Constipation is one of the most ubiquitous gastrointestinal issues experienced by many individuals. Some people experience constipation once or twice a week, while others become inured to their chronic recurrent episodes. Because of its prevalence, many dismiss it as a minor inconvenience. However, altered bowel habits can have a far greater impact on health than most people realize.
In this article, Assoc. Prof. Dr. Sathaporn Manatsathit invites readers to explore constipation in greater depth—from common behavioral causes to more serious underlying conditions that require appropriate medical attention. He also offers guidance on colorectal cancer screening to help readers recognize and manage the risks effectively.
Constipation: A Minor Discomfort or A Sign of Something Serious?
Constipation is a common gastrointestinal condition that may occur at any age but is especially prevalent among older adults and those leading a fast-paced, sedentary lifestyle, with heightened stress, anxiety, depression, or habitual suppression of the urge to defecate.
Assoc. Prof. Dr. Sathaporn explained, “Our body reflexively triggers an urge to defecate in the morning or approximately 15–30 minutes after a meal. However, modern busy lifestyles, including rushing to school or work, often leave little time for proper bowel habits. In many cases, once people leave home, heavy traffic or busy schedules compel them to suppress the urge or delay using the restroom until the sensation becomes intense. Habitual defecation suppression can gradually disrupt normal bowel function and contribute to chronic constipation. Some individuals may go several days or even a week without a bowel movement, resulting in hard, dry stools that require excessive straining and cause discomfort or pain. Over time, this straining may increase the risk of hemorrhoids or lead to more concerning symptoms, including rectal bleeding.”
The term “constipation” is often understood as not having a daily bowel movement, passing a volume of stool that seems smaller than the amount of food consumed, prolonged straining, hard stools, smaller stool size, or a feeling of incomplete evacuation. Some of these common understandings align with the medical definition, while others do not.
Therefore, if you suspect that you are constipated, it is important to seek medical consultation for a comprehensive evaluation. The consultation is especially crucial when hemorrhoids are present, as they often indicate a history of recurrent or chronic constipation. Although many patients seek medical attention specifically to treat their hemorrhoids, they frequently fail to address or manage the underlying constipation seriously and consistently.
Behavioral Causes of Constipation
Assoc. Prof. Dr. Sathaporn explains that constipation is seldom due to a single factor. Instead, it is the cumulative consequence of various daily habits and behaviors, such as:
- Dietary habits: Many individuals often consume a low-fiber diet, do not drink enough water, and heavily rely on processed foods, which can harm gut health.
- Modern work lifestyle: This is common among office employees who are sedentary for prolonged periods with minimal physical activity and often delay using the restroom. Habitual suppression of defecatory urge can slow intestinal peristalsis and gradually reduce bowel mobility over time.
Medical and Disease-Related Causes of Constipation
Another contributing factor to constipation is the presence of existing medical conditions or underlying diseases that may have gone undiagnosed. In some cases, constipation may serve as an early warning sign of a disease. In other cases, it may manifest as the condition progresses.
Contributing factors include:
- Neurological diseases: The conditions include Parkinson’s disease, dementia, depression, stroke (ischemic or hemorrhagic), and spinal cord disorders, which can affect bowel movement control.
- Endocrine and metabolic disorders include diabetes, hypothyroidism (an underactive thyroid), hyperparathyroidism (an overactive parathyroid), and adrenal insufficiency, which can slow down intestinal motility.
- Structural and functional bowel disorders: These include colon tumors, abdominal adhesions, chronic inflammatory bowel disease (IBD), hernias, intestinal dysmotility, or anal sphincter dysfunction. Constipation may present as an initial warning sign or a secondary complication.
- Pregnancy: During pregnancy, the enlarging uterus mechanically compresses and displaces the intestines, reducing their peristaltic activity. As a result, constipation is common among pregnant women and often becomes more pronounced as gestational age advances.
