Constipation is defined by infrequent bowel movements, typically fewer than three times a week, often involving difficulty passing hard, dry, or lumpy stool. This common digestive issue frequently results in abdominal discomfort, including cramping and bloating. While many associate constipation pain with the lower abdomen, it can cause side pain. This side pain is a direct consequence of the large intestine becoming distended with backed-up matter, localizing pressure to the upper sides of the body.
Constipation and the Source of Side Pain
The large intestine, or colon, is not a straight tube but contains several sharp bends where it changes direction. Two of these turns, known as flexures, are common sites for matter and gas to accumulate, causing pain that is felt in the sides of the torso. The splenic flexure is located high in the upper left abdomen, tucked near the spleen and under the diaphragm. This sharp angle can trap gas and stool, leading to a sensation of sharp or cramp-like pain in the upper left side.
Similarly, the hepatic flexure is the corresponding bend in the upper right abdomen, positioned near the liver. When hardened stool or trapped gas collects at this location, it creates pressure against the surrounding structures, resulting in discomfort on the right side. The pain experienced in these areas is essentially a sensation of distension, where the colon wall stretches due to the increased volume of contents inside.
The pain is often exacerbated by trapped gas that commonly accompanies constipation. As stool slows down, bacteria ferment the retained waste, producing excess gas. This gas contributes to stretching and pressure on the flexures, intensifying cramping and side discomfort. Relief frequently occurs after a successful bowel movement or passing gas, indicating the pressure has been reduced.
Differentiating Constipation Pain from Other Causes
While constipation-related side pain is common, it is important to recognize warning signs that suggest a more serious, non-constipation cause. Pain from simple constipation is typically relieved with a bowel movement or the passing of gas and is rarely incapacitating. Severe, sudden, or rapidly worsening abdominal pain that is debilitating requires immediate medical attention.
Certain accompanying symptoms are “red flags” requiring professional evaluation. These include a high fever with chills, persistent vomiting, or blood in the stool (bright red or black and tarry). Pain that radiates into the back, groin, or shoulder, or pain that does not improve within 24 to 48 hours of trying home remedies, should be assessed by a healthcare provider. An inability to pass gas along with abdominal pain can signal a potential bowel obstruction, requiring urgent care.
Strategies for Managing Constipation Pain
Managing the pain caused by constipation involves immediate relief measures combined with long-term lifestyle adjustments. For immediate comfort, applying a warm compress or taking a warm bath can help relax the abdominal muscles and ease cramping sensations. Gentle abdominal massage, performed by tracing the path of the colon, can also help stimulate bowel activity.
Over-the-counter options can soften stool or promote movement. Osmotic laxatives, such as polyethylene glycol, work by drawing water into the intestines to soften the stool, making it easier to pass. For long-term prevention, increasing fluid intake is important, as hydration keeps the stool soft and mobile. Adults should aim for at least 64 ounces of water or other non-caffeinated liquids daily.
Gradually increasing dietary fiber intake (25 to 31 grams per day for adults) is an effective preventative strategy. Fiber-rich foods like prunes, flaxseed, whole grains, and fresh vegetables add bulk to the stool, promoting regular bowel movements. Regular physical activity, such as a brisk walk, stimulates intestinal muscles, helping propel waste through the colon and reducing the likelihood of painful impaction.