When Is Constipation an Emergency? Know the Danger Signs

Most people have been constipated at least once in their lifetime. Sometimes, this means going several days without a bowel movement when you’re usually more regular. You might also be straining more to poop or feel bloated. If you’ve been constipated, 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 team. 

What are the danger signs of constipation?

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

These signs include:

• Discomfort, bloating, or the urge to have a bowel movement but being unable to go 

• Symptoms that don’t seem to get better, even after trying your best

• 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 an underlying medical condition. Your healthcare team 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 a visit to the ER. This is to make sure your symptoms aren’t caused by a medical or surgical condition that needs urgent treatment. 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, or 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 medical intervention or even surgery, such as:

• Obstruction in the bowel

• Diverticular bleeding or infection

• Volvulus (twisting of the bowels)

• Bowel perforation (a hole or tear in the intestines)

• An incarcerated or strangulated hernia (a hernia that is stuck and can’t be pushed back in)

• Ileus (temporary paralysis of the bowels)

• Colorectal or anal cancer

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

What are complications of severe constipation?

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

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

• Anal fissure (small tear around your anus)

• Fecal incontinence (loss of control over bowel movements)

• Urinary incontinence (loss of control over your bladder)

• Rectal prolapse (when part of your rectum falls out of your anus)

• Hemorrhoids (swollen veins near your rectum) 

• Diverticulosis (pockets in the wall of your bowel) 

• Stercoral colitis (inflammation of your 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 as soon as you notice any symptoms. When you begin to manage your constipation, some of these other conditions can improve or be prevented as well.

What causes constipation?

Constipation usually happens when stool moves slower than normal through your bowels. This can happen for several reasons, including:

• 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 can make your stool hard, which is more difficult to pass. 

• Too little physical activity: Exercise and physical activity help keep your bowels moving — literally. Not getting regular physical activity can cause constipation.

• Certain medications: Some common medications known to cause constipation include opioid pain medications, iron supplements, and tricyclic antidepressants, among others.

• Certain medical conditions: Sometimes a medical condition can prevent your bowels from working like normal. Conditions that can lead to constipation include irritable bowel syndrome (IBS), hypothyroidism, bowel obstruction (blockage), ileus (temporary paralysis of the bowels), and colon cancer.

What are symptoms of constipation?

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

Other symptoms of constipation include:

• Firm, hard stools

• Straining to pass stools

• Feeling like you haven’t completely emptied your bowels

• Passing thin stools or pellets 

• Abdominal pain

• Bloating

• Painful bowel movements

• Blood in your stool

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 strategies can help even if constipation is caused by other medical conditions:

• Drink plenty of water. Exactly how much water you need depends on a range of factors. As a general guideline, women should aim to drink about 2.7 L per day, while men should get about 3.7 L of water per day. 

• Add fiber to your diet. Fiber helps to relieve constipation by adding bulk to stool, making it larger and softer to move along. It’s recommended that women get at least 25 g per day and men get at least 38 g per day. Foods high in fiber include different grains, fruits, vegetables, and nuts. Taking in too much fiber can sometimes make you even more constipated. So, make sure to drink plenty of water as well. 

• Stay active. Exercise and physical activity help stimulate your bowels and keep things moving. Even a little light movement, like walking, can go a long way to prevent and treat constipation.

• Consider taking an over-the-counter (OTC) medication. There are a range of OTC medications to treat constipation, including stimulant laxatives, stool softeners, and enemas. It’s best to check in with a healthcare professional first. They can help you figure out the best option for you.

• Try an abdominal massage. Gently massaging your belly, along the path of your large intestine, may help stool move faster through your bowels. This may ease constipation and lessen gas and bloating. Again, it’s best to check in with your healthcare team first, so they can show you how to do the massage and make sure it’s best for you.

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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:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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