In general, it’s also important to actually go (or try to, at least) when your body is telling you to, Dr. Staller says. Your GI tract has a circadian rhythm it likes to follow, which is why you probably feel the urge to go at certain times and not others (and why travel, or anything else that disrupts your routine, can make it harder to go). “Many people neglect their body’s call to defecate, and that can lead to constipation, especially if the call is ignored again and again over time,” Dr. Staller says.
With that said, here’s when to see a doctor for constipation.
You shouldn’t hesitate to seek medical care any time you’re concerned, but doctors say there are certain times when constipation definitely requires a professional’s input. The following are signs you’re dealing with chronic constipation or otherwise severe constipation:
1. You’ve been outside your range of normal for over a week.
“Normal” poop schedules vary by person. For some people it’s going every day, for others it’s every three days, and some are in between, Dr. Bedford says. If you normally go pretty frequently and suddenly haven’t gone for longer than a week, it’s time to call your doctor, says Dr. Staller. This could be a sign of something like fecal impaction, which happens when hardened poop accumulates and gets stuck in your intestines, and which a medical provider may need to remove manually.
2. You’re in pain.
Constipation can cause pain because the poop builds up in your colon and stretches it, Dr. Lee says. That’s not something you should have to live with. Even if you’ve only been backed up for a few days, pain with constipation that won’t go away is definitely a reason to call your doctor, says Dr. Lee. They may be able to recommend something like a laxative that makes it easier to go.
3. There’s blood on your toilet paper.
If you strain to go and notice some blood on your TP, it could be due to a small tear in your anus, known as an anal fissure, or hemorrhoids, which are inflamed veins in or around your anus. It could even just be because you wiped too hard. But in rare cases, seeing blood when you poop could also be a sign of something more serious, like colon cancer. You should check in with your doctor so they can evaluate you and rule out anything serious.
4. There’s a possibility your medication is the cause.
Various drugs can lead to constipation. Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit certain enzymes in your body from producing prostaglandins, which are hormone-like substances that can signal various muscles—including those in your digestive system—to contract, which can help you poop. (Sometimes the release of prostaglandins can make you poop too much, like during your period.) Some blood pressure medications reduce how often the smooth muscles in your intestines contract and move food along. Narcotics can also lead to constipation through a variety of mechanisms, like inhibiting your GI tract’s ability to push food through your system.
Other medications, like allergy drugs, antacids, and iron pills can all back you up, too, according to the Cleveland Clinic. If your constipation kicked off when your new medication regimen did, your doctor may be able to suggest other drug options without this frustrating side effect.
5. You’ve been constipated for weeks and you have no idea why.
Usually, you have some clue as to why you’re constipated. Maybe you haven’t been able to get to the gym much lately, or you’ve been on a serious cheese kick. But if you have no idea what’s going on and changing up your diet and lifestyle choices doesn’t help, it’s time to see your doctor, Ashkan Farhadi, M.D., a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, Calif., tells SELF. It’s possible you may have an underlying condition, like irritable bowel syndrome, he says.
Once you check in with your doctor, they’ll probably order some blood tests and perform exams to try to determine whether there’s a medical reason why you can’t poop. Depending on the results, they’ll advise you on next steps, which could be as simple as making some lifestyle and dietary tweaks, trying laxatives, or trying other medications to speed up how quickly your stool moves. Don’t be embarrassed—this is their job, after all. Sometimes seeing a doctor is just a necessary step towards spending less time worrying about constipation and more time actually enjoying your life.