Constipation refers to bowel movements that are infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement.

Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week.

Common causes of constipation include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders.

Underlying associated diseases include hypothyroidism, diabetes, Parkinson’s disease, celiac disease, non-celiac gluten sensitivity, colon cancer, diverticulitis, and inflammatory bowel disease.

Medications associated with constipation include opioids, certain antacids, calcium channel blocker, and anticholinergics.

Causes of constipation can be:

Primary or functional constipation is defined by ongoing symptoms for greater than six months not due to an underlying cause such as medication or medical conditions. It is associated with abdominal pain, thus distinguishing it from irritable bowel syndrome. It is the most common kind of constipation. Some primary causes include dietary choices such as insufficient dietary fiber or fluid intake, or decreased physical activity.

Secondary constipation includes side effects of medication such as opiates, endocrine and metabolic disorders such as hypothyroidism, and obstructions such as colorectal cancer. Celiac disease and non-celiac gluten sensitivity may also present with constipation.