University of Utah Health Care gastroenterology specialists provide comprehensive diagnosis and treatment of conditions caused by constant constipation and irritable bowel syndrome. The most important factor in treating patients with constant constipation and IBS is accurately diagnosing the cause of the disorder. For our patients, we provide the latest in diagnostic testing, and our team approach brings together physicians from multiple disciplines who work together to create individualized treatment plans for our patients.

Treatments

  • Dietary modifications
  • Medications 
Articles

Constipation

What is constipation?

Constipation is when your stools are painful or they do not happen often enough. It is the most common GI (gastrointestinal) problem.

You have constipation if:

  • You have bowel movements less than 3 times a week
  • Your stool is hard, dry, and in small pieces

Normal bowel movements vary depending on the person. They may happen as often as 3 times a day. Or they may happen just 3 times a week.

What causes constipation?

Your stool gets hard and dry when your colon (large intestine) takes in (absorbs) too much water.

In most cases, as food moves through your colon, the colon absorbs water while it makes stool. Muscle movements (contractions) push the stool toward your rectum. When the stool gets to the rectum, most of the water has been soaked up. The stool is now solid.

If you have constipation, your colon's muscle movements are too slow. This makes the stool move through your colon too slowly. The colon absorbs too much water. The stool gets very hard and dry.

Some of the most common diet and lifestyle causes of constipation are:

  • Not getting enough exercise
  • Not drinking enough liquids
  • Not eating enough fiber
  • Not taking a bowel movement when you need to
  • Changes in your lifestyle, such as travel, pregnancy, and old age

Other causes of constipation include:

  • Medicines
  • A problem with how your stomach and bowels work (irritable bowel syndrome)
  • Your intestine does not work well
  • Taking too many medicines that help to loosen your bowels (laxatives)

What are the symptoms of constipation?

Each person’s symptoms may vary. Symptoms of constipation may include:

  • Difficult and painful bowel movements
  • Less than 3 bowel movements a week
  • Feeling swollen (bloated)
  • Not having much energy
  • Stomach (abdominal) pain

The symptoms of constipation can look like other health problems. Always talk to your health care provider to be sure.

How is constipation diagnosed?

Most people have constipation at one time or another. To see if you have constipation, your health care provider will do several tests. These tests will depend on how long you have had symptoms and how serious your case is.

First your health care provider will look at:

  • Your age
  • If you have any blood in your stool
  • Any changes in your bowel habits
  • Weight loss

Your health care provider will likely:

  • Ask about your past health. You will be asked to give details about your constipation. This will include how long you have had symptoms, how often you have bowel movements, and any other information that may be helpful.
  • Give you a physical exam.
  • Do a digital rectal exam. For this, your health care provider will gently put a gloved, greased (lubricated) finger into your rectum. Using his or her finger, your health care provider will check the muscle that closes off the anus. This exam helps tell if the area is soft, blocked, or bloody. It can also check how much and what kind of stool you have. Your health care provider will also see if your rectum is bigger than normal.

Your health care provider may also do other tests such as:

  • Abdominal X-ray.
  • Lower GI series (also called barium enema). This is an X-ray exam of your rectum, the large intestine, and the lower part of your small intestine. You will be given a fluid called barium. Barium coats the organs, so that they can be seen on an X-ray. The barium is put into a tube and inserted into your rectum as an enema. An X-ray of your belly will show if you have any narrowed areas (strictures), blockages, or other problems.
  • Colonoscopy. This test looks at the full length of your large intestine. It can help check for any abnormal growths, tissue that is red or swollen, sores (ulcers), or bleeding. A long, flexible, lighted tube (colonoscope) is put into your rectum up into the colon. This tube lets your health care provider see the lining of your colon and take out a tissue sample (biopsy) to test it. He or she can also treat some problems that may be found.
  • Sigmoidoscopy. This test lets your health care provider check the inside of part of your large intestine. It helps to tell what is causing constipation. A short, flexible, lighted tube (sigmoidoscope) is put into your intestine through the rectum. This tube blows air into your intestine to make it swell. This makes it easier to see inside.
  • Colorectal transit study. This test shows how long it takes for food to move through your colon. You will be asked to swallow pills (capsules) filled with small markers that can be seen on an X-ray. You must also eat a high-fiber diet during the test. X-rays will be taken 3 to 7 days after you have the capsules. The X-rays will show how the capsules moved through your colon.
  • Anus and rectum (anorectal) function tests. These tests can tell if you are constipated because your anus or rectum is not working well.

