When’s the last time you pooped? If your answer is “three days ago,” that might mean you’re constipated. But if you have little rabbit poops multiple times a day and never feel quite finished, you could also be constipated. The symptoms of constipation look different for everyone, and many people who are constipated have no idea.
New research by King’s College London, published in the American Journal of Gastroenterology last week, found there’s a discrepancy between what people think constipation is and what it actually is. The team, including lead author Eirini Dimidi, PhD, RD, collected data from 2,557 people (934 of whom had self-reported constipation), 411 general practitioners, and 365 gastroenterology specialists.
“We kept meeting people who would tell us they suffered from constipation, but, when we screened them against the formal diagnostic criteria used around the world, they wouldn’t meet the criteria,” says Dr. Dimidi, a research associate at King’s. Conversely, only one third of those who reported constipation symptoms recognized those symptoms as constipation, she says.
So, what exactly is constipation?
New York-based gastroenterologist Rita Knotts, MD, says that some of the telltale signs include having less than three bowel movements per week, having to use your your finger get things moving, having hard or lumpy poop, straining to poop, or having an incomplete poop. Should you experience at least two of these symptoms for at least three to six months, you might get an official constipation diagnosis. One of the biggest reasons for misconceptions about constipation is that people are always comparing themselves to others.
“Women always say to me, ‘I don’t go like my husband does, my husband goes after every meal. He eats and he goes,'” says Dr. Knotts, an assistant professor of medicine at NYU Langone Health. “But everybody’s bowels are different and everybody’s colons are different.”
Niket Sonpal, MD, a New York-based internist and gastroenterologist says another misconception is that you can’t be constipated while pooping frequently.
“Just going to the bathroom doesn’t mean that you had a full bowel movement,” says Dr. Sonpal. “It’s not just about yea or nay, poop.” Constipation is about also the quality, the shape, the consistency, the color, and whether or not you feel empty. If your poop falls under type one (separate, hard lumps) or two (lumpy and sausage-like) on the Bristol Stool Scale, he says you’re constipated.
Dietary issues are a frequent cause of constipation. Increased intake of water and fiber can help, says Dr. Sonpal. If that doesn’t work, it’s time to consult your doctor. Anything from a weak pelvic floor to medication side effects to stress and mental-health issues can contribute to constipation.
“Not everybody is aware, or sensitive to these things, and if it’s been going on for a really long time, you won’t necessarily classify yourself as being constipated. You just think this is like a part of your life,” says Dr. Knotts. “It’s always good to just ask a health-care provider, because you shouldn’t suffer.”
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