How long has it been, girl?
Forget being coy: Constipation is a pain in the ass—literally and figuratively.
Sure, it’s usually NBD (about 2.5 million people visit their doctors about constipation each year, according to the American College of Gastroenterology), but despite being pretty normal, there are a few signs your constipation is something more serious.
“In the majority of cases, [constipation is] harmless but in rare scenarios it can lead to hospitalization or life-threatening complications,” says Melissa Latorre, M.D., a gastroenterologist and assistant professor of medicine at NYU Langone Health. “What’s more important is to exclude mimickers of constipation such as colorectal cancer.”
To figure out if you should see someone about your constipation symptoms, it’s important to know what to look for.
What exactly does constipation look like?
Everyone’s poops (and poop schedules) are different, but the National Institute of Diabetes and Digestive and Kidney Diseases defines constipation as having fewer than three bowel movements a week that are hard, lumpy, or difficult and painful to pass.
It can also feel really uncomfortable—while not necessarily being painful. “Occasionally people can feel fullness or bloating, but pain is not really a characteristic symptom and if this is occurring regularly, you should seek the help of a digestive specialist,” says Latorre.
When is it time to see a doctor about constipation?
Many people get spooked if they can’t go to the bathroom for a few days, but it’s not a medical emergency, says Robynne Chutkan, M.D., a gastroenterologist in Chevy Chase, Maryland, and author of Gutbliss: A 10-Day Plan to Ban Bloat, Flush Toxins, and Dump Your Digestive Baggage.
However, if it’s been a week since your last bowel movement—and you’ve tried at-home treatments to no avail—that’s a good time to call your doc to schedule an in-office visit, says Chutkan,
Other than how frequently—er, how infrequently—you’re on the toilet, more serious symptoms you should look out for include: changes in stool texture, blood in stool, hemorrhoids, weight loss, decreased appetite, or nausea and vomiting.
In those cases, a doctor’s number-one concern about your number-twos is colorectal cancer. So they’ll want to rule it out before figuring out any other causes of constipation.
In rare cases, your constipation could also be a form of digestive obstruction, where there is an actual blockage in your system, says Latorre. “Patients will usually look very sick with nausea, vomiting, abdominal distention, and pain. They key difference is that they are also unable to pass gas,” she explains. If you’re experiencing any of those symptoms, get to a doctor ASAP.
When you do go see an M.D. (and rule out colorectal cancer), they’ll likely ask you to keep a “bowel diary,” in which you write down all of your symptoms, the frequency, and when they occur, Latorre says. “It’s also important to have an up-to-date medication list as some medications, like diuretics, iron, calcium, and opiates are notorious for causing constipation,” she says.
How you can treat constipation at home.
If constipation is a pretty new thing for you (i.e., you’ve been going fewer than three times a week, for weeks on end), you should try to remedy things at home.
It may sound obvious, but really, the best ways to help your digestion are to eat a diet high in fiber (25 to 35 grams a day), stay hydrated, and exercise, says Latorre.
“If you’re not moving, neither are your bowels,” says Chutkan. Increase your unprocessed fiber intake from natural sources, like fruits, vegetables, and legumes, and make sure you’re upping your H20 intake to move everything smoothly through your system.
If that doesn’t work, try a fiber supplement or one to two tablespoons of pure psyllium husk (you can find this in a product like Metamucil) with plenty of water, says Chutkan.
Beyond lifestyle updates, you could also try laxatives—and there are two main types: osmotic and stimulant. “Osmotic laxatives help pull water into your colon to hydrate stool,” while stimulant laxatives actually contract your bowels, says Latorre. But, keep in mind, if you’re using laxatives regularly, that’s a sign you need to visit a gastroenterologist, she adds.
But yeah, don’t ignore it if you haven’t pooped in awhile: “Stool is waste matter,” says Chutkan. “It’s toxic, and it’s not supposed to be hanging around in your colon for several days at a time.”
So even if your symptoms aren’t bad enough for you to head to the hospital, you should still try to get your pipes moving—ASAP.