Constipation

Overview

Constipation means having fewer than three bowel movements a week, or passing stools that are hard, dry, difficult, or painful. It is a common digestive problem that often gets better with simple lifestyle changes.

Yes, constipation is very common. It affects about 1 in 5 people in the UK at some point, and it is more common in older adults and during pregnancy.

Constipation can affect people of all ages, but it is more common in women, older adults, and those who are less active. It can also occur in children and young adults.

Symptoms

Common symptoms

• Having fewer than three bowel movements in a week
• Stools that are hard, dry, or lumpy
• Straining or pain when passing stool
• Feeling like you haven't emptied your bowels completely
• Bloating or discomfort in your belly

Symptoms in children

• Having fewer than two bowel movements a week
• Stools that are large, hard, or dry – sometimes like small pebbles
• Pain when passing stool, leading to withholding or crying
• Soiling (leaking liquid stool) because of a backed-up bowel

Symptoms in older adults

• Fewer bowel movements than usual
• Straining or needing to push very hard
• Feeling bloated or having abdominal pain
• Loss of appetite or feeling full quickly
• Sometimes confusion or feeling unwell if there is a severe blockage

Causes

Main causes

• Not eating enough fiber (found in fruits, vegetables, whole grains, and beans)
• Not drinking enough fluids – especially water
• Lack of physical activity
• Ignoring the urge to pass stool
• Changes in routine – like travel, stress, or being in hospital
• Certain medications (for example, painkillers, antacids, or antidepressants)

Risk factors

• Age – being over 65
• Female gender – especially during pregnancy or after childbirth
• Low fiber diet and low fluid intake
• Being less active or having a sedentary lifestyle
• Mental health conditions like depression or anxiety
• Neurological conditions such as Parkinson’s disease or multiple sclerosis

When to see a doctor

See a doctor urgently if:

• You have severe abdominal pain that does not improve
• You are vomiting and have a bloated belly and cannot pass gas or stool
• You see blood in your stool (bright red or dark tarry)
• You have unexplained weight loss or a sudden change in bowel habits lasting more than a few weeks

Book a routine appointment if:

• Your constipation has lasted more than three weeks despite trying simple remedies
• You have pain when passing stool that is getting worse
• You need to use laxatives regularly (more than once a week)
• You have a family history of bowel cancer or inflammatory bowel disease

Diagnosis

A healthcare provider will usually diagnose constipation by asking about your symptoms, diet, and medical history. They may also do a physical exam, which can include checking your abdomen and a rectal examination.

Tests that may be done

• Blood tests to check for anemia, thyroid problems, or other conditions
• Abdominal X-ray or CT scan if a blockage is suspected
• A colonoscopy (a camera test to look inside the colon) if you have warning signs or a family history of colon cancer

What to expect at your appointment

The doctor will ask you about how often you have bowel movements, the consistency of your stools, and any other symptoms like pain or bloating. They may also ask about your diet, fluid intake, exercise, and any medicines you are taking. Most people do not need any special tests – simple changes often help.

Treatment

Treatment for constipation usually starts with lifestyle changes – increasing fiber and fluids, and getting more exercise. If those do not help, a doctor may recommend over-the-counter or prescription treatments to soften stools or make them easier to pass. For long-term constipation, a care plan tailored to your needs can be very effective.

Self-care at home

• Drink 6 to 8 glasses of water or other fluids each day
• Eat more fiber-rich foods – such as wholemeal bread, oats, fruits, vegetables, beans, and lentils
• Try to be physically active most days – even a 20-minute walk can help
• Respond to the urge to pass stool – do not hold it in
• Sit properly on the toilet – knees higher than hips, lean forward, and relax

Medical treatments

If lifestyle changes are not enough, a doctor may suggest gentle laxatives. These are medicines that help stools pass more easily. They come in different types: bulk-forming (which adds fiber to stool), stool softeners, osmotic laxatives (which draw water into the bowel), and stimulant laxatives (which trigger bowel contractions). Your doctor will recommend the type best suited for you. Always follow the dosage instructions and do not use laxatives for longer than recommended without medical advice.

When is surgery considered?

Surgery for constipation is very rare. It may be considered only for severe, long-term constipation that does not respond to any other treatment, and when the problem is caused by a specific physical issue such as a narrowing (stricture) of the bowel or a problem with the muscles that control bowel movements. Your healthcare team would discuss all other options first.

Living with this condition

Living with constipation often means making small adjustments to your daily routine. Many people find that a regular meal schedule, drinking enough water, and being active helps keep things moving. It is also helpful to give yourself time to go to the bathroom without rushing, especially after meals.

Lifestyle tips

• Eat meals at regular times each day
• Include plenty of high-fiber foods in your diet
• Drink water throughout the day – keep a bottle with you
• Move your body – activities like walking, swimming, or yoga can help
• Set aside a quiet time for the toilet – for example, after breakfast

Diet and exercise

A diet rich in fiber is key. Aim for 30 grams of fiber each day from foods like wholemeal bread, brown rice, oats, fruits (especially pears, apples, and berries), vegetables, beans, and lentils. Also drink plenty of water, as fiber needs fluid to work well. Regular moderate exercise – such as walking for 30 minutes most days – helps stimulate bowel activity.

Mental health and emotional wellbeing

Constipation can be frustrating and sometimes embarrassing, which may lead to stress or anxiety. Stress itself can also make constipation worse. It is important to be kind to yourself and remember that this is a common health issue. If you feel anxious about it, talk to your doctor or a counselor. Managing stress through relaxation techniques or talking therapies can also help your digestion.

Prevention

In many cases, yes. Eating a high-fiber diet, drinking enough fluids, being physically active, not ignoring the urge to go to the toilet, and managing stress can all help prevent constipation. If you take medications that cause constipation, ask your doctor if there are alternatives or ways to manage this side effect.

Screening programmes

There is no specific screening test for constipation. However, routine bowel cancer screening (e.g., the NHS faecal immunochemical test every two years for people aged 60 to 74) is important for everyone, as it can detect problems early.

Complications

If left untreated

• Hemorrhoids (swollen veins in the back passage) from straining
• Anal fissures (small tears in the skin around the anus) – these can be painful and bleed
• Fecal impaction (a large, hard lump of stool that gets stuck) – this may need special treatment
• Rectal prolapse (when part of the rectum comes out of the anus) – more common in older adults

Long-term outlook

The outlook for constipation is generally very good. Most people improve with simple lifestyle changes and, if needed, short-term use of laxatives. Even long-term constipation can be managed effectively with a combination of diet, exercise, and medical guidance. Serious complications are rare, especially with early attention. With the right support, you can keep your bowel habits healthy and comfortable.

Find support

International organisations

• International Foundation for Gastrointestinal Disorders (IFFGD) ↗

Local organisations

• Guts UK (UK charity for digestive health) ↗ · United Kingdom
• NHS – Constipation ↗ · United Kingdom

Helplines

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