Common Causes Of Constipation

Overview

Constipation is when you have bowel movements less often than usual, or your stool is hard, dry, and difficult to pass. It is a symptom, not a disease on its own. Many things can cause it, and most people can improve it with simple changes. This article explains common causes and when to get help. For advice about your own symptoms, speak with a qualified healthcare provider.

Yes. Constipation is one of the most common digestive complaints. Almost everyone has it at some point.

It can affect anyone, including children. It is more common in women, pregnant people, older adults, and people who take certain medicines or have limited mobility.

Symptoms

Common symptoms

• Having fewer than three bowel movements a week
• Hard, dry, or lumpy stool
• Straining or pushing hard to pass stool
• Feeling that you have not fully emptied your bowel
• Bloating, wind, or belly discomfort
• Needing extra time or help to pass stool

Symptoms in children

• Fewer bowel movements than usual for your child
• Hard or painful stools
• Holding in stool or crossing legs to avoid going
• Belly pain or reduced appetite
• Soiling or leaking stool, which can happen when stool builds up

Symptoms in older adults

• Constipation linked to medicines, low fluid intake, or less movement
• Hard stools that are difficult to pass
• Bloating or belly discomfort
• Confusion or worsening wellbeing in frail older adults, which needs medical advice

Causes

Main causes

• Not enough fibre in the diet
• Not drinking enough fluids
• Low physical activity
• Ignoring the urge to go to the toilet
• Changes in routine, such as travel or shift work
• Stress or emotional strain
• Pregnancy
• Some medicines, including certain pain medicines, antidepressants, and iron supplements
• Health conditions such as irritable bowel syndrome, diabetes, or an underactive thyroid
• Problems with the muscles or nerves of the bowel
• Bowel blockage, which is uncommon but serious

Risk factors

• Low-fibre diet
• Dehydration
• Little exercise or limited mobility
• Taking medicines that cause constipation
• Pregnancy
• Older age
• Being female
• Depression or eating disorders
• Recent surgery or hospital stay
• Travel or changes in daily routine

When to see a doctor

See a doctor urgently if:

• Blood in your stool or black, tarry stool
• Severe belly pain or a swollen, hard belly
• Vomiting with inability to pass stool or gas
• Fever with belly pain
• Unexplained weight loss
• New constipation that is severe or sudden, especially in an older adult

Book a routine appointment if:

• Constipation lasting more than a few weeks
• Constipation that keeps coming back or affects daily life
• Needing constipation medicines often
• Alternating constipation and diarrhoea
• Constipation with rectal bleeding, pain, or lumps around the back passage
• A family history of bowel cancer or other bowel disease, if you are worried

Diagnosis

A healthcare provider usually diagnoses constipation by asking about your bowel habits, diet, fluids, activity, medicines, and health history. They may also examine your belly and, sometimes, your back passage. Tests are not usually needed unless there are warning signs or the problem continues.

Tests that may be done

• Blood tests to check for conditions such as thyroid problems or low iron
• Stool tests if there is bleeding or infection is suspected
• A rectal exam to check for hardness, blockage, or bleeding
• Colonoscopy or sigmoidoscopy, tests that look inside the bowel with a small camera, if there are warning signs
• Imaging, such as an X-ray or scan, in selected cases

What to expect at your appointment

Your provider will likely start with simple questions and advice. They may ask you to keep a bowel diary or try lifestyle changes before suggesting tests. If tests are needed, your provider will explain why and what to expect.

Treatment

Treatment starts with lifestyle and routine changes. If those are not enough, a healthcare provider or pharmacist can suggest other options. The goal is to make bowel movements softer and easier to pass, and to find any underlying cause.

Self-care at home

• Eat more fibre from fruit, vegetables, whole grains, beans, and lentils, adding it slowly so your body adjusts
• Drink enough fluids, especially water
• Stay active with regular walking or other movement you can manage
• Go to the toilet when you feel the urge, and do not ignore it
• Set a regular toilet time, such as after breakfast
• Use a footstool so your knees are higher than your hips when sitting on the toilet
• Manage stress with relaxation, breathing, or gentle activity
• Ask your pharmacist before using any over-the-counter constipation product

Medical treatments

If lifestyle changes are not enough, a healthcare provider or pharmacist may suggest treatments that soften stool or help the bowel move. They will consider your age, health, other medicines, and the likely cause. Always follow their advice and do not use constipation products for a long time without checking first.

When is surgery considered?

Surgery is rarely needed for ordinary constipation. It may be considered only if a structural problem, such as a bowel blockage, is found and other treatments have not helped. Your specialist team would discuss this carefully with you.

Living with this condition

Constipation can be frustrating and uncomfortable, but it is usually manageable. Keep a simple record of what you eat, drink, and when you go to the toilet. This can help you and your provider see patterns. Be patient, because bowel habits can take time to change.

Lifestyle tips

• Keep a regular daily routine, including meals and toilet time
• Make time to sit on the toilet without rushing
• Avoid sitting for long periods; move around regularly
• Limit highly processed foods if they seem to make symptoms worse
• Get enough sleep and manage stress where possible
• Review medicines with your pharmacist or doctor if you think they are contributing

Diet and exercise

A balanced diet with plenty of fibre and fluids helps most people. Add fibre gradually to avoid bloating. Regular movement, such as walking, gardening, or gentle exercise, helps the bowel work normally. Drink more fluids in hot weather or when you are more active.

Mental health and emotional wellbeing

Constipation can cause embarrassment, worry, and frustration, and it can affect your mood and daily life. These feelings are common and worth talking about. If you feel overwhelmed or have thoughts of harming yourself, contact your local crisis service or emergency number right away.

Prevention

Many cases can be prevented or reduced by eating enough fibre, drinking enough fluids, staying active, and not ignoring the urge to go to the toilet. A regular routine also helps.

Vaccines

Not applicable. There is no vaccine for constipation.

Screening programmes

There is no routine screening test for constipation itself. Bowel cancer screening is offered to eligible adults in many countries according to local guidelines. Ask your local health service if you are unsure about screening.

Complications

If left untreated

• Haemorrhoids (piles), which are swollen veins around the back passage
• An anal fissure, a small tear that can cause pain and bleeding
• Faecal impaction, a hard mass of stool that cannot pass
• Bowel obstruction, a rare but serious blockage
• Urinary problems or pelvic discomfort
• Reduced quality of life and distress

Long-term outlook

The outlook is usually very good. Most people improve with simple changes and, if needed, advice from a healthcare provider. Even persistent constipation can often be managed once the cause is found. Seek help if symptoms are severe or do not settle.

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