Constipation

Going days without a bowel movement. Straining every time. Feeling like you never fully empty. Constipation is one of the most common reasons people see a gastroenterologist, and it usually gets better once you know what's causing it.

Gastroenterologist Rajiv Sharma, MD, and our registered dietitians treat chronic constipation at Mirage Health in Chandler and Mesa, AZ, serving patients across the East Valley. We look for the cause, not just the next laxative.

What counts as constipation

Doctors usually call it constipation when you have fewer than three bowel movements a week, or when stools are hard, lumpy or hard to pass. It becomes chronic when it lasts three months or longer.

• Fewer than three bowel movements a week
• Hard, dry or lumpy stools
• Straining or pushing for a long time
• Feeling like you can't fully empty
• Needing to press on your belly or change position to go
• Bloating and belly discomfort that ease after a bowel movement

Common causes of chronic constipation

• Low fiber and not enough water, especially in the Arizona heat
• Medications, including opioid pain medicines, iron, some blood pressure medicines, antidepressants and GLP-1 medications such as Ozempic and Mounjaro
• IBS with constipation (IBS-C), often with belly pain and bloating
• Pelvic floor dysfunction, when the muscles that control a bowel movement don't relax the right way
• Slow transit, when stool moves through the colon more slowly than normal
• Thyroid problems, diabetes and other conditions that slow the gut
• Changes in routine, travel, less activity or ignoring the urge to go

When constipation needs a doctor soon

Call us if constipation is new and won't go away, or if home treatment isn't working. See a doctor promptly if you have any of these:

• Blood in your stool or on the toilet paper
• Unexplained weight loss
• New constipation after age 45, or a family history of colon cancer
• Low iron or anemia on bloodwork
• Thin, pencil-like stools that keep happening

Go to the emergency room if your belly is swollen and painful and you can't pass gas or stool, or you're vomiting. These can be signs of a blockage.

How we diagnose the cause

Dr. Sharma starts with your history, medications, diet and a physical exam. Depending on your symptoms, testing may include:

• Bloodwork, including thyroid levels, calcium and a blood count
• A colonoscopy, especially if you're 45 or older or have warning signs
• Anorectal manometry to check how the pelvic floor muscles work
• A colon transit study to see how fast stool moves through your colon
• Breath testing if bloating points to SIBO

Constipation treatment at Mirage Health

Diet and hydration with our dietitians

Our registered dietitians build a fiber and fluid plan you can actually follow, and adjust it if fiber makes you more bloated. Dietitian visits are self-pay.

Medication review

If a medicine is causing constipation, we work with the doctor who prescribed it on changes or ways to manage it.

Prescription treatment

When over-the-counter fiber and laxatives aren't enough, prescription medications can help the bowel move more regularly.

Pelvic floor therapy

If testing shows pelvic floor dysfunction, pelvic floor physical therapy (biofeedback) retrains the muscles. We refer you to a therapist we trust.

Treating related problems

Constipation often comes with hemorrhoids, IBS or SIBO. We treat these together so you don't have to see three different offices.

What your first visit looks like

Bring a list of your medications and supplements, including fiber and laxatives you've tried. Dr. Sharma will ask how often you go, what your stools look like and what you've already tried, then decide which tests make sense.

New patient visits are 30 minutes, so there's time for your questions. New patients are seen within 7 days, and you don't need a referral to book.

Serving Chandler, Mesa and the East Valley

Chandler office: 2201 W Fairview St, Suite 5, Chandler, AZ 85224, near the 101 and Chandler Boulevard.

Mesa office: 1910 S Stapley Dr, Suite 120, Mesa, AZ 85204, near the 60.

Procedures are done at Chandler Endoscopy Center, Pinnacle Surgery Center in Tempe, Oath Mesa Surgery Center and Southwest Endoscopy Center in Gilbert. Patients come to us from Chandler, Mesa, Gilbert, Tempe, Ahwatukee, Sun Lakes, Queen Creek, San Tan Valley and Apache Junction.

Cost and insurance

We accept Medicare, Arizona Medicaid (APEP), Aetna, Blue Cross Blue Shield of Arizona, Cigna, First Health Network, Humana, Oscar, UnitedHealthcare, SCAN Classic, TRICARE for Life and more. We check your coverage before your visit. Paying yourself? Our cash prices are posted online, and we offer CareCredit and Afterpay.

Constipation: questions patients ask

When should I see a doctor for constipation?

See a doctor if constipation lasts more than a few weeks, keeps coming back, or comes with blood, weight loss or severe pain. If you're 45 or older and haven't had a colonoscopy, it's worth checking.

Is it safe to take laxatives every day?

Some laxatives are fine for long-term use and others aren't. A gastroenterologist can tell you which ones fit your situation.

Can constipation cause bloating?

Yes. Stool that sits in the colon produces gas and pressure. Treating the constipation often fixes the bloating too.

Why am I constipated on Ozempic, Wegovy or Mounjaro?

GLP-1 medications slow the whole gut, and most people eat and drink less on them. Water, fiber and a bowel plan help. See our GLP-1 side effects page.

What is pelvic floor dysfunction?

The muscles at the bottom of the pelvis tighten when they should relax during a bowel movement. It's common, and therapy works well.

Do I need a colonoscopy for constipation?

Not always. It's recommended if you're 45 or older and due for screening, or if you have warning signs like bleeding or weight loss.

Can constipation cause hemorrhoids?

Yes. Straining puts pressure on the veins around the anus. Softer stools help hemorrhoids heal.

Do you see patients from across the East Valley?

Yes. Our Chandler and Mesa offices see patients from Gilbert, Tempe, Ahwatukee, Sun Lakes, Queen Creek, San Tan Valley, Apache Junction and the rest of the East Valley. Procedures are done at centers in Chandler, Tempe, Mesa and Gilbert.

Do I need a referral?

No. You can book directly. Some HMO and Medicare Advantage plans require one, so we'll check your plan.

Tired of straining?

Get a plan from a GI specialist. Serving Chandler, Mesa and the East Valley. Book online or call 480-210-3155.