Is this your symptom?
- Can't pass a stool or pain when passing a stool
- 3 or more days without passing a stool
- Caution: any stomach pain from constipation comes and goes. Most often, it is mild. Use the Stomach Pain care guide if there is sudden onset or constant stomach pain.
Causes of Constipation
- Low Fiber Diet can cause constipation. To increase the fiber in your diet, choose higher-fiber breakfast cereals or bread with whole grains. Choose whole wheat pasta and brown rice. Add beans, lentils or chickpeas to your diet and include plenty of fresh vegetables and fruit. Nuts and seeds are another good source of fiber and can be eaten as a snack. So can fresh fruit and raw vegetables.
- Not Enough Fluids. Drinking 6-8 glasses of fluids a day (avoid alcohol) will help keep you healthy and prevent dehydration. It will also help keep your stools soft. If you have had diarrhea or vomiting and have become dehydrated, you may become constipated. The same can happen in hot weather or if you have a fever for a long time. If you work in a hot environment and have been sweating a lot due to activity, drink more fluids.
- Lack of Exercise can make the bowels sluggish. Keep active to prevent this.
- Limited Bathrooms or Bathroom Time. Not enough bathrooms at home or at work, or lack of privacy, can lead to delay in passing a stool. This can cause constipation, as the stool is harder to pass later.
- Anorectal Disease.
Diseases which affect the rectum and anus can lead to constipation. Painful stools are too hard to pass. These diseases include:
- Anal Fissure. A crack in the skin at the anus caused by passing a large hard stool. This causes pain and bleeding when passing a stool.
- Anal Stricture. Narrowing of the anus makes it is hard to pass a normal stool. Stools may appear narrow when passed. There may also be an anal fissure, with bleeding.
- Irritable Bowel Syndrome (IBS) causes bouts of diarrhea, constipation and abdominal pain. The exact cause is unknown. Factors may include stress, diet, lifestyle or hormones. Symptoms are similar to problems that inflame the bowel, such as ulcerative colitis and Crohn's disease. They may need to be ruled out before a diagnosis of IBS is made.
- Intestinal Obstruction (serious).
Part of the bowel can get blocked for a number of reasons. This prevents the stools from passing along the length of the bowel. It can begin slowly or can come on suddenly. It may seem like constipation, but it is a more serious problem and needs urgent treatment. Obstruction can be caused by:
- Strictures: narrowing anywhere in the bowel
- Colorectal Cancer can cause a growth which blocks the bowel.
- Pelvic Mass. A large growth in the pelvis can press on the rectum and block stools from passing through that part of the bowel. Growths may include ovarian cysts and fibroids. The late stages of pregnancy have a similar effect. Constipation is common in pregnant women.
- Diverticulosis means sacs form on the inner lining of the bowel. They can get large and inflamed or infected. It makes it hard for stools to pass through that part of the bowel. This issue gets more common with age.
- Twisted Bowel. The bowel can twist and become blocked. This often causes severe abdominal pain, vomiting, an inability to pass wind and a bloated abdomen. Call 911 if you have these symptoms.
- Other Medical Conditions. Some medical conditions are linked to constipation. These include underactive thyroid, low calcium or potassium levels, porphyria and lead poisoning. If you have constipation often, your doctor can order tests for these conditions.
- Medicines can cause constipation. These include painkillers like morphine and codeine, iron and some antidepressants.
- Nerve Damage. If there has been damage to the bowel nerves, the bowel may not be able to push the stools along. Damage could be due to injuries to the spine or pelvis, nerve damage due to poorly-controlled diabetes, or a congenital reason such as spina bifida.
- Chronic Laxative Abuse caused by an attempt to lose or control weight.
- Slow Passage of Food through the Intestines. Most often, this type runs in families. It's called slow transit time.
When to Call for Constipation
Go to ER Now
Call Doctor or Seek Care Now
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Contact Doctor Within 24 Hours
Contact Doctor During Office Hours
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Self Care at Home
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Go to ER Now
- Vomited 2 or more times and stomach looks more swollen than normal
- Stomach pain is constant and lasts more than 2 hours
- Vomiting bile (green color)
Call Doctor or Seek Care Now
- Rectal pain lasts more than 1 hour (includes straining) after using care advice
- You feel weak or very sick
- You think you need to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Leaking stool
- Tried a suppository or enema but it did not work
- Minor bleeding from the rectum when you pass a stool
- Last normal stool was more than 5 days ago
- You think you need to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Suppository or enema was needed to get the stool out
- Infrequent stools do not get better after changes to diet
- You are taking a new drug which may be the cause
- You are using stool softeners and have not talked to your doctor about the problem
- You have lost weight and you are not dieting
- Mucus in the stool (might see this on toilet paper)
- Painful stools occur 3 or more times after changes to diet
- Constipation happens often
- You have other questions or concerns
Self Care at Home
- Mild constipation
Care Advice for Stomach Pain
What You Should Know About Stomach Pain:
- Mild stomach pain can be caused by something simple. It could be from gas pains or eating too much.
- Sometimes, stomach pain signals the start of a viral infection. This will lead to vomiting or loose stools.
- Watching your child for 2 hours will help tell you the cause.
- Here is some care advice that should help.
Lie Down:
- Have your child lie down and rest until feeling better.
Clear Fluids:
- Offer clear fluids only (such as water, flat soft drinks or half-strength Gatorade).
- For mild pain, offer a regular diet.
Prepare for Vomiting:
- Keep a vomiting pan handy.
- Younger children often talk about stomach pain when they have nausea. Nausea is the sick stomach feeling that comes before they throw up.
Pass a Stool:
- Have your child sit on the toilet and try to pass a stool.
- This may help if the pain is from constipation or diarrhea.
- Note: for constipation, moving a warm wet cotton ball on the anus may help.
Do Not Give Medicines:
- Any drug (like ibuprofen) could upset the stomach and make the pain worse.
- Do not give any pain medicines or laxatives for stomach cramps.
- For fever higher than 102° F (39° C), acetaminophen (such as Tylenol) can be given.
What to Expect:
- With harmless causes, the pain is most often better or gone in 2 hours.
- With stomach flu, belly cramps may happen before each bout of vomiting or diarrhea. These cramps may come and go for a few days.
- With serious causes (such as appendicitis), the pain worsens and becomes constant.
Call Your Doctor If:
- Pain becomes severe
- Constant pain lasts more than 2 hours
- Mild pain that comes and goes lasts more than 24 hours
- You think your child needs to be seen
- Your child becomes worse
Extra Help - Worried Stomach:
- Help your child talk about events that trigger the stomach pain. Talk to your child about how to cope with these the next time around.
- Help your child worry less about things she can't control.
- To treat the pain, help your child get very relaxed. Lying down in a quiet place and taking slow deep breaths may help. Make the belly go up and down with each breath. Then try to relax all the muscles in the body. Think about something pleasant. Listening to audios that teach how to relax might also help.
- Make sure your child gets enough sleep.
- Make sure that your child doesn't miss any school because of stomach pains. Stressed children tend to want to stay home when the going gets rough.
- Caution: your child should see her doctor for an exam. Do this before concluding frequent stomach pains are from worrying too much.

