In common constipation, the stool is hard, difficult, and painful to pass. Usually, there is an infrequent urge to void. Straining to pass stool may cause hemorrhoids. In later stages of constipation, the abdomen may become distended and diffusely tender and cramp, occasionally with enhanced bowel sounds.
The definition of constipation includes the following:
- infrequent bowel movements (typically three times or fewer per week)
- difficulty during defecation (straining during more than 25% of bowel movements or a subjective sensation of hard stools), or
- the sensation of incomplete bowel evacuation.
Severe cases ("fecal impaction") may feature symptoms of bowel obstruction (vomiting, very tender abdomen) and "paradoxical diarrhea", where soft stool from the small intestine bypasses the impacted matter in the colon.
Further Reading
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