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Constipation is one of the most common GI complaints, affecting up to 20% of Americans. Chronic constipation — defined as fewer than 3 bowel movements per week with hard, dry stools, straining, or a sensation of incomplete emptying — that persists for 3 months or longer warrants medical evaluation to identify the underlying cause.

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Causes of Chronic Constipation​​

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• IBS-C (constipation-predominant IBS) — the most common functional cause

• Slow transit constipation — reduced colonic motility

• Pelvic floor dysfunction (dyssynergic defecation) — failure of rectal muscles to coordinate

• Hypothyroidism and other metabolic conditions

• Medications: opioids, calcium channel blockers, iron supplements, antidepressants

• Structural causes: rectal prolapse, rectocele, stricture

• Colorectal cancer — any new onset constipation in an adult over 45 should prompt colonoscopy

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Alarm Features Requiring Prompt Evaluation​

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• New onset constipation in a patient over 45

• Constipation accompanied by rectal bleeding

• Unintentional weight loss

• Family history of colorectal cancer or polyps

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Treatment Options

 

Treatment depends on the underlying cause. First-line approaches include dietary fiber increase, adequate fluid intake, and exercise. Osmotic laxatives and stool softeners are commonly used. Prescription medications including linaclotide, plecanatide, lubiprostone, and prucalopride are effective for IBS-C and chronic idiopathic constipation. Biofeedback therapy may be recommended for pelvic floor dysfunction.

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Diagnosing IBS

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IBS is a clinical diagnosis based on the Rome IV criteria. However, our physicians rule out other conditions that can mimic IBS before confirming the diagnosis. Testing may include blood work (CBC, CMP, thyroid, celiac antibodies), stool tests, and hydrogen breath testing for small intestinal bacterial overgrowth (SIBO) — a condition that frequently co-occurs with IBS. Colonoscopy may be recommended in patients over 45 or those with alarm features.​

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Book a Constipation Evaluation in NJ — Call (908) 851-2770 or Schedule Online