Slipped disc, pinched nerve, poor posture, osteoporosis, old age, obesity, lifting heavy weights, or the dreaded undetected tumor. When your lower back hurts, you’re likely to attribute your pain to one or more of these common causes.

Nobody ever suspects constipation—and why would they? The difficult and infrequent bowel movement can leave you feeling uncomfortably bloated and with a distended tummy. But a dull and aching sensation on your lower back? Don’t discount it, says Carlo M. Cornejo, MD of the Section of Gastroenterology of the top hospital in the Philippines Makati Medical Center (MakatiMed).

“An accumulation of stool in the intestines can manifest as lower back pain. The buildup of stool can put extra pressure on the back muscles, which causes soreness and discomfort,” says the MakatiMed gastroenterologist. “So too can fecal impaction, or dry stool that gets stuck in the column or rectum. This is a complication caused by chronic constipation. It usually happens among older adults.”

Common causes of constipation include inadequate fiber, dehydration, too much alcohol, and a sedentary lifestyle. Dr. Cornejo explains that certain medications such as antihistamines, blood pressure medicines, antidepressants, and diuretics can also cause constipation.

“How often you pass stool varies from person to person. Some do it twice a day, others are fine with a thrice-weekly bowel movement,” Dr. Cornejo points out. “You’ll know you’re constipated if you experience fullness in the stomach, gassiness, straining when you sit on the toilet, and that dull lower backache.”

For the simplest case of constipation, over-the-counter laxatives and stool softeners are always available for a quick fix. But for constipation and backache that persist and recur, it’s a must to visit a doctor as it could be a serious case of fecal impaction and would require additional treatments.

“Doctors will perform a digital rectum examination where they insert a gloved and lubricated finger into the anus to check for stool buildup. In some cases, a CT scan may be required if impaction happens deep into the colon,” shares Dr. Cornejo. “Once fecal impaction is confirmed, they will manually remove the impacted stool using their finger. They may also perform enema and inject fluid into the rectum to loosen dry stool.”

To prevent constipation and fecal impaction, Dr. Cornejo advises adding more fiber-rich foods like leafy green vegetables, oatmeal, beans and legumes, papaya, prunes, and avocado to your meals; keeping hydrated or adding natural laxatives like tea or coffee for some; and working out regularly. “Some even achieve regularity by adding probiotics to their diet and minimizing their alcohol intake. These tips are especially helpful now we’re in the season of drinking and feasting,” the expert adds.

It may also help to follow a regular bowel movement schedule. Dr. Cornejo says the best time to do it is around 20-40 minutes after eating, ideally after breakfast.

“Remember, constipation or lower back pain, especially the chronic type that seems to worsen with time, is not natural, especially if you’ve already taken steps to address them. It’s your body’s way of telling you something,” says Dr. Cornejo. “Don’t tolerate it or mask it with laxatives and pain relievers. See your doctor soonest.”

For more information, please contact MakatiMed On-Call at +632.88888 999, email mmc@makatimed.net.ph, or visit www.makatimed.net.ph. Follow @IamMakatiMed on Facebook and Twitter.