When it comes to your bowel movements, it can be hard to tell when a little trouble crosses the line into chronic constipation territory. But since constipation can range from annoying poop problems to seriously worrisome, it’s basically priority number one when it’s been days since you’ve gone number two. Whether it’s the first time you haven’t pooped in a week and you’re freaking out or you’ve dealt with severe constipation for a while, here’s what you need to know about when to see a doctor for constipation.
Here’s what it actually means to be constipated.
The common conception of constipation is pretty straightforward: It basically means you can’t poop, right? Sure, yes. But if you’re trying to figure out the trouble you’re having with your bowel movements, “can’t poop” doesn’t exactly cover all that constipation can entail. Luckily, there are a couple of specific symptoms of constipation to be on the lookout for, according to the Mayo Clinic and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). If you’re dealing with any of the following, you can probably consider yourself constipated:
Passing fewer than three stools a week
Having poop that’s lumpy, hard, or dry
Needing to strain to poop
Feeling like there’s some sort of blockage preventing you from pooping
Feeling like there’s still leftover poop that you can’t empty no matter how hard you try
Needing help to poop, like pressing on your stomach or using your fingers to remove stool from your rectum
All that said, these symptoms can fall on a spectrum from “NBD” to “you should see someone about that.” Doctors generally think of constipation in two ways: occasional, meaning you experience these symptoms here and there, and chronic, which many professionals consider as experiencing at least two of these symptoms for three months or more, Kyle Staller, M.D., M.P.H., a gastroenterologist at Massachusetts General Hospital, tells SELF.
If your constipation is of the occasional variety, there are a few things you can try before looping in a professional.
Eating enough fruits, vegetables, and whole grains should be your first line of defense, Rudolph Bedford, M.D., a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, Calif., tells SELF. These foods contain fiber, which helps to keep your stool soft and easier to pass, according to the NIDDK. Women under 50 should try to get at least 25 grams of fiber per day, according to the Institute of Medicine. Fiber can’t do its job without sufficient liquid, though, so make sure you’re drinking enough water every day.
You can also make it a point to avoid constipation-causing foods for a bit, especially if you’ve been eating them a lot lately. Some of the biggest culprits include cheese (the high fat content can bulk up your poop too much, making it hard to pass), white rice (it also bulks up your poop), and green bananas (they’re packed with starch, which moves slowly through your digestive tract), Christine Lee, M.D., a gastroenterologist at the Cleveland Clinic, tells SELF.
If you’re not already, being active is another way to get things moving. Exercise helps increase the motility in your colon and encourages regular bowel movements, Dr. Staller says.
In general, it’s also important to actually go (or try to, at least) when your body is telling you to, Dr. Staller says. Your GI tract has a circadian rhythm it likes to follow, which is why you probably feel the urge to go at certain times and not others (and why travel, or anything else that disrupts your routine, can make it harder to go). “Many people neglect their body’s call to defecate, and that can lead to constipation, especially if the call is ignored again and again over time,” Dr. Staller says.
With that said, here’s when to see a doctor for constipation.
You shouldn’t hesitate to seek medical care any time you’re concerned, but doctors say there are certain times when constipation definitely requires a professional’s input. The following are signs you’re dealing with chronic constipation or otherwise severe constipation:
1. You’ve been outside your range of normal for over a week.
“Normal” poop schedules vary by person. For some people it’s going every day, for others it’s every three days, and some are in between, Dr. Bedford says. If you normally go pretty frequently and suddenly haven’t gone for longer than a week, it’s time to call your doctor, says Dr. Staller. This could be a sign of something like fecal impaction, which happens when hardened poop accumulates and gets stuck in your intestines, and which a medical provider may need to remove manually.
2. You’re in pain.
Constipation can cause pain because the poop builds up in your colon and stretches it, Dr. Lee says. That’s not something you should have to live with. Even if you’ve only been backed up for a few days, pain with constipation that won’t go away is definitely a reason to call your doctor, says Dr. Lee. They may be able to recommend something like a laxative that makes it easier to go.
3. There’s blood on your toilet paper.
If you strain to go and notice some blood on your TP, it could be due to a small tear in your anus, known as an anal fissure, or hemorrhoids, which are inflamed veins in or around your anus. It could even just be because you wiped too hard. But in rare cases, seeing blood when you poop could also be a sign of something more serious, like colon cancer. You should check in with your doctor so they can evaluate you and rule out anything serious.
4. There’s a possibility your medication is the cause.
Various drugs can lead to constipation. Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit certain enzymes in your body from producing prostaglandins, which are hormone-like substances that can signal various muscles—including those in your digestive system—to contract, which can help you poop. (Sometimes the release of prostaglandins can make you poop too much, like during your period.) Some blood pressure medications reduce how often the smooth muscles in your intestines contract and move food along. Narcotics can also lead to constipation through a variety of mechanisms, like inhibiting your GI tract’s ability to push food through your system.
Other medications, like allergy drugs, antacids, and iron pills can all back you up, too, according to the Cleveland Clinic. If your constipation kicked off when your new medication regimen did, your doctor may be able to suggest other drug options without this frustrating side effect.
5. You’ve been constipated for weeks and you have no idea why.
Usually, you have some clue as to why you’re constipated. Maybe you haven’t been able to get to the gym much lately, or you’ve been on a serious cheese kick. But if you have no idea what’s going on and changing up your diet and lifestyle choices doesn’t help, it’s time to see your doctor, Ashkan Farhadi, M.D., a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, Calif., tells SELF. It’s possible you may have an underlying condition, like irritable bowel syndrome, he says.
Once you check in with your doctor, they’ll probably order some blood tests and perform exams to try to determine whether there’s a medical reason why you can’t poop. Depending on the results, they’ll advise you on next steps, which could be as simple as making some lifestyle and dietary tweaks, trying laxatives, or trying other medications to speed up how quickly your stool moves. Don’t be embarrassed—this is their job, after all. Sometimes seeing a doctor is just a necessary step towards spending less time worrying about constipation and more time actually enjoying your life.
Originally Appeared on SELF