Constipation is a common problem defined as infrequent, difficult, or incomplete bowel movements. At the Michigan Bowel Control Program, part of the University of Michigan’s Division of Gastroenterology, our multidisciplinary team has been trained in a variety of disciplines including gastroenterology, urogynecology, colorectal surgery, physical therapy, psychiatry, nursing, and nutrition counseling. In addition, our doctors and nurses offer over 100 years of combined experience in treating chronic bowel conditions and can provide the necessary expertise to properly interpret the results of sophisticated gastrointestinal tests and provide you with an individualized treatment plan that’s right for you.

Constipation Symptoms

Normal bowel movement frequency may range from three bowel movements per day to three bowel movements per week. If you have less than three bowel movements a week, it’s considered to be constipation. However, constipation can have other defining features, such as: 

  • The passage of hard, pellet-like stools
  • A decrease in typical bowel movement frequency (not necessarily less than three bowel movements a week)
  • The need to strain when having a bowel movement
  • A sense of incomplete evacuation of the rectum with a bowel movement
  • The need to use enemas, suppositories, oral laxatives, or other means to maintain regularity of bowel movements 

There are many reasons for the development of constipation. These include dietary and lifestyle habits, medications, and behavioral issues. For some, constipation may be a symptom associated with a medical condition, such as multiple sclerosis, stroke, hypothyroidism, kidney failure, and depression. There can also be more than one underlying cause for constipation. 

Testing for Chronic Constipation

While mild constipation is often diagnosed with a medical history and physical exam and treated with diet and exercise, those with chronic constipation generally need more extensive testing and treatment. 

For those with chronic constipation, it’s important for your medical team to rule out other conditions that have constipation as a symptom, such as a blockage in your intestine or colon, or irritable bowel syndrome. You may be required to have one or more tests, such as: 

  • Barium enema x-ray: Exam using barium, a contrast dye, to view the colon, lower part of small intestine, and rectum
  • Colonoscopy: Exam of the colon and rectum
  • Sigmoidoscopy: Exam of the lower part of colon and rectum
  • Colorectal transit study: Exam to study movement of stool through the colon
  • Anorectal function test:  Exam evaluating sensation of the rectum and function of the anal sphincter
  • Defecography: A dynamic X-ray that evaluates the evacuation of stoll from the rectum

Once testing is completed, our team of medical professionals—including those from gastroenterology, urogynecology, colorectal surgery, physical therapy, psychiatry, nursing, and nutrition counseling disciplines—work together to interpret your tests, diagnose your condition, and create an individualized treatment plan.

Chronic Constipation Remedies and Treatments

There are a variety of treatments to provide constipation relief, whether the constipation is mild or severe, including:

Diet and lifestyle adjustments: Adding fiber to your diet, drinking plenty of water, exercising, and not waiting to empty your bowels can improve your constipation. Our team will discuss an adjustment plan for you if needed. 

Laxatives and prescription medications: A variety of laxatives are available. If a laxative is recommended, we will explain the different types and suggest one that is best for you. If laxatives don’t provide relief, a prescription medication may be recommended.

Physical therapy:  Used to retrain the muscles of the pelvic floor when they are not working properly.  This may include the use of biofeedback, which is a treatment using visual cues to  help one better understand muscle function of the pelvic floor and rectum.

Surgery: If other treatments don’t help with chronic constipation, surgery to remove part of the colon may be necessary. Surgery may also be needed if chronic constipation causes severe rectal prolapse (where straining causes part of intestinal lining to protrude from the anus). 

For more information on constipation, read our Frequently Asked Questions About Colonoscopy.

Other Information About Digestive and Liver Health

To see related medical services we offer, visit our Digestive and Liver Health overview page.

Make an Appointment

To schedule an appointment to discuss chronic constipation or any other gastrointestinal problem, call us at 888-229-7408.