When Is Constipation Considered an Emergency?
Medically reviewed by Jay N. Yepuri, MD, MS
It happens to about everyone at some point. You can't move your bowels, or your stool is so hard that it hurts to go. You're constipated and uncomfortable. Most of the time, you can get back on track within a few days with some self-care.
However, severe constipation is an emergency when you also have a fever, vomiting, or severe abdominal bloating and pain.
This article describes severe constipation, when it's an emergency, and how to relieve symptoms.
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Severe Constipation Symptoms
Typically, constipation is no cause for alarm. But chronic constipation is a sign that something isn't working right. And some symptoms suggest severe constipation that requires emergency care.
Takeaway
Severe constipation is typically accompanied by bleeding, fever, vomiting, or severe abdominal pain. Chronic constipation is repeated bouts of constipation over three months or more.
No Bowel Movements for an Extended Period
Some people have more than one bowel movement daily, while others have only a few a week. Both can be normal, depending on the person. Constipation is when you've had fewer than three bowel movements in a week. Other signs of constipation have to do with consistency, such as stool that is:
Dry
Lumpy
Difficult or painful to pass
Even when you go, you might feel you haven't passed everything. Straining every time or not having a bowel movement for a week are signs of severe constipation.
Abdominal Pain
Abdominal pain can accompany constipation due to trapped gas and hard stool. You may feel minor stomach cramps or sharp pains throughout your abdomen.
Bloating
The longer stool stays in your colon, the more time gut bacteria have to ferment it. That's how constipation traps gas in the abdomen, making you feel bloated and full. You might even have some visible abdominal distention.
Vomiting
Problems in the lower gastrointestinal tract can cause loss of appetite, nausea, and vomiting. It may be due to severe constipation, complications of constipation, or a gastrointestinal disease.
Blood in Your Stool
You might have rectal bleeding due to complications such as hemorrhoids (swollen veins in the lower rectum and inside or outside the anus) or anal fissures (small cracks and tears on the skin around the anus). Rectal bleeding with constipation can also indicate a condition such as diverticulitis or colon cancer.
Fever
Constipation doesn't cause a fever, so you likely have something else. Diverticulitis and appendicitis can cause both constipation and fever. It's also possible that the fever is unrelated to the constipation.
Complications of Severe Constipation
Straining and hard stools can lead to hemorrhoids and anal fissures. Severe constipation can lead to fecal impaction and rectal prolapse.
Fecal impaction is when you have a large amount of tightly packed hard stools that you can't push out. The mass blocks the path, making constipation even worse. Sometimes, a person with severe constipation can experience overflow diarrhea (paradoxical diarrhea) when watery stool leaks out around the impacted mass.
Untreated fecal impaction can lead to intestinal perforation, bowel obstruction, and ulceration. It can also affect other parts of the body, such as damage to the bladder or compression of nerve and vascular structures.
Rectal prolapse occurs when the intestinal lining pushes out from the anal opening. After a bowel movement, the protrusion may slip back into place, or you may be able to push it back in yourself. It may get worse if you continue to strain to move your bowels or have very hard stools.
When to See a Healthcare Provider
There's no set timetable for when constipation becomes an emergency. If self-care measures don't help, it's time to see a healthcare provider, especially if you have a personal or family history of colon or rectal cancer or unexplained weight loss.
Signs that you may need immediate care include constipation with:
Bleeding from the rectum or blood in your stool
Constant or persistent abdominal or lower back pain
Inability to pass gas
Vomiting
Fever
Constipation can be the primary problem or secondary to a medical condition or medication. If constipation is severe or chronic, it's important to determine the cause.
For fecal impaction, immediate treatment may involve abdominal massage and digital disimpaction. That's when a healthcare provider uses a gloved finger manually to break up and remove stool from the rectum. Other treatments may include suppositories or enemas.
Constipation Relief and Prevention Tips
A low-fiber diet, not drinking enough water, a sedentary lifestyle, and ignoring the urge to go can make constipation more likely. To help relieve or prevent constipation, try to:
Drink plenty of water
Exercise regularly
Go to the bathroom when you feel the urge
Eat more fiber
To increase dietary fiber, try to include more:
Whole grains: Whole wheat bread and pasta, oatmeal, and bran cereals
Legumes: Lentils, black beans, kidney beans, soybeans, and chickpeas
Fruits: Berries, apples, oranges, and pears
Vegetables: Carrots, broccoli, peas, and collard greens
Nuts: Almonds, peanuts, pecans
If you can't get enough fiber in your diet, try using fiber supplements that help absorb water and keep you regular. It might also help to avoid low-fiber foods such as ice cream, cheese, meat, and processed foods.
You can also try bowel training. The goal is to be more regular in attempting to move your bowels at the same time each day, say 15 to 45 minutes after breakfast. Try to relax and allow plenty of time. It can take a while to form a new habit.
Over-the-Counter Remedies
Some over-the-counter (OTC) remedies can help relieve constipation.
Stool softeners are oral liquids, tablets, or capsules that soften hard stool to make it easier to move your bowels with less straining. It usually takes a few days to work. Avoid using stool softeners longer than a week without speaking with a healthcare provider.
Bulk-forming laxatives bulk up the stool, which can help move it through. Stimulant laxatives cause contractions of the intestinal wall to help push stool through. And osmotic laxatives pull water into the intestinal tract, which makes it easier to pass stool.
These products are available without a prescription, but using them as directed is important. Misuse of laxatives can lead to:
Dependency on laxatives
Severe dehydration
Stretched or infected colon
Irritable bowel syndrome (IBS)
If you often need laxatives, consulting with a healthcare professional is best.
Related: The 6 Best Fiber Supplements of 2023, According to a Dietitian
Summary
You might feel constipated if you haven't gone for three days, while someone else feels constipated after just one day. If you're severely constipated, you might also have abdominal pain, bloating, and vomiting. You may need emergency care.
Unresolved constipation can lead to serious complications. Severe or chronic constipation can also signify an underlying condition. You can try increasing fluids and eating more fiber. Or you can use a stool softener or laxative. If this doesn't work, see a healthcare provider for diagnosis and treatment.
Read the original article on Verywell Health.
