When Is Constipation an Emergency?

Most people have been constipated at least once in their lifetime. For some, this means going several days without a bowel movement when you usually are more regular. Or maybe you’re straining more to poop. Or you feel bloated. If you’ve been constipated in one way or another, you know how uncomfortable it can be.

But when is constipation actually an emergency or something you should be concerned about? Let’s take a closer look at some of the signs you should watch out for, and when it’s time to contact your healthcare provider. 

What causes constipation?

Constipation usually happens when stool moves slower than normal through your bowels. This can happen for several reasons including your lifestyle habits, medications, or medical conditions. 

Lifestyle habits

Your dietary and exercise habits can play a role in constipation. These include:

• An unbalanced diet: Eating a diet low in fiber is a common cause of constipation. Foods rich in fiber, such as vegetables, fruits, whole grains, and legumes add bulk to your stool and help it move along better. 

• Lack of hydration: Not drinking enough water is also a common cause of constipation. This makes the stool become hard, which is more difficult to pass. 

• Too little physical activity: Exercise and physical activity help keep the bowels moving, literally. Not having regular physical activity can cause constipation.

Medications

Certain medications have negative effects on the bowels and can slow down the movement of stool. A lot of them are even medications that are commonly used. Some common medications known to cause constipation are:

• Opioid pain medications, like oxycodone

• Iron supplements

• Antihistamines, like Benadryl

• Antidepressants, like amitriptyline and paroxetine

• Calcium channel blockers, like diltiazem

• Medications for overactive bladder, like oxybutynin

• Medications for nausea, like ondansetron

Medical conditions

In some cases, medical conditions that prevent the bowels from working normally cause constipation. These conditions include:

• Irritable bowel syndrome (IBS) 

• Hypothyroidism 

• Bowel obstruction or blockage

• Ileus (temporary paralysis of the bowels)

• Colon cancer

What are the signs and symptoms of constipation?

It’s not necessarily a bad thing if you don’t poop every day. Some people go every other day. But, it’s generally agreed that constipation is having fewer than three spontaneous bowel movements per week.

Other symptoms and signs of constipation include:

• Firm, hard stools

• Straining to pass stools

• Feeling like you haven’t completely emptied your bowel

• Passing thin stools or pellets 

• Abdominal pain

• Bloating

• Painful stooling

• Blood in stool

• Noticing your stool is clogging the toilet

How do you know if your constipation is serious?

Constipation can be uncomfortable, but it’s not often dangerous. That being said, you should still address your symptoms with a healthcare provider. There are signs that your constipation could be due to something more serious. These include:

• Discomfort, bloating, or the urge to have a bowel movement but you’re unable to do so 

• Nothing seems to be helping your symptoms, despite your best effort

• Blood mixed in your stool 

• Unintentional weight loss

• Feeling full easily

• Thinning hair or brittle nails

If you have any of these symptoms, your constipation may be due to one of the underlying medical conditions mentioned above. Your healthcare provider can do further testing to figure out what’s causing your constipation and how to best treat it.

When should you go to the ER for constipation?

In some instances, constipation does require an ER visit. This is to make sure your symptoms aren’t due to a medical or surgical condition that needs to be treated urgently. You should go to the ER if you have: 

• Severe abdominal or rectal pain 

• Vomiting

• Rectal bleeding

• Signs of an infection like fever, rapid breathing, high heart rate

• An inability to pass stool and feeling like it’s stuck 

In serious cases, these symptoms could be a sign of conditions that could need surgery, such as:

• Obstruction in the bowel

• Diverticular bleeding

• Hemorrhoids

• Colorectal or anal cancer

In the ER you may have some blood tests, an X-ray of the abdomen, or a CT scan if necessary. 

What happens if you stay constipated for too long?

Untreated constipation can lead to other conditions and cause other problems. Some of these conditions can include:

• Fecal impaction (large amount of hard stool stuck in the rectum)

• Anal fissure (small tear around the anus)

• Fecal incontinence (unable to control when you pass stool)

• Urinary incontinence (unable to control when you pass urine)

• Rectal prolapse (when the rectum falls out of the anus)

• Hemorrhoids (swollen veins near the rectum) 

• Diverticulosis (pockets in the bowel) 

• Stercoral colitis (inflammation in the colon from too much stool)

It’s hard to say how long you have to be constipated before you develop any complications. This will differ for everyone. That’s why it’s best to treat your constipation once you notice any symptoms. When you begin to manage your constipation, some of these other conditions can improve or be prevented as well. 

How to treat and prevent constipation at home

The good news is that you can treat and prevent constipation at home in most cases. Let’s take a look at some common ways to keep constipation at bay. These tips can help even if the constipation is caused by other medical conditions. 

1. Increase the amount of water you drink in a day 

It’s recommended that women drink at least 2.7 L and men drink at least 3.7 L of water daily. This can be easier said than done, so here are a few tips to help increase how much water you drink:

• Use a calibrated water bottle and carry it around. 

• Limit alcohol, caffeine, sun exposure and other things that cause dehydration.

• Add fruits to your water to improve the taste.

• Set an alarm to help keep you accountable and remind you to drink more water during the day.

2. Increase the amount of fiber in your diet 

Fiber helps to relieve constipation by adding bulk to the stool, making it larger and softer to move along. It’s recommended that women eat at least 25 g a day, and men eat at least 38 g a day. 

You can increase fiber in your diet by adding things like:

• Oatmeal

• Vegetables

• Fruits

• Nuts

• Chia seeds

• Flax seeds

• Psyllium

Taking in too much fiber can sometimes make you even more constipated. So it’s important to keep up your water intake. This will help to make sure the fiber works to relieve your constipation symptoms.  

3. Exercise regularly

Exercise and physical activity helps stimulate the bowels to keep things moving. Aim for at least 150 minutes of moderate-intensity physical activity a week. This can be broken down into 30 minutes, 5 days a week. Exercise also has a number of health benefits for your heart, mood, and weight.

4. Over-the-counter medications

Over-the-counter (OTC) medications can help manage symptoms of constipation. These include stimulant laxatives, stool softeners and enemas. Some examples of OTC medications for treating constipation are:

• Polyethylene glycol (Miralax)

• Magnesium citrate

• Bisacodyl (Dulcolax)

• Senna

• Docusate sodium (Colace)

You should start taking these medications under the direction of your healthcare provider. They will help to make sure there’s no underlying condition and which treatments are right for you.

If none of these treatments are working to control or prevent your constipation symptoms, let your healthcare provider know. 

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Written by:

Mobola Kukoyi, MD, MPH

Dr. Mobola Kukoyi is a board-certified emergency and trauma physician with expertise in medical education, consulting, and public health. She earned her medical degree from Duke University School of Medicine.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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