the feeling of still needing to go once you've already passed some stool is usually because you're still backed up.
Flatulence, particularly foul-smelling flatulence
According to Dr. Maser, if you notice you're passing gas more often than usual—and especially if it smells particularly bad—it might be related to constipation. As for why it happens, there are two schools of thought. "There's the mechanical and there's the bacterial overgrowth theory," she explains.
Basically, your farts could get smellier because, just like with bloating, air is getting trapped in your stomach, surrounded by poop, which just makes the air smellier before getting passed. The other theory is that stool being backed up causes bacterial overgrowth, and that bacteria produces gas, and sometimes it's smelly gas. It might also be one of the reasons people get bloated.
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Needing help to have a bowel movement
If you find yourself pressing down on your stomach or shifting positions in order to help yourself poop, or even using your fingers to help extract stool from your bowel, that's definitely a sign of constipation. If you're going as far as to use your hands, you're probably closer to the "extreme" side of constipation, says Dr. Maser, which is still not entirely uncommon.
What you can do about constipation symptoms
The most effective thing you can do to help with any constipation symptoms is to have a complete bowel movement and then work on habits that might help prevent you from getting constipated again in the future.
To relieve your current constipation, a big glass of water or a cup of coffee can help get your system moving, Dr. Bedford says. "Caffeine itself will stimulate abdominal muscles and squeezing and may help people to eliminate," he explains. Exercise can also help.
If these things don't work, over-the-counter laxatives are an option. Both Dr. Bedford and Dr. Maser recommended using laxatives when you're constipated, but to use them sparingly. They both suggested that osmotic agents, like Miralax, can be effective. These types of laxatives help keep water in the stool, which makes them easier to pass. Other options include stimulant laxatives, lubricants, and enemas.
But it's important not to overuse laxatives, as they can actually make constipation worse when used too frequently. Stimulant laxatives in particular can cause dependency over time, Dr. Maser says.
After you've successfully gotten your system moving again, try incorporating some gut-healthy lifestyle changes into your routine, like eating more fruits, vegetables, and whole grains high in fiber.
One thing to remember: While fiber is helpful in preventing constipation, it can make you even more uncomfortable if you're already constipated. "Fiber requires a lot of water intake, and if you don't take in enough water, the fiber can harden and be even more difficult to pass," Dr. Maser says. The average person should get at least 25 grams of fiber a day, she says, but the average American gets significantly less than that.
In addition to fiber, drink plenty of water, get regular exercise, and only take laxatives sparingly, preferably when recommended by a doctor.
If all of that still isn't helping, talk to your doctor about the medications you're on. Medications and supplements are a major culprit behind constipation, Dr. Bedford says. Iron pills, calcium and aluminum reflux tablets like Tums, the anti-nausea medicine Zofran, depression medications, allergy medications like Benadryl, and pain medications including opiates all can cause constipation, he says. If that's the case, your doctor can help you come up with a routine that allows you to take any necessary medicines while still keeping your bowel movements healthy.
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