What can cause abdominal pain and constipation?

Abdominal pain is a common symptom of constipation, so they often occur together. There are many reasons why people experience abdominal pain and constipation, ranging from certain lifestyle factors to severe medical conditions.

Constipation is a widespread condition that can affect people of any age. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), around 16 out of 100 adults in the United States experience symptoms of constipation.

In this article, we list the symptoms of constipation and abdominal pain and explore some potential causes. We also look at when to see a doctor and treatment options.

Symptoms of constipation

Abdominal pain may be a symptom of constipation.

The NIDDK define constipation as having fewer than three bowel movements a week.

Other symptoms of constipation include:

abdominal pain

difficulty or pain when passing stools

hard, dry, or lumpy stools

the sensation that the bowel is not empty after having a bowel movement

Symptoms of abdominal pain

Abdominal pain can vary in type, severity, and duration. When it accompanies constipation, abdominal pain may cause the following:

a dull ache in the stomach

cramping pains

bloating or excess gas

loss of appetite

Possible causes

There are many causes of abdominal pain and constipation. We discuss some of these below:

Dietary choices

Eating a low-fiber diet increases the risk of constipation and abdominal pain. Dietary fiber is essential for healthy bowel movements because it helps bulk up and soften stool, which allows it to pass more easily through the intestines.

A 2012 meta-analysis found that dietary fiber intake increased the frequency of bowel movements in people with constipation.

According to the NIDDK, people should aim to eat between 25 and 31 grams (g) of fiber each day. However, people who want to add more fiber to their diet should do so gradually.

Making sudden or extreme changes to eating habits can also cause changes in bowel movements. Hydration is also essential for constipation relief, as water softens stool and helps it move through the bowel.

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Stress and anxiety

There is a link between the nervous system and the digestive system, which scientists refer to as the gut-brain axis. Research suggests that stress and anxiety can affect the bacteria in the gut, leading to bowel problems.

Depression and other mood disorders, as well as lifestyle factors that contribute to stress, can also trigger abdominal pain and constipation in some people.

Medications and supplements

Some medications and dietary supplements can worsen or cause constipation. According to the NIDDK, the following types of medication can contribute to constipation:

antacids containing aluminum and calcium

anticholinergics

antispasmodics

anticonvulsants

calcium channel blockers

diuretics

narcotic medicines for pain relief

some antidepressants

Mineral supplements that may cause constipation include iron and calcium.

Lack of physical activity

Exercise can increase the contraction of muscles in the intestines, which can help push stool along.

A sedentary lifestyle may lead to abdominal pain and constipation. Regular physical activity reduces the amount of time it takes food to move through the gut.

Exercise also increases heart rate and the contraction of muscles throughout the body, including those in the intestines. When intestinal muscles contract, they help push stool along.

A 2012 study on adolescents from Hong Kong suggests that there is a dose-response relationship between physical activity and constipation, with symptoms improving as a person does more exercise.

Weakened pelvic muscles

The muscles of the pelvic floor support the bowel, as well as the bladder and uterus. Weakened pelvic muscles can make it more difficult for a person to pass stool. They may also experience urinary problems.

Factors that can weaken the pelvic muscles include:

aging

childbirth and pregnancy

obesity

straining due to long-term constipation

Celiac disease

Celiac disease is an immune reaction to eating gluten, a protein that is naturally present in wheat, barley, and rye.

According to the Celiac Disease Foundation, around 1 in 100 people worldwide have this condition. People are more likely to develop celiac disease if a close relative has the condition.

When people with celiac disease eat gluten, it causes damage to the small intestine and can trigger a range of digestive systems and other problems. However, symptoms can vary between people and tend to affect children and adults differently.

Some common symptoms of celiac disease can include:

abdominal pain or cramping

chronic diarrhea

constipation

bloating and gas

nausea and vomiting

weight loss

fatigue

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a chronic condition involving several different digestive symptoms that tend to occur together. IBS is a functional disorder, which means that it does not cause any detectable changes in the cells or tissues of the bowel.

IBS is a common condition, affecting around 10-15% of people worldwide, according to the International Foundation for Gastrointestinal Disorders.

