constipation self care basics

Overview

Constipation is when you have infrequent bowel movements, difficulty passing stool, or both. Your stool may be hard, dry, or lumpy, and you may feel like you cannot fully empty your bowels. It is a common problem that is usually temporary and not a sign of a serious illness.

Yes, constipation is very common. It is one of the most frequent digestive complaints and affects millions of people worldwide. In the UK, it is estimated that around 1 in 7 adults and up to 1 in 3 children experience it at some point.

Constipation can affect anyone at any age, but it is more common in older adults, especially those over 65, and in people who are not physically active. It also occurs frequently during pregnancy, after surgery, or while taking certain medications. Children, particularly during toilet training, and people with some long-term conditions can also be affected.

Symptoms

Common symptoms

• Having fewer than three bowel movements a week
• Stools that are hard, dry, or lumpy
• Straining or pain when passing stool
• Feeling as though not all stool has passed
• A blocked feeling in the rectum or abdomen
• Needing to press on your belly to help pass stool

Symptoms in children

• Fewer than two bowel movements a week
• Hard, dry, or large poo that is painful to pass
• Tummy aches and cramps
• Avoiding the toilet or hiding to poo
• Soiling underwear with loose poo (leakage)

Symptoms in older adults

• The same symptoms as in adults, plus:
• Reduced appetite or feeling full quickly
• Confusion or agitation (especially in people with dementia)
• Not mentioning constipation even when present
• Soiling due to faecal impaction

Causes

Main causes

• Not eating enough fibre from fruits, vegetables, and whole grains
• Drinking too little fluid, especially water
• Lack of physical activity or being bed-bound
• Ignoring the urge to have a bowel movement
• Changes in routine, such as travel or a different toilet environment
• Pregnancy and hormonal changes
• Ageing, which can slow the digestive system
• Certain medicines, such as some painkillers, antacids, and antidepressants
• Irritable bowel syndrome (IBS) or other digestive conditions

Risk factors

• Being over the age of 65
• Being female, especially during and after pregnancy
• Dehydration or low fluid intake
• A low-fibre diet high in processed foods
• Physical inactivity or long periods of bed rest
• Taking medications that can slow the bowels
• Stress, anxiety, or depression
• Having a long-term condition such as diabetes or underactive thyroid

When to see a doctor

See a doctor urgently if:

• If you have constipation with severe abdominal pain, vomiting, or fever
• If you are passing blood from your rectum or have black, tarry stools
• If you are unable to pass gas or stool and your abdomen is swollen
• If you have a hernia and develop constipation with pain

Book a routine appointment if:

• If your bowel habits have changed and lasted more than three weeks
• If constipation is not relieved by self-care measures
• If you regularly need to use laxatives
• If you have unintentional weight loss or loss of appetite
• If you have a family history of bowel cancer and are worried about changes

Diagnosis

A doctor will ask about your symptoms, how long you have had them, your medical history, and any medicines you take. They may gently feel your abdomen and, in some cases, perform a quick examination of your back passage (rectum). No special tests are needed for most people.

Tests that may be done

• Blood tests to check for thyroid, calcium, or other health conditions
• A digital rectal examination to feel for any blockage or abnormalities
• A stool sample to look for infection or blood
• A referral for a colonoscopy or imaging scan if more serious conditions need to be ruled out

What to expect at your appointment

The doctor may ask you to keep a diary of your food, drinks, and bowel habits for a couple of weeks. They might also suggest trying simple diet changes first. If needed, they will refer you to a specialist, such as a gastroenterologist or a dietitian, for further assessment and support.

Treatment

Treatment for constipation usually begins with self-care: drinking more fluids, eating more fibre, and getting regular physical activity. If these steps do not help, a doctor or pharmacist can discuss laxatives or other treatments with you. Always speak to a healthcare professional before taking any medicine.

Self-care at home

• Increase your water intake gradually throughout the day — aim for 6 to 8 glasses unless your doctor says otherwise
• Add fibre to your diet slowly to avoid bloating — include fruits, vegetables, oats, beans, and whole grains
• Exercise regularly, such as walking or swimming, to help stimulate your bowels
• Set a regular time each day, like after meals, to sit on the toilet without rushing
• Do not ignore the urge to have a bowel movement
• Try gentle abdominal massage or use a footstool to raise your knees when on the toilet
• Reduce stress with deep breathing or relaxation exercises

Medical treatments

If self-care is not enough, your doctor or pharmacist may suggest a laxative or stool softener. These work in different ways — some draw water into the bowel, some soften the stool, and some gently stimulate the bowel. Always use them under guidance and do not take a laxative for longer than recommended without medical advice.

When is surgery considered?

Surgery is very rarely needed for constipation. It is only considered if a specific condition like a structural blockage or severe anal problem is causing the issue, and only after all other treatments have been tried. In those rare cases, a specialist will discuss the options thoroughly with you.

Living with this condition

Try to keep a daily routine: eat at regular times, drink plenty of fluid, and set aside a quiet moment to use the toilet after breakfast or a meal. Do not rush or strain. If you feel the urge, go as soon as you can. Keeping a small diary can help you notice what helps and what does not.

Lifestyle tips

• Stay physically active each day — even a brisk walk helps
• Build fibre into every meal gradually
• Drink water throughout the day, not just when thirsty
• Maintain a healthy weight to reduce pressure on your pelvic floor
• Manage stress with mindfulness, meditation, or talking to someone you trust

Diet and exercise

Aim for about 30 grams of fibre a day in the UK. Good sources include wholemeal bread, oats, brown rice, pulses (such as beans and lentils), and fruit with the skin on. Slowly increase fibre to avoid bloating. Combine this with at least 150 minutes of moderate exercise per week, such as brisk walking or cycling, to help keep your bowels moving.

Mental health and emotional wellbeing

Constipation can feel embarrassing and frustrating. It may lead to anxiety, poor body image, or low mood, and stress can actually make symptoms worse. Remember that constipation is a very common medical issue, not a personal failure. If it is affecting your mental health, consider speaking to your GP or a mental health support service. There is no shame in asking for help.

Prevention

You can often prevent constipation with the same habits that treat it: drink enough fluids, eat a high-fibre diet, stay active, and create a regular toilet routine. It is not always preventable, especially if it is linked to medicines or a medical condition, but the risk can be much lower with a healthy lifestyle.

Vaccines

There is no vaccine to prevent constipation. If you are eligible for other vaccines, like the flu or COVID-19 vaccine, keeping up to date can help you stay generally healthy, which may indirectly reduce your risk of digestive disruptions.

Screening programmes

There is no routine national screening only for constipation. In the UK, the NHS offers bowel cancer screening tests to certain age groups. This screening is designed to detect hidden blood in stool, not constipation itself, but it is a helpful way to catch problems early. Always take up screening invitations if you receive them.

Complications

If left untreated

• Prolonged straining can cause haemorrhoids (swollen veins around the anus)
• Anal fissures (small tears in the skin of the anus) can form, making poo painful
• Faecal impaction, where hard stool becomes stuck in the bowel and is very hard to pass
• A blocked or obstructed bowel, which is a serious emergency
• Overflow soiling, where liquid poo leaks around the hard stool

Long-term outlook

The outlook is very good. Most people with constipation get better with simple changes and do not need any medical treatment. Even if symptoms last a few weeks, they usually resolve with patience and consistency. If you need more help, a healthcare professional can guide you and provide support that works for your situation. You can feel hopeful — recovery is very achievable.

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