Constipation

Constipation is more than a missed bowel movement. The clinically useful pattern combines stool frequency, stool form, the effort required to evacuate, and whether the patient feels empty afterward. Chronic constipation is present when at least two characteristic symptoms occur for at least three of the last six months; one isolated day without a bowel movement does not establish the diagnosis. The first nursing decision is not which laxative to give. It is whether the presentation is uncomplicated constipation or a possible obstruction, perforation, severe colitis, or fecal impaction. Abdominal distension, vomiting, peritoneal signs, or complete absence of stool and flatus changes the priority to urgent assessment and referral rather than routine bowel medication. When dangerous causes are excluded, the treatment sequence makes physiological sense: correct contributing factors, support stool water and transit, then escalate medication if the response is inadequate. The patient's medication list, hydration status, mobility, toileting position, and bowel pattern all help explain why constipation developed and which intervention is safest.