Symptoms of IBS can include:

abdominal pain and cramping

constipation, diarrhea, or both

bloating and gas

a whitish mucus in the stool

Doctors do not fully understand what causes IBS, but stress, hormonal imbalances, and food sensitivities can trigger symptoms in some people.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) is an umbrella term for several chronic gastrointestinal conditions, including Crohn’s disease and ulcerative colitis.

IBD causes inflammation along the digestive tract, which can lead to bowel damage and a wide range of systems that tend to come and go in cycles. People with IBD have an increased risk of colorectal cancer.

According to the Crohn’s and Colitis Foundation, IBD affects around 1.6 million people in the US.

IBD tends to cause recurrent, bloody diarrhea, but it can sometimes also cause constipation. Other common symptoms can include:

abdominal pain and cramping

fatigue

loss of appetite

nausea and vomiting

weight loss

Colorectal cancer

Colorectal cancer is the term that doctors use for cancer of the colon or rectum.

According to the American Cancer Society, the lifetime risk of developing colorectal cancer is approximately 1 in 24 for females and 1 in 22 for males.

Signs and symptoms of colorectal cancer include:

a persistent change in bowel habits, such as constipation or diarrhea

abdominal pain and cramping

blood or mucus in the stool

changes in stool consistency

a sensation of incomplete evacuations after having a bowel movement

weakness and fatigue

unexpected weight loss

Other bowel problems

Many conditions that affect the large intestine have the potential to cause abdominal pain and constipation. These can include:

Anal fissure: A tear in the tissue that lines the anus.

Bowel obstruction: A potentially life-threatening condition that occurs when something blocks the small or large intestine.

Diverticulitis: Inflammation of diverticula (small pouches) that form in the intestinal walls.

Brain or spinal injuries and disorders

The spinal cord and brain control a person’s ability to pass stool. Injuries or conditions that damage the brain and spinal cord can affect this ability.

For example, a person may no longer experience the sensation that lets them know when they need to have a bowel movement, or they may lose voluntary control over defecation.

Damage to the brain and spinal cord can result from:

traumatic injury

multiple sclerosis

Parkinson’s disease

stroke

When to see a doctor

See a doctor if home remedies and lifestyle changes do not relieve constipation and abdominal pain.

People with abdominal pain and constipation should also see a doctor if they have:

a family history of colorectal cancer

an inability to pass gas

blood in the stool or rectal bleeding

fever

lower back pain

persistent fatigue

severe or constant abdominal pain or tenderness

unexplained weight loss

recurrent vomiting

Treatment

Many cases of constipation and abdominal pain will clear up with home remedies or lifestyle changes.

If these do not work, then a doctor can recommend medications for constipation. In severe cases, surgery may be necessary.

We discuss these different treatment options below:

Home remedies and lifestyle changes

A person can relieve or prevent constipation by eating a fiber-rich diet.

The following tips may help to relieve or prevent constipation and other bowel problems:

eating more fiber-rich foods, such as fruits, vegetables, whole grains, and legumes

drinking plenty of water to stay hydrated

exercising regularly

taking probiotic supplements to encourage a healthy balance of bacteria in the gut

not postponing bowel movements once the urge arises

not rushing a bowel movement and making sure all of the stool passes from the body

doing pelvic floor exercises to help bowel movements and prevent incontinence

Medication

Several over-the-counter (OTC) and prescription medicines can help treat constipation. A doctor or pharmacists can advise a person on suitable treatment options.

According to the NIDDK, OTC laxative options include:

fiber supplements, including Citrucel, FiberCon, and Metamucil

stool softeners, such as Colace and Docusate

osmotic agents, such as Milk of Magnesia and Miralax

lubricants, such as mineral oil

stimulant laxatives, such as Correctol and Dulcolax

Prescription medications for constipation include lubiprostone, linaclotide, plecanatide, and prucalopride.

Surgery

A doctor may recommend surgery for a person if their constipation is due to a structural issue, such as a blockage or muscle problems. However, doctors normally reserve surgery for when other treatments have been unsuccessful.

Summary

Constipation is a widesespread condition that often occurs along with abdominal pain. It is rarely a cause for concern and typically results from lifestyle and dietary factors or as a side effect of some medications.

However, constipation can sometimes be a sign of an underlying medical condition. People should talk to a doctor if constipation does not respond to dietary and lifestyle changes or if symptoms are severe, recurrent, or worrisome.

A doctor can investigate the issue, make a diagnosis, and recommend a course of treatment.

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