- Side effects from medications: Many commonly prescribed medications can contribute to constipation. These include certain analgesics, particularly opioids, iron supplements, calcium supplements, cardiovascular medications, antihypertensive agents, psychotropic medications, and anticonvulsants.
When Does Constipation Require Medical Attention?
Assoc. Prof. Dr. Sathaporn added, “Once we recognize that constipation is not merely a behavioral issue but may be associated with underlying diseases, intestinal abnormalities, or even serve as a warning sign of hidden conditions, consultation with a gastroenterologist can help identify the true underlying cause and develop an appropriate treatment plan.”
Warning signs of constipation that require prompt medical attention
- A change from normal bowel habits to persistent constipation lasting more than three months
- Long-term constipation that changes to normal bowel movements or chronic diarrhea for more than three months
- Persistent alternating episodes of constipation and diarrhea
- Blood in the stool
- Unexplained weight loss
- Abdominal pain accompanied by other concerning symptoms
Is Constipation Related to Colon Cancer?
Assoc. Prof. Dr. Sathaporn further explains, “Many medical conditions can lead to constipation, including intestinal obstruction, irritable bowel syndrome, and hypothyroidism. Colorectal cancer is also among the potential causes of constipation.”
Currently, colonoscopy plays a pivotal role in the early detection of abnormalities, particularly in individuals at high risk for colorectal cancer:
- Adults aged 45 years and older
- Individuals with a family history of colorectal cancer in first- or second-degree relatives
- Individuals who experience a significant change in bowel habits, such as from normal bowel movements to chronic constipation
“Even individuals without any symptoms who are 45 or older or have grandparents, parents, siblings, or distant relatives such as aunts or uncles with a history of colorectal cancer should undergo colonoscopy.” Assoc. Prof. Dr. Sathaporn emphasized.
Furthermore, for individuals who have already undergone a colonoscopy, doctors may recommend follow-up screenings based on their specific risk levels—typically every 5 years. In certain cases, these repeat screenings are advisable sooner to detect colorectal cancer early on.
The Benefits of Colonoscopy Go Beyond Cancer Screening
A colonoscopy is a screening procedure for colorectal cancer that allows doctors to visualize the lining and structure of the colon using a high-definition endoscope. It can also detect other abnormalities related to bowel health, including:
- Identifying abnormal polyps before they progress to cancer
- Removing polyps on the same sitting without the need to schedule for a separate surgery
- Effectively minimizing the risk of colorectal cancer.
- Diagnosing and treating other colon conditions, such as abnormalities of the colon and rectum, and identifying and managing sources of gastrointestinal bleeding
Assoc. Prof. Dr. Sathaporn emphasizes, “Cancer screening is not only about determining whether one is at risk. It is a proactive approach to preventive health care, ensuring that the colon remains healthy and functioning well over time.”
Colonoscopy for Colorectal Cancer Screening: Preventive Health Care for Everyone
At MedPark Hospital, we recognize the importance of maintaining colon health as part of comprehensive, holistic care. We thoughtfully design our colonoscopy screening program with careful attention to patient safety, convenience, and peace of mind.
“At MedPark Hospital, our highly experienced Gastroenterology and Hepatology specialists in advanced endoscopies perform the colonoscopy procedure. We utilize advanced endoscopic technology with high-definition imaging, enabling doctors to detect even subtle abnormalities. All diagnostic and therapeutic procedures adhere to strict medical standards. Our professional nursing team provides close guidance on bowel preparation at every step.”
Taking Care of Your Health Starts with Lifestyle Adjustments and Ongoing Body Awareness.
Assoc. Prof. Dr. Sathaporn shares this message of care with readers: “Taking care of your gut health can start with simple habits, such as not putting off bowel movements, maintaining a regular schedule, staying physically active, eating enough fiber, and paying attention to even subtle changes in your body.”
Good gut health is foundational to overall well-being. A colonoscopy is not something to fear but rather a proactive, long-term approach that can significantly reduce the risk of colorectal cancer.
