7 Constipation Danger Signs To Watch For (Doctor Explains)

Hello Everyone. 

Constipation is So Common; Especially In females and the Elderly. 

My problem with Constipation as a doctor is that it may lead to potentially serious complications (particularly in the older age groups). 

In this article, you will learn how constipation can cause such complications and what signs to watch for (especially if you have an elderly loved one with severe constipation).

What damage can constipation do to your body?

A. Life-threatening complications (but fortunately, less common).

• Stool Impaction: it is a complication of prolonged severe constipation. The stool forms a hard impossible-to-pass mass in the last part of the colon or the rectum.
• Intestinal perforation (often due to neglected stool impaction).

B. Other significant complications of constipation:

• Anal fissures.
• Piles (hemorrhoids).
• Stool incontinence.
• Rectal prolapse.
• Rectal ulcers.

Today, we will discuss the danger signs and symptoms of constipation that may indicate the development of one of the abovementioned complications.

1. Severe Abdominal pain.

Typically, constipation causes no to mild abdominal pain. In most people, uncomplicated constipation causes mild abdominal discomfort, pain, or bloating. Others don’t feel any pain at all.

Severe abdominal pain in a patient with severe or prolonged constipation is considered a dangerous sign of constipation.

Severe abdominal pain can be due to:

• Fecal impaction.
• Intestinal obstruction.
• Constipation-induced intestinal perforation (peritonitis).

Severe intolerable abdominal pain and/or tenderness due to fecal impaction is often associated with a persistent urge to poop with an inability to pass the hard poop.

Vomiting and passage of liquid poop from the impacted mass can also occur.

Learn more about Fecal impaction in this in-depth article.

2. Persistent Urge to pass stool.

A persistent urge to pass stool while unable to do so is often a sign of fecal impaction.

The impacted stool mass settles in the sigmoid colon or rectum, becomes stony-hard, and is impossible to pass.

The persistence of the urge to poop in patients with severe constipation should always raise the suspicion of stool impaction.

Stool impaction is a dangerous constipation complication as it may lead to:

• Complete intestinal obstruction with persistent vomiting and severe abdominal distension.
• The large mass can cause damage to the rectal or sigmoid colon wall up to a perforation.
• If perforation occurs, the stool matter spreads into the abdominal cavity causing life-threatening sepsis or septic shock.

3. Leakage of liquid stools (false diarrhea).

In patients with stool impaction due to constipation, the stool behind the hard fecal mass becomes semi-liquid due to the high motility of the colon in a trial to push the impacted feces.

As a result, the semi-liquid stool may pass from around the impacted mass and cause false diarrhea.

Patients with fecal impaction typically experience a persistent urge to poop with only small semi-liquid stool coming out.

4. Persistent nausea or vomiting.

As we explained above, severe neglected constipation may lead to fecal impaction. Prolonged untreated, impacted stool may progress to full intestinal obstruction.

Persistent nausea or vomiting can indicate an intestinal obstruction in patients with severe constipation especially if they are associated with other signs of obstruction such as prolonged constipation, inability to pass flatus, abdominal pain, and severe abdominal distension.

5. Progressive severe abdominal distension.

Constipation is often associated with mild to moderate bloating and distension of the abdomen. However, this mild bloating is not associated with significant abdominal pain, vomiting, or nausea.

However, abdominal distension can be a dangerous sign of constipation when it becomes:

• Very noticeable (severe distension).
• Rapidly progressive over hours of a few days.
• Associated with severe nausea or vomiting.
• Associated with severe abdominal pain.

The progressive severe abdominal distension may indicate an intestinal obstruction in such a case.

6. Passage of blood in the stool.

Blood in the stool in patients with severe constipation can occur due to a variety of causes, such as:

• Development of a new anal fissure or recurrence of an old one.
• Development of new piles or bleeding from an existing pile due to severe constipation.
• Rarely, bleeding can be due to rectal ulcers or intestinal perforation.

Constipation causes the development and/or bleeding from anal fissures and piles.

The bleeding from an anal fissure is often reddish, scanty on the outside of the stool, and is often associated with severe pain during defecation.

On the other hand, bleeding piles cause significant blood loss, and the blood can pass alone or with the stool.

7. Signs of sepsis/septic shock.

Septic shock or sepsis can occur as a severe complication of constipation. It is commonly caused by intestinal obstruction and/or intestinal perforation.

The dangerous signs of septic shock due to constipation include:

• Dizziness, lightheadedness.
• Rapid breathing (shortness of breath).
• Fever.
• Fast Heartbeats.
• Low blood pressure.
• Cool, clammy skin.
• Bluish tinge of fingers and lips.
• Extreme weakness, inability to stand or walk.
• In extreme cases, confusion or coma occurs.
• Sepsis is often due to peritonitis. So, patients often have symptoms of peritonitis, including severe abdominal pain, tenderness, and vomiting.

FAQs

Who is at higher risk of constipation complications?

• Being an elderly female.
• Reduced physical activity.
• Bed-ridden, debilitated elderly.
• Neurological diseases: Parkinson’s disease, spinal cord injuries, multiple sclerosis, and others.
• Regular use of medications such as non-steroidal anti-inflammatory drugs and some anti-hypertensives.

What can happen if you’re constipated for too long?

Many people can become constipated and unable to pass stool for too long (for several days or more than a week).

Being constipated for too long may rarely cause complications such as fecal impaction or intestinal obstruction. However, call your doctor if you cannot poop for several days or a week.

Watch out for constipation danger signs if you are constipated for too long. These danger signs include severe abdominal pain, persistent vomiting, urge to poop or fever.

At which point should I be concerned about constipation?

You may become constipated for several days or even more than a week. Call your doctor if you cannot poop for more than a week or have severe abdominal pain, persistent vomiting, persistent urge to poop(but nothing comes out), severe abdominal distension, or fever.

What does a blocked bowel (Intestinal Obstruction or Stool Impaction) feel like?

A blocked bowel can be a complication of severe constipation and stool impaction.

The symptoms of a blocked bowel include:

• Inability to pass stool (absolute constipation).
• Inability to pass flatus.
• Severe unusual abdominal distension.
• Severe abdominal pain.
• Persistent vomiting.
• The vomiting may contain fecal material.