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Difficulty with the type or frequency of stool passage.

There is a clear-cut difference to be made between the new onset of difficulty with stool evacuation/frequency – this likely warrants urgent investigation (please call for an appointment ASAP) versus long-term issues with constipation.

Constipation is to some extent a subjective sensation of less than desired stool frequency and/or of difficulty with its passage. The subjectivity arises because the normal bowel habit varies from person to person.

For short-term constipation that has occurred as a result of recent travel, change in diet or exercise, it is perfectly reasonable to trial over-the-counter laxatives. Be aware that there is a difference between osmotic laxatives and stimulant or cathartic laxatives. Long-term use of the latter class CAN lead to problems. BUT as a rule of thumb, if this medication needs to be taken for more than two weeks then further thoughtful investigation may be warranted.

Long-term (chronic) constipation can be said to occur if the problems has been going on for at least 3 months. Increased effort to pass stool (straining), passage of hard stools or a sense of incomplete evacuation that occurs 25% or more of the time satisfies diagnostic criteria.

Conditions that increase the likelihood of constipation include hypothyroidism, neurological problems such as Parkinson’s disease, and medications, many of which have GI side-effects. Less commonly, structural or anatomical factors may make a contribution.

As always, a thoughtful history and physical exam by a gastroenterologist go a long way to determine what is going on. Recommendations to change diet, increase exercise and fluid/fiber intake may well follow. Tests may include blood tests, X-ray based stool marker studies and/or colonoscopy. Medications may be necessary.

Based in the heart of uptown and the Garden District of New Orleans, Dr. Huilgol (”Dr. Viv”) and the team at NOLA Gastro is committed to working with you to investigate what is going on, so you can make the correct choices for you.

GI health matters. Let’s work it out together.

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