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What causes pelvic pain and constipation?

My wife is 44 and she's almost always constipated. We used to think it was because her diet is low fiber, but in the last 6 months she also developed serious pelvic pain. What do these symptoms indicate? Are they connected?
Constipation is a very common medical problem, and serious constipation can definitely cause pelvic and abdominal pain. It does this because the feces that are not passed begin to accumulate and to stretch out the large intestine, causing pain. So it is possible that the new onset of pain is just the effect of worsening constipation that needs to be more aggressively treated. Most cases of constipation cannot be managed just with fiber and often require other laxative or stimulant medications. It is also important to determine if the constipation is a new symptom. For example, if your wife was never constipated prior to this last year, then it is more likely that a hormone imbalance, like hypothyroidism, is causing the new symptoms and this is less likely if it is a life long complaint. Regardless, your wife should get a thorough medical examination by her primary care doctor and likely some blood work to rule out other causes of constipation. In addition to hypothyroidism, long standing lactose intolerance can cause constipation. Also, celiac disease (an intolerance to the gluten protein in wheat and similar grains) can also cause constipation. Finally, irritable bowel syndrome, characterized by pain, cramping and either constipation or diarrhea is often brought out in times of stress.
This answer is for general informational purposes only and is not a substitute for professional medical advice.
If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under ZocDoc’s Terms of Service.

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