Constipation in Young Adults & Teenagers

Low fiber intake, chronic dehydration, and lack of activity are common causes of constipation. Increased fiber intake, hydration, and exercise are usually effective in treatment of constipation in young adults and teenagers alike. Occasionally, a laxative may need to be used for a very short term to deal with the symptoms.

Constipation in this age group can also be the result of more serious underlying disease processes, poor bowel habits, and pelvic dyssynergia. An evaluation by a specialist is recommended when constipation lasts for longer than two weeks or is associated with the following:

1. Pain with Bowel movements
2. Rectal Bleeding
3. Prolapsing tissue or hemorrhoids
4. Weight Loss or lack of appetite
5. Abdominal Pain or Swelling

In these settings, it is important to evaluate for potential worrisome disorders such as Crohns disease, Intussusception, Paradoxical Puborectalis Contraction, Presacral Mass, and many others. Also, it is important to evaluate and treat anal fissures, hemorrhoids and other benign disorders that can result from and contribute to the worsening constipation. Evaluation of abdominal pain in young men suffering from constipation is fairly staring forward. However, evaluation of lower abdominal pain and treatment of constipation in teenage girls and young women is more complicated. This is due to the potential of pelvic organs causing and masking some of these symptoms. In our practice, we use on-site abdominal ultrasound to help diagnose and treat these issues quickly and effectively.

When left untreated, constipation can progress to cause anal pain, rectal pain, anorectal spasms, hemorrhoids, pelvic or rectal prolapse, and anal fissures. While many medications provide short term symptomatic relief, they don’t treat the underlying disorder. When the cause of the constipation is not addressed, the symptoms tend to worsen over time requiring stronger medications. This is particularly true if there is a family history of these issues.

As most Primary Care Physicians and GI Specialists are limited in the time and resources they can afford for management of this problem, much of an Office Proctology practice involves treatment of its long-term sequelae. These include bleeding hemorrhoids, persistent painful hemorrhoids, anorectal spasms, rectoceles, rectal prolapses, fecal impaction and fecal incontinence.

Intervention at the earliest stages of the process is ideal. Thankfully, adolescents have not usually become dependent on medications to control their symptom. This gives us a much greater change to treat them successfully so they have long term relief without experiencing anorectal sequelae of constipation or requiring ever-increasing doses of medications to control their symptoms.

After treating any acute processes such as bleeding, pain, hemorrhoids or fissures, a thorough evaluation in the office allows us to understand the pathophysiology in the individual. Many patients see significant improvement with dietary changes, behavioral modification, biomechanical retraining, and guided exercises. The response is augmented by optimizing the selective use of supplements and medications that are most effective for them during significant exacerbations. Surgery is rarely indicated or needed.

As with everything we treat, when managing constipation in young adults, our experienced doctors empower our patients by educating them on the underlying cause of their symptoms. We partner with our patients to minimize their reliance on medications, avoid future anorectal disorders, and improve their quality of life.