How is constipation treated?

Your health care provider will come up with a care plan for you based on:

  • Your age, overall health, and past health
  • How serious your case is
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • Your opinion and what you want to do

In most cases, diet and lifestyle changes can help reduce constipation symptoms. They can also stop it from happening. These changes may include:

  • Drinking more water and juice.
  • Getting regular exercise.
  • Giving yourself time to have a bowel movement each day.
  • Eating more fiber. Eating 20 to 35 grams of fiber each day will help your body to make soft, large stool. Foods with a lot of fiber include beans, whole grains, bran cereals, fresh fruits, and vegetables. Eat fewer foods that have little or no fiber. These include ice cream, cheeses, meats, and processed foods.
  • Taking laxatives. Your health care provider may have you take laxatives to help loosen your bowels if diet and lifestyle changes have not worked.
  • Stopping or changing medicine.
  • Doing biofeedback. Biofeedback is a way of using the mind to control a body function. It is used for chronic constipation that is caused by problems with the anus or rectum (anorectal dysfunction). It retrains the muscles that control the release of bowel movements.

Foods

Moderate fiber

High fiber

Bread

Whole wheat bread, granola bread, wheat bran muffins, Nutri-Grain waffles, popcorn

 

Cereal

Bran Flakes, Raisin Bran, Shredded Wheat, Frosted Mini Wheats, oatmeal, Mueslix, granola, oat bran

All-Bran, Bran Buds, Corn Bran, Fiber One, 100% Bran

Vegetables

Beets, broccoli, Brussels sprouts, cabbage, carrots, corn, green beans, green peas, acorn and butternut squash, spinach, potato with skin, avocado

 

Fruits

Apples with peel, dates, papayas, mangoes, nectarines, oranges, pears, kiwis, strawberries, applesauce, raspberries, blackberries, raisins

Cooked prunes, dried figs

Meat substitutes

Peanut butter, nuts

Baked beans, black-eyed peas, garbanzo beans, lima beans, pinto beans, kidney beans, chili with beans, trail mix

What are complications of constipation?

Constipation can cause other health problems such as:

  • Hemorrhoids. Red, swollen veins in the rectum. They happen when you need to keep straining to have a bowel movement.
  • Anal fissures. Tears in the skin around the anus. They happen when hard stool stretches your sphincter muscle. They can cause bleeding in your rectum.
  • Rectal prolapse. This is when a small amount of your intestinal lining pushes out from your anal opening. It is caused by straining to have a bowel movement.
  • Fecal impaction. This is when a large lump of hard, dry stool stays stuck in your rectum. The colon’s normal pushing action can’t push out the stool. This is seen mostly in children and older adults.

Can constipation be prevented?

Many of the same lifestyle changes that help treat constipation may also help to stop it from happening:

  • Have plenty of fiber, water, and liquids each day.
  • Get regular exercise.
  • Allow plenty of time for bowel movements. When you need to have a bowel movement, be sure to do it.
  • Try to have a bowel movement at the same time each day.
  • If another health problem makes you more likely to have constipation, take your health care provider’s advice for treating that problem.

Living with constipation

Follow your health care provider’s advice for treating constipation and stopping it from happening.

When should I call my health care provider?

Most people have constipation at one time or another. But call your health care provider if:

  • Constipation lasts longer than 3 weeks.
  • Constipation pain is stopping you from doing your daily activities.
  • You have symptoms of any of the complications of constipation.

Key points about constipation

  • Constipation is the most common GI (gastrointestinal) complaint.
  • You are constipated when your stools are painful and happen less than 3 times a week.
  • Your stool will be hard, dry, and in small pieces.
  • Your stools get hard and dry when your colon takes in (absorbs) too much water.
  • Constipation symptoms can include stomach cramps and feeling tired.
  • Constipation can cause other health problems such as hemorrhoids (red, swollen veins in the rectum).
  • Making diet and lifestyle changes can reduce constipation symptoms. These changes can also stop constipation from happening.

