When Is Constipation an Emergency? 5 Signs It's Time to See a Doctor, According to Gastroenterologists
Constipation is anything but comfortable—the bloating, fullness, and cramping is enough to make anyone want to park on the couch and stay there until it passes.
For the most part, constipation is a common occurrence. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that 16 out of every 100 adults have symptoms of constipation. But sometimes that inability to go number two is more than just a run-of-the-mill digestive issue, and turns into a need-to-see-a-doctor-ASAP issue.
So how do you know if you're dealing with a constipation emergency and need to seek medical treatment? Here, gastroenterologists weigh in on some of the more alarming symptoms of constipation—and what treatment for a more serious case of constipation looks like.
What is constipation—and how can it turn into an emergency?
First, it's useful to understand what's happening when you're constipated. The digestive system is essentially one long tube, starting at your throat and ending at your rectum, with twists and turns along the way, according to the NIDDK. Once food reaches your large intestine, the water in the food gets absorbed—that's when the waste products, or anything left over, becomes stool.
Normally, that stool will be evacuated, but when you get constipated, that stool builds up in your colon—often the sigmoid colon, which is at the very end of your digestive system right before your rectum—and blocks the flow. "All the gases and air are really backing up," Rudolph Bedford, MD, gastroenterologist at Providence Saint John's Health Center in Santa Monica, CA tells Health. It can make you uncomfortable and bloated until you're able to poop. Meanwhile, your colon continues to pull water out of the stool, making it harder and bumpier.
Technically speaking, the NIDDK says constipation is when you have any of the following symptoms:
- Fewer than 3 bowel movements a week
- Stools that are hard, dry, or lumpy
- Stools that are difficult or painful to pass
- Feeling like all stool hasn't passed
When should you see a doctor for constipation?
While the backed up stool will usually (eventually) pass, constipation can sometimes turn into a serious situation—first and foremost due to the pain that severe constipation can bring. But constipation can also be part of a more concerning condition, or lead to serious problems in your colon. These are the symptoms that mean you should get to a doctor ASAP, because your constipation has gone from routine to possible emergency.
1. When you have severe abdominal pain
As mentioned, constipation can be super uncomfortable. But if the discomfort and cramping goes from uncomfortable to seriously painful, it's time to seek help. "[Constipation] can sometimes feel worse than labor pain," Elana Maser, MD, assistant professor of gastroenterology at the Icahn School of Medicine at Mount Sinai and gastroenterologist at the Feinstein IBD Center at Mount Sinai Hospital in New York City tells Health.
That kind of pain needs to be managed, even while your doctor tries to help you have a bowel movement. And the pain itself isn't necessarily a signal that some other emergency is going on—one person can be severely constipated and in little discomfort while another person is only moderately constipated but in terrible pain. "The emergency is the pain," Dr. Maser says.
2. When there's blood in your stool
If you do manage to pass some amount of stool and it contains blood—or you see blood on the toilet paper when you wipe—check in with a doctor. "Everyone thinks they're hemorrhoids, but that could be the first manifestation of colorectal cancer," says Dr. Bedford. Colorectal cancer is the fourth most common type of cancer in the United States, according to the Centers for Disease Control and Prevention (CDC), killing more than 50,000 people each year.
Of course, seeing blood in the toilet or on your toilet paper doesn't automatically mean cancer, either. There are various other conditions—inflammatory bowel disease (IBD), anal fissures, or hemorrhoids—could be the reason you're seeing red. Regardless, it's essential to check in with your doctor to get whatever treatment is necessary.
3. When you haven't pooped in a week
If your constipation is new to you and you're not entirely sure how to handle it, see a doctor if it lasts for a week, Dr. Bedford says. By a week, your constipation might not yet be an emergency—but it's time to start getting a professional involved so things don't get worse.
Too long without a bowel movement could lead to fecal impaction, where stool hardens and bulks up so much that you can't pass it, Dr. Bedford explains. It's more common among elderly patients and people with other conditions that complicate their constipation, but it's still a threat. In that case, a doctor has to help the patient by breaking the stool up with their fingers. It's not especially pleasant for either party, and it can be a painful procedure. "The key is to never get to that position," Dr. Bedford says.
4. When you also have a fever
Constipation itself doesn't cause fevers. But if you have a fever and are constipated, that's a strong signal to get to a doctor ASAP. Most often, it signals that you might have a condition called diverticulitis. Diverticula are small pouches that can form in the colon. They usually don't cause problems, but sometimes they can become inflamed or infected, leading to a condition called diverticulitis. "That certainly will cause a fever along with abdominal pain," Dr. Bedford says.
Even in mild cases, you'll likely need a round of antibiotics to treat diverticulitis. Serious cases can cause blockages, bleeding, or tears in the colon—not something you want to mess with. If you're constipated and develop a fever, definitely see a doctor quickly.
5. If you're also vomiting
If you start vomiting while constipated, it could be a sign that your colon is seriously blocked, and you need to seek treatment immediately. "Vomiting and inability to keep food down...would be concerning," Dr. Maser says. Several conditions can cause vomiting, including fecal impaction, so your best bet is to get to your doctor quickly for an assessment.
What does treatment looks like during a constipation emergency?
Beyond doing a general physical and getting a history, your doctor might also order tests to see if there's an underlying condition causing your constipation, Dr. Bedford says, such as diabetes, hypothyroidism, or anemia.
Meanwhile, they might suggest enemas or a laxative to try to help you have a bowel movement. Depending on your age, after you're cleaned out, they may suggest a colonoscopy or sigmoidoscopy to make sure your colon is healthy—especially if there's blood in your stool, he says. If you're feverish, your doctor may order a CAT scan to figure out what's causing your fever. They'll be doing all these things in concert, Dr. Bedford says, to try to help you be more comfortable as soon as possible.
But even if reading this list makes you realize your constipation isn't an emergency, that doesn't mean it's a problem you should ignore. "There's no such thing as normal constipation," Dr. Bedford says. "Constipation in itself is an abnormal condition which you should do whatever you need to do to avoid."
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