Constipation: Causes, Symptoms, Treatment & Prevention

What Is Constipation?

Constipation generally means that bowel movements are less frequent than usual and/or that stools (poo) are hard, dry or difficult to pass. Many health organizations consider having fewer than three bowel movements per week, together with straining or hard stools, as constipation. However, what is “normal” can vary from person to person.

Constipation can be:

• Short term (acute) – lasting days to a few weeks, often linked to changes in diet, travel, illness or medication.
• Long term (chronic) – lasting for several weeks or more, sometimes due to underlying health problems or ongoing habits.

Common Symptoms of Constipation

People with constipation may notice one or more of the following:

• Fewer bowel movements than usual (often < 3 times per week).
• Hard, dry, lumpy stools that are difficult or painful to pass.
• Straining or needing to push hard when using the toilet.
• A feeling that you have not completely emptied your bowels.
• Bloating, “fullness”, or discomfort in the abdomen.
• Mild cramps or stomach ache.
• Needing extra time or special positions to pass stools.

Constipation can also contribute to problems like piles (haemorrhoids), small tears around the anus (anal fissures), or, in severe cases, faecal impaction, where a large, hard mass of stool becomes stuck in the rectum and requires medical treatment.

What Causes Constipation?

In many cases, constipation happens when stool moves too slowly through the large intestine, allowing too much water to be absorbed so the stool becomes dry and hard. Common reasons include:

Functional or chronic constipation

Some people have long-term constipation without a clear structural disease. This can be called functional constipation or chronic idiopathic constipation. It may be related to the way the intestines or pelvic floor muscles work, to stress, or to long-standing habits. Specialist assessment is often needed in these cases.

When Should You See a Doctor?

Mild, short-term constipation is common and often improves with self-care. However, you should talk to a doctor or other health professional as soon as possible if:

• Constipation lasts more than a few weeks or keeps coming back.
• There is blood in or on your stool, or your stool looks black and tarry.
• You have unexplained weight loss, fever, or feel very tired.
• You have severe or persistent abdominal pain or vomiting.
• You are older than about 50 and notice a new change in bowel habits.
• You have a family history of bowel cancer or inflammatory bowel disease.
• You are taking medicines that may cause constipation and symptoms are troublesome.

How Is Constipation Diagnosed?

Your doctor will usually start by asking about your symptoms, general health, diet, activity level and medicines. They may:

• Ask how often you have bowel movements and what your stools look like.
• Perform a physical examination, which can include a gentle rectal exam.
• Arrange blood tests to check for problems such as thyroid or metabolic issues.
• Order imaging tests (for example, an X-ray or colonoscopy) if they suspect something more serious.

In people with long-term or complex constipation, specialist tests may check how quickly food moves through the gut or how the pelvic floor muscles work during a bowel movement.

Self-Care: Lifestyle Changes That Can Help

For many people, simple daily habits can ease constipation and help prevent it from returning. Changes usually take a few days to a few weeks to show full effect.

1. Eat more fibre – slowly

Fibre adds bulk and softness to stools, helping them move more easily through the bowel. Aim for a variety of high-fibre foods:

• Fruit: apples, pears, berries, plums, prunes, kiwi.
• Vegetables: carrots, broccoli, peas, leafy greens.
• Whole grains: oats, wholemeal bread, brown rice, whole-grain pasta, bran cereals.
• Beans, lentils, chickpeas and other pulses.
• Nuts and seeds (if you tolerate them well).

2. Drink enough fluids

Water helps keep stools soft. Most adults do well with around 6–8 glasses (about 1.5–2 litres) of fluid per day, more in hot weather or if you are very active. Water, herbal teas and soups are good choices. Limit alcohol and very sugary drinks, which can have the opposite effect.

3. Move your body

Physical activity stimulates the natural movement of the intestines. Even simple habits can make a difference:

• Walk for 20–30 minutes most days of the week.
• Take the stairs instead of the lift when you can.
• Do gentle stretching or yoga, especially for the core and hips.

4. Create a bowel routine

Try to give yourself unhurried time to use the toilet every day, ideally at the same time. Many people find that the urge is strongest after breakfast:

• Go as soon as you feel the urge; do not hold it in.
• Sit with your feet on a small stool so your knees are slightly higher than your hips.
• Lean forward slightly with your elbows on your knees and relax your belly.
• Avoid excessive straining – breathe slowly and give yourself time.

5. Review your medicines

If you suspect a prescribed or over-the-counter medicine is contributing to constipation, do not stop it on your own. Talk to your doctor or pharmacist about options. They may adjust the dose or suggest an alternative.

Medicines for Constipation

If lifestyle measures are not enough, your doctor or pharmacist may recommend laxatives. These are medicines that help you have bowel movements more easily. Types include:

• Bulk-forming agents (e.g., fibre supplements) – help stools hold more water and become softer. Best used with plenty of fluids.
• Osmotic laxatives – draw water into the bowel to soften stool and make it easier to pass.
• Stool softeners – make stools less hard and dry.
• Stimulant laxatives – encourage the bowel muscles to contract.
• Suppositories or enemas – used in some cases to treat more severe constipation or faecal impaction.

Some newer medicines act on the lining of the gut to increase fluid and movement and are usually prescribed for chronic constipation when other treatments have not helped.

Laxatives can be very helpful, but they should be used at the lowest effective dose for the shortest time that keeps you comfortable. Always follow the instructions on the package and any advice from your health professional.

Constipation in Special Situations

Pregnancy

Constipation is common in pregnancy due to hormonal changes, pressure from the growing uterus and iron supplements. Eating more fibre, drinking enough fluid and staying active are usually safe first steps. Some laxatives are considered safe in pregnancy, but always check with your midwife, doctor or pharmacist before taking any medicine.

Children and older adults

Children and older adults are particularly prone to constipation. In older people, reduced mobility, low fluid intake and multiple medicines often play a role. In children, painful stools can lead to fear of using the toilet and “holding on”, which makes things worse. In both cases, early advice from a health professional is important.

Quick Checklist to Help Prevent Constipation

Small, consistent changes are often more effective than extreme short-term fixes. If your symptoms don’t improve despite your best efforts, or if anything about your bowel habit worries you, it’s always worth talking to a qualified health professional.