Next steps

Tips to help you get the most from a visit to your health care provider:
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Articles
Articles

Irritable Bowel Syndrome (IBS)

What is IBS?

Irritable bowel syndrome (IBS) is a disorder that affects your large intestine or colon. It causes:

  • Belly or abdominal cramps
  • Gas
  • Swelling or bloating
  • Changes in your bowel habits, such as diarrhea or constipation

When you have IBS your colon looks normal. But it does not work the way it should.

Health experts have not been able to find an exact physical cause for IBS. It is often thought that stress is one cause. Stress may make IBS symptoms worse.

IBS is a long-term, chronic condition. It can be painful. But it doesn’t cause lasting harm to your intestines. And it doesn’t lead to serious disease such as cancer.

There is no link between IBS and Crohn's disease, ulcerative colitis, or other inflammatory bowel diseases.

What causes IBS?

The exact cause of IBS isn’t known. Some experts think that if you have IBS your colon may be more sensitive than normal. That means it has a strong reaction to things that should not normally affect it.

When you have IBS, your colon muscles begin to move and tighten uncontrollably (spasm) after only mild stimulation or after normal events such as:

  • Eating
  • Swelling or bloating from gas or other material in the colon
  • Some medicines
  • Some foods

Women with IBS seem to have more symptoms during their periods. This could mean that the chemicals (reproductive hormones) released during a woman’s menstrual cycle may increase IBS symptoms.

Some things can make IBS symptoms worse. The 2 things most likely to make your IBS symptoms worse are the foods you eat and having emotional stress.

  • Diet. Eating makes your colon muscles move or contract. This normally gives you an urge to have a bowel movement 30 to 60 minutes after a meal. Having fat in your diet can cause contractions in your colon after a meal. With IBS the urge may come sooner. You will also have cramps or diarrhea.
  • Stress. If you have IBS, stress can make your colon move uncontrollably or spasm. Experts don’t fully understand why. But they believe this happens because the colon is partly controlled by the brain and spinal cord (nervous system). The nervous system controls how your body moves and reacts to things. Going for counseling or therapy and trying to reduce your stress can help to ease IBS symptoms. But this doesn’t mean that IBS is caused by a mental or emotional disorder. IBS is caused in part because of a problem with how the muscles of the colon move.

Who is at risk for IBS?

You are more likely to be at risk for IBS if you:

  • Are young. Most people first get IBS before they are 45 years old.
  • Are a woman. Women get IBS almost twice as much as men.

What are the symptoms of IBS?

Each person’s symptoms may vary. Some of the most common symptoms include:

  • Having belly or abdominal pain
  • Having painful constipation or diarrhea
  • Going back and forth between having constipation and having diarrhea
  • Having mucus in your stool

The symptoms of IBS may look like other health problems. Always see your doctor to be sure.

How is IBS diagnosed?

Your health care provider will look at your past health and give you a physical exam. He or she will also do lab tests to check for infection and for redness and swelling (inflammation).

There are usually no physical signs to tell for sure that you have IBS. There is also no exact test for IBS.

Your health care provider will do lab tests and imaging tests to make sure that you don’t have other diseases. These tests may include the following:

  • Blood tests. These are done to see if you are lacking healthy red blood cells (anemia), have an infection, or have an illness caused by inflammation or irritation.
  • Urinalysis and urine culture.These help to see if you have an infection in any part of your urinary system (urinary tract infection or UTI). This includes your kidneys, the tubes that send urine from the kidneys to the bladder (ureters), your bladder, and the urethra, where urine leaves your body.
  • Stool culture. This test checks for any abnormal bacteria in your digestive tract that may cause diarrhea and other problems. To do this, a small stool sample is taken and sent to a lab.
  • Stool testing for blood (fecal occult blood test). This test checks for hidden (occult) blood in your stool that can only be seen with a microscope. A small amount of stool is put on a special card. This is then tested in your health care provider’s office or sent to a lab. If blood is found, it may mean you have redness and swelling (inflammation) in your GI (gastrointestinal) tract.
  • Upper endoscopy, also called EGD (esophagogastroduodenoscopy). This test looks at  the inside or lining of your food pipe (esophagus), stomach, and the top part of your small intestine (duodenum). This test uses a thin, lighted tube, called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your health care provider can see the inside of these organs. He or she can also take a small tissue sample (biopsy) if needed.
  • Abdominal X-rays. This test makes images of your internal tissues, bones, and organs.
  • Abdominal ultrasound. This test shows your internal organs as they work. It checks how blood is flowing through different blood vessels.
  • Colonoscopy. This test looks at the full length of your large intestine. It can help check for any abnormal growths, red or swollen tissue (inflammation), sores (ulcers), or bleeding. A long, flexible, lighted tube called a colonoscope is put into your rectum up into the colon. This tube lets your health care provider see the lining of your colon and take out a tissue sample (biopsy) to test it. He or she may also be able to treat some problems that may be found.

