Living with constipation

Overview

Constipation is when poo moves too slowly through your digestive system. It often means you have fewer than three bowel movements a week, and your stools are hard, dry, or difficult to pass. It is a common digestive issue that can usually be managed with lifestyle changes.

Yes, constipation is one of the most common digestive complaints. Many people experience it from time to time.

It can affect anyone, but it is more common in older adults, pregnant women, and people who are less physically active.

Symptoms

Common symptoms

• Having fewer than three bowel movements a week
• Hard, dry, or lumpy stools
• Straining or pain when passing stool
• Feeling that you have not emptied your bowels completely
• Bloating or stomach discomfort

Symptoms in children

• Fewer than three bowel movements a week
• Large, hard, dry stools that are painful to pass
• Avoiding the toilet because it hurts
• Soiling (leaking stool) in underwear because of a blocked bowel

Symptoms in older adults

• More frequent straining when trying to poo
• Hard stools that are difficult to pass
• Feeling of fullness or bloating in the belly
• Loss of appetite or confusion in severe cases

Causes

Main causes

• Eating too little fibre, such as fruits, vegetables, and whole grains
• Not drinking enough fluids
• Lack of physical activity
• Ignoring the urge to go to the toilet
• Certain medicines, including some painkillers, antacids, and antidepressants
• Changes in routine, such as travel, stress, or being ill

Risk factors

• Being female or pregnant
• Being older than 65
• Having a condition like diabetes, an underactive thyroid, or Parkinson's disease
• Taking medications that can cause constipation as a side effect
• Using laxatives too often, which can make your bowel muscles lazy

When to see a doctor

See a doctor urgently if:

• You have blood in your stool or on the toilet paper
• You have severe stomach pain or a swollen belly
• You are vomiting or cannot keep fluids down
• You have unintentional weight loss

Book a routine appointment if:

• Constipation lasts more than three weeks despite changing your diet and lifestyle
• Constipation is affecting your daily life or causing significant discomfort
• You need to use laxatives regularly for more than a few weeks
• You are over 50 and have a change in your normal bowel habits
• You have a family history of bowel cancer or other bowel conditions

Diagnosis

A doctor will ask about your symptoms, medical history, and any medicines you take. They may also gently press on your abdomen and, if needed, perform a rectal examination to check for blockages or weakness in the muscles used for pooing.

Tests that may be done

• Blood tests to check for thyroid problems or other conditions
• An X-ray of your abdomen to look for a blockage
• A colonoscopy, where a thin tube with a camera is used to view your large bowel
• Tests to measure how quickly food moves through your bowel (transit study)

What to expect at your appointment

Most of the time, a diagnosis is based on your symptoms, and tests are not needed. If you do have tests, they are usually quick and painless. A colonoscopy involves some preparation to clear your bowel first, but it is a common procedure done by a specialist.

Treatment

Constipation is usually treated with lifestyle changes first. If these are not enough, your doctor may suggest other treatments, including medicines that help soften stool or encourage the bowel to move. These should only be used under medical advice.

Self-care at home

• Adding more fibre to your diet gradually, such as fruits, vegetables, and whole grains
• Drinking plenty of water and other non-caffeinated fluids
• Doing regular physical activity like walking or swimming
• Setting a regular time each day to sit on the toilet, especially after meals
• Responding promptly when you feel the urge to go
• Using a footstool to raise your feet while sitting on the toilet, which can help with pooing

Medical treatments

Your doctor may recommend laxatives, which are medicines that help you poo. These come in different types, such as ones that soften stool, ones that stimulate the bowel, and ones that add bulk. You should never take laxatives without a doctor’s guidance, and they are not meant for long-term use unless prescribed. Other options include prescription medicines that draw water into the bowel or help the muscles work more effectively. There are also therapies such as biofeedback, which can help you retrain the muscles you use to pass stool.

When is surgery considered?

Surgery is rarely needed for constipation. It may be considered only if a physical blockage or a serious condition is found, or if other treatments have not helped and your symptoms severely affect your quality of life.

Living with this condition

Living with constipation can be frustrating and uncomfortable, but there are many ways to manage it. Starting a routine, listening to your body, and making gradual changes to your diet and activity levels can make a big difference. Be patient with your body, and give treatments time to work.

Lifestyle tips

• Pacing yourself — increase fibre slowly to avoid bloating and gas
• Scheduling bathroom time after meals to train your bowel
• Staying active with daily walks or gentle exercise
• Managing stress with deep breathing, meditation, or hobbies
• Keeping a diary of what you eat and drink to spot triggers

Diet and exercise

Aim to eat a balanced diet rich in fibre, including wholemeal bread, oats, brown rice, fruits, and vegetables. Add fibre gradually to give your gut time to adjust. Drink plenty of water — about six to eight glasses a day helps keep stool soft. Regular exercise, even a brisk 20-minute walk, encourages your bowels to move.

Mental health and emotional wellbeing

Constipation can affect how you feel emotionally, especially if it is long-lasting. You may feel embarrassed, anxious, or low in mood. These feelings are normal. Talking to someone you trust, or to a professional, can help you cope. Remember that constipation is a health issue, not something to be ashamed of.

Prevention

Many cases of constipation can be prevented by eating a healthy high-fibre diet, drinking enough fluids, staying active, and not ignoring the urge to go to the toilet. However, some causes, such as certain medicines or medical conditions, may be harder to prevent.

Screening programmes

There is no routine screening for constipation itself. However, if you are over 50 or have a family history of bowel cancer, your doctor may recommend regular bowel screening tests, such as a stool test or colonoscopy, to check for early signs of problems.

Complications

If left untreated

• Haemorrhoids (swollen veins around the anus) due to straining
• Anal fissures (small tears in the skin around the anus) which can bleed and cause pain
• Faecal impaction, a hard mass of stool that cannot be passed and may require medical treatment
• A blocked bowel (intestinal obstruction) which is a medical emergency

Long-term outlook

It is important to remember that constipation is almost always treatable and often improves with simple lifestyle measures. Even when it is persistent, there are many safe and effective options. With the right support and a step-by-step plan, most people find real relief and can return to a comfortable, regular routine.

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