Almost everyone deals with constipation now and then. A trip, a change in routine or a new medication can slow things down for a few days. The question most people actually have is when it stops being a nuisance and becomes something a specialist should look at. This guide from the gastroenterologists at Centers for Gastroenterology is meant to help you answer that.

Is It Chronic, or Just a Slow Week?

Doctors generally consider constipation chronic when symptoms like these have been present for at least three months:

• Fewer than three bowel movements a week
• Hard or lumpy stools
• Straining most of the time
• A feeling that you have not fully emptied
• Needing to press on the abdomen or use other maneuvers to pass stool

Short bursts that clear up once your routine returns to normal are usually not a cause for concern. A pattern that keeps coming back, or never quite goes away, is worth a closer look.

What Usually Drives It

Chronic constipation rarely has a single cause. Common contributors include:

• Low fiber intake, not enough fluids and limited physical activity
• Medications such as some pain relievers, antacids, antidepressants and iron supplements
• Thyroid problems and other hormonal changes
• Irritable bowel syndrome with constipation, sometimes called IBS-C
• Pelvic floor dysfunction, where the muscles that control bowel movements do not coordinate properly
• Less often, a narrowing or blockage in the colon

Constipation is one of the intestinal and rectal conditions our team evaluates regularly, alongside related issues described on our intestinal and rectal diseases page.

Situations That Make Constipation More Likely

Some stretches of life come with a higher risk of constipation, and knowing that can help you plan ahead:

• Older age. Bowel movements can slow with age, and older adults are more likely to take medications that contribute.
• Pregnancy. Hormonal changes and prenatal iron supplements often slow digestion.
• After surgery or an injury. Opioid pain medication and reduced movement are a common combination for constipation. Ask about a bowel plan before you go home.
• Travel and schedule changes. Different food, less water and ignoring the urge to go can all slow things down.
• Long-term health conditions. Diabetes, Parkinson’s disease and some neurological conditions can affect how the bowel moves.

If one of these applies to you, mention it at your visit. It helps your physician narrow down the cause and choose the right treatment, and it may mean the problem is easier to fix than you expected.

Reasonable Steps to Try at Home First

For mild, recent constipation without warning signs, simple changes are a sensible first step:

• Increase fiber gradually from fruits, vegetables, beans and whole grains, or with a fiber supplement
• Drink enough water through the day
• Stay active, since movement helps the bowel move too
• Give yourself unhurried time in the bathroom, ideally at a similar time each day
• Ask your prescriber or pharmacist whether any of your medications could be contributing

Over-the-counter laxatives can help in the short term, but if you find you need them regularly, that is a sign to talk with a physician rather than keep self-treating.

Symptoms That Should Move Up Your Appointment

Schedule a visit with a gastroenterologist sooner rather than later if constipation comes with:

• Blood in or on the stool, or rectal bleeding
• Unexplained weight loss
• Significant abdominal pain or swelling
• Stools that have become noticeably narrower
• A new change in bowel habits after age 45, especially if you have not had colorectal cancer screening
• A family history of colorectal cancer or inflammatory bowel disease

These symptoms usually have a manageable explanation, but they should be checked rather than waited out.

What the Specialist Visit Involves

Your first appointment focuses on your history: how long symptoms have lasted, what your bowel habits look like, your diet and your medications. It helps to bring a short log of your bowel movements and a list of everything you take, including supplements. You can also fill out patient forms before your visit.

Depending on what your physician finds, testing may include:

• Blood work, including thyroid levels
• A colonoscopy to look at the colon directly, especially when warning signs are present or screening is due
• Anorectal manometry, which measures how well the muscles of the rectum and anal sphincter work together. This study is performed at our Loveland office.
• Other studies that track how quickly stool moves through the colon, when your physician thinks they will help

These tests help separate slow-moving bowels from problems with the muscles used to pass stool, which matters because the two are treated differently.

Treatment Built Around the Cause

Once the cause is clearer, your gastroenterologist can recommend a plan that fits it. Depending on your situation, that may include targeted diet and fiber changes, specific laxatives used on a schedule, prescription medications that help the bowel move, or pelvic floor therapy for people whose muscles are not coordinating well. If constipation is part of IBS, treatment addresses the broader pattern of symptoms, and our IBS page explains how that condition is managed.

Improvement often takes some trial and adjustment, and results vary from person to person. Follow-up visits give your physician a chance to fine-tune the plan.

Get Answers About Constipation in Northern Colorado

If constipation has been going on for months, or it comes with any of the warning signs above, our gastroenterologists can help you find the cause. Reach our Fort Collins team, our Loveland team or our Greeley team, or schedule online.