How is IBS treated?

Your health care provider will create a care plan for you based on:

  • Your age, overall health, and past health
  • How serious your case is
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • What you would like to do

Treatment for IBS may include:

  • Changes in your diet. Eating a proper diet is important if you have IBS. In some cases a high-fiber diet can reduce symptoms. Keep a list of foods that cause you pain, and talk about this with your health care provider.
  • Medicines. Your health care provider may prescribe fiber supplements or have you take something now and then to loosen your stool (a laxative). Other options may include medicines that ease nausea and vomiting (serotonin antagonists), stop muscle spasms (antispasmodic medicines), make you calm (tranquilizers), or help ease symptoms of depression (antidepressants).

Good fiber sources may include:

 

Foods

Moderate fiber

High fiber

Bread

Whole wheat bread, granola bread, wheat bran muffins, Nutri-Grain waffles, popcorn

 

Cereal

Bran Flakes, Raisin Bran, Shredded Wheat, Frosted Mini Wheats, oatmeal, Mueslix, granola, oat bran

All-Bran, Bran Buds, Corn Bran, Fiber One, 100% Bran

Vegetables

Beets, broccoli, Brussels sprouts, cabbage, carrots, corn, green beans, green peas, acorn and butternut squash, spinach, potato with skin, avocado

 

Fruits

Apples with peel, dates, papayas, mangos, nectarines, oranges, pears, kiwis, strawberries, applesauce, raspberries, blackberries, raisins

Cooked prunes, dried figs

Meat substitutes

Peanut butter, nuts

Baked beans, black-eyed peas, garbanzo beans, lima beans, pinto beans, kidney beans, chili with beans, trail mix

What are the complications of IBS?

The diarrhea and constipation that occur with IBS can cause hemorrhoids. If you already have hemorrhoids, they may get worse.

Your quality of life may be affected by IBS, because the symptoms may limit your daily activities.

What can I do to prevent IBS?

Health experts don’t know what causes IBS. They also don’t know how to stop it from happening.

Living with IBS

IBS symptoms can affect your daily activities. It’s important to work with your health care provider to manage the disease. You may need a plan to deal with issues such as diet, work, lifestyle, and emotional or mental health.

When should I call my health care provider?

Call your health care provider right away if your symptoms get worse or if you have new symptoms.

Key points about IBS

  • IBS is a disorder that affects your large intestine or colon.
  • It is a long-term, chronic disorder.
  • The exact cause of IBS is not known.
  • When you have IBS your colon looks normal. But it does not work the way it should.
  • The things most likely to cause IBS are diet and emotional stress.
  • Treatment may include changing your diet and taking medicines.

 

Next steps

Tips to help you get the most from a visit to your health care provider:
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Articles

Keisa M. Lynch, APRN, FNP-C, DNP

Patient Rating:

4.8

4.8 out of 5

Keisa M. Lynch, DNP, APRN, FNP is a family nurse practitioner in the department of Gastroenterology and Hepatology at the University of Utah School of Medicine. Her clinical interests include treatment, diagnosis and continuing care for gastrointestinal diseases and hepatology. Keisa received her Doctor of Nursing Practice (DNP) degree from The U... Read More

Specialties:

Constipation, Diarrhea, Eosinophilic Esophagitis, Esophageal Diseases, Family Nurse Practitioner, Gastroenterology, Gastroesophageal Reflux Disease (GERD), Hepatology, Inflammatory Bowel Disease/Crohn's/Ulcerative Colitis, Irritable Bowel Syndrome, Liver Disease, Women's GI Health, Women's Health

