Medical News Today: When is constipation an emergency?

Mild constipation is common. Very severe constipation or constipation accompanied by certain warning signs — such as blood in the stool or severe abdominal pain — can constitute a medical emergency.

Intestinal bleeding, appendicitis, a strangulated hernia, and fecal impaction are some examples of these medical emergencies, and constipation is a symptom of each.

Anyone who suspects that a person around them needs urgent aid should contact emergency services right away.

In this article, we look at when constipation may be an emergency, including warning signs and their causes.

Share on Pinterest

Mild constipation is common, and these bouts are not usually a cause for concern. Medication and lifestyle changes can help relieve mild constipation, and symptoms of it include:

The following sections look at some warning signs that can accompany constipation to constitute an emergency.

Dark stool or blood in the stool

Bleeding in the stomach or intestines can lead to dark or tarry stool.

Dark blood in stool indicates bleeding high up in the digestive tract. The blood has had time to travel through the person’s system and lose oxygen, giving it a darker color. Bright-colored blood may indicate bleeding lower in the digestive tract.

Bleeding can occur for a range of reasons, including bowel inflammation, a tear or tissue damage in the intestines, a bleeding ulcer, or a tumor, which may indicate bowel cancer.

Everyday factors can also cause dark stool, such as eating blueberries or licorice or taking iron tablets. However, if a person is bleeding from the rectum or they notice blood in their stool, they should speak to a doctor right away.

People with chronic constipation may strain too much and develop hemorrhoids. These are small pockets of tissue around the rectum and a common site of bleeding in the lower gastrointestinal tract.

Hemorrhoids can cause small amounts of bright red blood to appear in stool.

Minor hemorrhoid bleeding is not a cause for concern, but a large amount of bright red blood in stool constitutes an emergency. It could indicate a damaged area of the intestinal tract that requires swift medical attention.

Severe abdominal pain

Severe abdominal pain and constipation can result from several urgent health issues that may require surgery to correct.

Examples include:

• Appendicitis: This involves the appendix becoming inflamed and sometimes infected. Symptoms include constipation, a lack of appetite, a fever, and severe abdominal pain, usually in the lower right part of the stomach.
• Diverticulitis: This involves small pouches in the intestines — diverticula —becoming infected or inflamed. Some symptoms include nausea, vomiting, fever, and pain that feels worse in the left lower part of the stomach.
• A strangulated hernia: A hernia can become incarcerated, or stuck. If this happens, the area may be painful and feel firm. A hernia can also quickly become strangulated, which means that the bowel is not getting enough blood flow, leading to constipation and intense abdominal pain. It is a medical emergency.

People should not ignore severe abdominal pain, especially when it accompanies constipation. Seek immediate medical treatment when these symptoms occur together.

Vomiting stool or bile

Vomiting stool or bile can indicate a bowel obstruction. The vomit may smell like stool, and it may be dark brown or brown-purple. If a person vomits bile, the vomit may be greenish-yellow.

Vomiting stool is a medical emergency that requires decompression of the stomach. If possible, the doctor will insert a tube through the nose — a nasogastric tube — and use it to suck out the stomach contents.

This procedure will also remove any excess air that causes discomfort and swelling in the bowel.

Fecal impaction

Long term constipation can develop into fecal impaction, which involves hard, dry stool becoming stuck in the rectum and blocking other stool from passing.

A person with fecal impaction may feel the need to have a bowel movement but be unable to push anything out.

Fecal impaction can cause pain and vomiting. People may need emergency treatment or a hospital visit.

Some people have a greater risk of fecal impaction. Certain medications can slow down movement in the intestines, leading to severe constipation and impaction. Dehydration and chronic use of laxatives can also increase these risks.

To treat fecal impaction, a medical professional may need to perform disimpaction. This involves removing the blockage from the rectum, which, in many cases, allows a person to have usual bowel movements again.

Very few bowel movements

Doctors usually define constipation as going to the bathroom fewer than three times a week. Having fewer bowel movements than this may signal a more severe problem.

If a person is eating regularly but not having bowel movements, stool can quickly become backed up.

Sometimes this back-up is due to issues with the intestines, such as scarring or a tumor that is pressing on an area of the bowel, leaving little room, if any, for stool to pass. Doctors call this a bowel obstruction.

Obstructions can affect any part of the intestines, and they constitute medical emergencies. A back-up of stool can cause the intestines to rupture, which can be life-threatening.

Toddlers are often in an in-between stage of learning how to use a toilet instead of a diaper.

This can lead to constipation in toddlers who “withhold” their stool. This means that they do not go to the bathroom when they need to.

A toddler may withhold because:

• They do not want to stop playing.
• They have passed hard stool in the past and are afraid that it will hurt this time.
• They have diaper rash and are afraid that going to the bathroom will hurt.
• They feel uncomfortable or uncertain about using a toilet.

While it can be a regular occurrence among toddlers, withholding stool for too long can lead to encopresis. Also called soiling, encopresis involves a small amount of liquid stool leaking out around the hard stool that the child is holding back.

A caregiver should speak to a doctor if they suspect that a toddler has encopresis, or if they have any other concerns about a child’s bowel movements.

Encouraging the toddler to drink plenty of water and eat foods that contain fiber can lead to more regular bowel movements. If a child has constipation, a doctor may be able to recommend treatment.