Patients usually report constipation when there are changes to harder stool consistency, the presence of pellets, straining or feelings of incomplete evacuation, infrequent bowel movements, and a sensation of “want to, but can’t.” As a rule, constipation should be suspected if more than three days pass between bowel movements or if there is difficulty or pain when passing a hardened stool. Constipation is usually a variation of the functioning of colonic muscles, so movement of stools is slower than usual or the muscles contract to hold back stool. It is not a disease and usually can be treated medically.