Treating Abdominal and Back Pain From Constipation

Medically reviewed by Jane Kim, MD

Constipation causes abdominal pain because it slows the stool movement through the intestines, increasing abdominal pressure. The pain may feel crampy or sharp. It typically occurs in the lower abdomen, though it may radiate to the back. Additional constipation symptoms include difficulty passing stool, dry or hard stool, or the feeling of incomplete bowel movements.

This article reviews symptoms of abdominal pain from constipation, possible causes, relief, and prevention.

Symptoms of Abdominal Pain From Constipation

Signs of constipation include infrequent bowel movements (pooping less than three times a week), difficulty passing stool, abdominal discomfort, and hard or dry stools.

Sensation

Abdominal pain from constipation may feel like a sharp twinge or cramps. Pressing on the abdomen may worsen the pain because it increases the pressure from slow stool movement in the intestines. You may also experience fullness, bloating, a feeling of not fully emptying your bowels, and nausea.

Location

Many people feel constipation symptoms in the right or left lower abdomen. However, it may cause discomfort throughout the belly, extending to the upper abdomen. If fecal impaction (a build-up of stool) is causing your constipation, the hard stool can press on nerves in your lower back and contribute to back pain.

Frequency

Pain from constipation lasting less than one week (acute) may be intense and sudden. Constipation that lasts more than three months (chronic) may cause persistent discomfort. Infrequent or difficult bowel movements can contribute to the recurrent nature of the pain.

Related: Pelvic Pain in Women and Men

What Causes Abdominal Pain and Constipation?

Constipation causes an accumulation of stool in the intestines. It can also increase gas production, cause intestinal distention (swelling), and put pressure on the surrounding nerves. The pressure, swelling, and gas can stimulate pain receptors, leading to abdominal pain.

The following factors can lead to constipation:

• Hormone fluctuations

• Low fiber diet (fiber adds bulk to stool, aiding in its movement)

• Low fluid intake (can harden stools)

• Lack of physical activity or long periods of immobility

• Side effects of certain medications (e.g., opioids, antacids with aluminum or calcium, and some antidepressants)
  

• Underlying health conditions

Some underlying health conditions that can cause constipation include:

• Cancer or strictures (narrowing) in the large intestines

• Endometriosis with IBS-C patterns

• IBS with alternating constipation and diarrhea (IBS-M)

• Inflammatory bowel disease (IBD) such as Crohn’s or ulcerative colitis

• Irritable bowel syndrome with constipation (IBS-C)

• Metabolic or endocrine conditions (e.g., diabetes, thyroid disease, electrolyte disturbances, or kidney problems)

• Neurological conditions like multiple sclerosis (MS) or Parkinson’s disease
  

• Pelvic floor dysfunction (problems with muscles that support organs like the bladder and intestines)
  

Nervous System and Vagus Nerve Regulation

The vagus nerve supports the communication between the gut and brain—known as the "brain-gut axis." It helps regulate nervous system-controlled functions like breathing, heart rate, digestion, and bowel movements. Nervous system problems can disrupt muscle movements that move food through the intestines and out of the body, leading to constipation.

Related: The Brain Gut Connection in IBS

How to Treat Constipation and Manage Abdominal Pain

How Should You Sit on the Toilet When Constipated?

Sitting on the toilet with your feet on a stool, so your knees are higher than your hips, may help relax the pelvic floor muscles and aid bowel movements.

A warm compress on the abdomen, a warm bath, or a gentle abdominal massage can help alleviate abdominal pain due to constipation. The following may also provide constipation relief:

• Coffee

• Drinking a glass of warm water

• Dulcolax (bisacodyl) or glycerin suppositories

• Enemas

• Gentle exercises, like walking

• Prune juice

You can use over-the-counter (OTC) stool softeners like Colace (docusate sodium)
and OTC oral laxatives like Miralax, milk of magnesia, Senokit, or ExLax for occasional constipation, but should not be used regularly.

Additionally, pelvic floor therapy helps strengthen or relax pelvic floor muscles that may contribute to constipation. 

Use Caution With Suppositories, Laxatives, and Enemas

Use suppositories, laxatives, and enemas cautiously and under medical supervision. Over-reliance can disrupt bowel function or lead to side effects like dehydration.

Related: Guide to Over-the-Counter Laxatives

Staying Ahead of Constipation and Abdominal Pain

The following may help you stay ahead of abdominal pain due to constipation:

• Avoid excess use of laxatives or enemas

• Consider pelvic floor exercises for pelvic floor dysfunction

• Drink plenty of fluids (especially water)

• Eat a high-fiber diet (fruit, vegetables, whole grains, beans) or take fiber supplements 
  

• Engage in regular physical activity

• Establish a consistent bathroom routine to promote regular bowel movements

• Identify and manage trigger foods by using a food diary

• Include probiotics in your diet

• Manage stress through relaxation techniques
  

Consult a healthcare provider for persistent constipation or pain.

Related: Supplements and Herbs for Diarrhea, Constipation, and Stomach Discomfort

When to See a Healthcare Provider

Occasional constipation is common and is typically manageable with lifestyle adjustments or home remedies. However, if you experience persistent or severe constipation or abdominal pain, seek medical evaluation. The following are indicators that you should consider seeing a healthcare provider:

• Accompanying symptoms like nausea, vomiting, fever, or abdominal swelling

• Alternating patterns of constipation and diarrhea

• Blood in the stool

• Family history of colorectal health concerns

• No relief from home remedies, OTC medications, dietary modifications, or lifestyle changes

• Persistent symptoms (constipation and abdominal pain that last for a week or more without improvement)

• Pre-existing conditions (e.g., IBS, endometriosis)

• Severe pain (if abdominal pain is severe, debilitating, or interferes with your daily activities)
  

• Unintended weight loss
  

• You suspect underlying health conditions or medication side effects 
  

Related: Abdominal Pain: When Should I See a Healthcare Provider?

Summary

Signs of constipation include infrequent bowel movements, difficulty passing stool, abdominal discomfort, and hard or dry stools. Low fiber intake, dehydration, a lack of physical activity, underlying health conditions, or certain medications may contribute to constipation.

To address constipation, consider lifestyle changes such as adopting a high-fiber diet, drinking plenty of fluids, regular exercise, home remedies, and brief use of over-the-counter laxatives or enemas. If symptoms persist, especially severe pain, blood in your stool, or unexplained weight loss, consult a healthcare provider.

Read the original article on Verywell Health.