Constipation is a common gastrointestinal condition that causes physical and psychosocial problems.

Two forms of constipation are:

  • Slow transit constipation
  • Normal transit constipation

Slow transit constipation occurs when your colon fails to move waste fast enough through your large intestine. While there is a wide range of what is considered normal in terms of number of bowel movements per week, slow transit constipation usually results in fewer than normal bowel movements.

Normal transit constipation usually has a normal frequency of bowel movements. It is characterized by stools that may be hard, dry, and painful to pass.

What causes constipation?

There may be many contributing factors that result in constipation. It is important to seek your doctor’s advice to determine the causes in your individual case and begin addressing them through treatment.

Constipation symptoms

Symptoms of constipation include:

  • Straining bowel movements
  • Lumpy/hard stools
  • Feelings of incomplete evacuations
  • Feelings of anorectal blockage
  • Need for manual maneuvers to help evacuation
  • Nausea
  • Poor appetite
  • Diarrhea

Immediately call your doctor if you:

  • Feel weak or sick
  • Begin to vomit bile
  • Have vomiting with abdomen swelling
  • Have severe rectal pain

Diagnosing constipation

University of Iowa providers will obtain a thorough history and physical to aid in the diagnosis. After discussing your symptoms, your doctor may perform a colonoscopy to determine factors that may be causing your symptoms.

The colonoscopy followed by laboratory tests will identify a variety of colonic abnormalities such as an abnormally long colon or growths in the tissue lining the colon.

Treating constipation

Constipation can be treated with dietary counseling, medication, and sometimes surgery.


A daily amount of 25-30 grams of fiber could increase stool frequency and colonic transit. Fibers retain a stool’s water and thus a lack of fiber reduces intestinal motility, making bowel movements more difficult to pass. Drinking liquids will also ease bowel movements. Adults should drink six to eight glasses of water daily.


Medical management options may include

  • Laxatives to improve bowel movements
  • Regular enemas to flush the rectum of feces

Most patients with constipation respond to laxatives. If additional medications are required, your doctor will determine the best solution for your condition.


In severe cases, surgery may be needed. Because of the major impact and permanence of these procedures, they should be considered to be a course of last resort. One option is the removal of the colon. Another is the creation of an ileostomy.

Last reviewed: 
August 2018

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