Locations:

Redwood Health Center
Gastroenterology
(801) 213-9797
University Hospital
Gastroenterology, Clinic 3
(801) 213-9797
University Hospital
Kidney and Liver Clinic
(801) 213-9797

Whitney Mentaberry, APRN, NP-C

Patient Rating:

4.6

4.6 out of 5

Whitney J. Mentaberry NP-C, BSN-RN, is a family Nurse Practitioner in the department of Gastroenterology, Hepatology, and Nutrition at the University of Utah School of Medicine. Whitney specializes in the diagnosis and continuing care for gastrointestinal diseases. Whitney received her Master of Science in Nursing degree from Westminster College in... Read More

Specialties:

Barrett's Esophagus, Constipation, Diarrhea, Eosinophilic Esophagitis, Esophageal Diseases, Esophageal Motility Disorders, Fecal Incontinence, GI Motility, Gastroenterology, Gastroesophageal Reflux Disease (GERD), Hepatology, Inflammatory Bowel Disease/Crohn's/Ulcerative Colitis, Irritable Bowel Syndrome, Liver Biopsies, Liver Disease, Women's GI Health

Locations:

Redwood Health Center
Redwood Urgent Care
(801) 213-9797
Redwood Health Center
Gastroenterology
(801) 213-9797
University Hospital
Kidney and Liver Clinic
(801) 213-9797
University Hospital
Gastroenterology, Clinic 3
(801) 213-9797

Talina Skirko, APRN, FNP-C, DNP

Talina R. Skirko, APRN, FNP-C, DNP is a family nurse practitioner in the department of Gastroenterology at the University of Utah School of Medicine. Her clinical interests include treatment, diagnosis and continuing care for gastrointestinal diseases. Her specific interests include general gastroenterology, esophageal diseases, nutrition, and irri... Read More

Specialties:

Constipation, Diarrhea, Esophageal Diseases, Gastroenterology, Gastroesophageal Reflux Disease (GERD), Irritable Bowel Syndrome, Women's GI Health

Locations:

University Hospital
Gastroenterology, Clinic 3
(801) 213-9797

Matthew H. Steenblik, M.D.

Dr. Matthew Steenblik completed his medical degree and Internal Medicine residency training at the University of Utah. He then served as chief medical resident in the Department of Medicine before completing his Gastroenterology fellowship at the University of Utah where he also served as chief fellow. He is currently seeing all types of cases i... Read More

Ashok K. Tuteja, M.P.H., M.D., MRCP(UK)

Patient Rating:

4.2

4.2 out of 5

Ashok K. Tuteja, M.D., M.P.H., M.R.C.P. received his medical degree from Delhi University. He did his internal medicine residency in England where he was awarded Membership in the Royal College of Physicians (M.R.C.P.). He received his Masters in Public Health from Oregon Health Sciences University. He completed his gastroenterology fellowship at... Read More

Specialties:

Constipation, Diarrhea, Endoscopy, Fecal Incontinence, GI Motility, Gastroenterology, Irritable Bowel Syndrome

Locations:

Redwood Health Center
Gastroenterology
(801) 213-9797
University Hospital
Gastroenterology, Clinic 3
(801) 213-9797
Veterans Administration Medical Center (801) 584-1236

Michael J. Walker, M.D.

Dr. Michael Walker received his medical degree from the Chicago Medical School at Rosalind Franklin University of Medicine and Science and completed an Internal Medicine residency at the University of Utah. He then served as chief medical resident in the Department of Medicine. Following this time, he completed his Gastroenterology fellowship at ... Read More

University Hospital
Clinic 3
50 North Medical Drive
Salt Lake City, UT 84132
Map
Appointments
(801) 213-9797
Redwood Health Center 1525 West 2100 South
Salt Lake City UT 84119
Map
Appointments
(801) 213-9797
Redstone Health Center 1743 W. Redstone Center Dr.
Park City, UT 84098
Map
Appointments
(801) 213-9797
South Jordan Health Center 5126 W. Daybreak Parkway
South Jordan, UT 84095
Map
Appointments
(801) 213-9797