When to seek care for constipation

Overview

Constipation is when you have difficulty passing stool (poop) or you go to the toilet less often than usual. Your stool may be hard, dry, or lumpy, and you may feel like you haven't fully emptied your bowels. It's a common problem that usually gets better with simple changes.

Yes, constipation is very common. About 1 in 7 adults and up to 1 in 3 children have it at some point. It affects people of all ages.

Constipation can affect anyone, but it is more common in older adults, pregnant women, people who are not active, and those who eat a low-fiber diet. It also happens often in children, especially around potty training.

Symptoms

Common symptoms

• Fewer than three bowel movements per week
• Hard, dry, or lumpy stool
• Straining or pain when passing stool
• Feeling like you haven't completely emptied your bowels

Symptoms in children

• Pain or crying when pooping
• Bowel movements less than three times a week
• Large, hard, or dry poop that blocks the toilet
• Loss of appetite or stomach ache

Symptoms in older adults

• Hard stool that is difficult to pass
• A feeling of incomplete emptying
• Abdominal bloating or discomfort
• Confusion or agitation if constipation is severe (in those with dementia)

Causes

Main causes

• Not eating enough fiber (like fruits, vegetables, whole grains)
• Not drinking enough fluids
• Lack of physical activity
• Ignoring the urge to go to the toilet
• Changes in routine (like travel or stress)

Risk factors

• Being older (over 65)
• Being female or pregnant
• Taking certain medications (like painkillers, antidepressants, or iron supplements)
• Having certain medical conditions (like diabetes, thyroid problems, or irritable bowel syndrome)
• A family history of constipation

When to see a doctor

See a doctor urgently if:

• Severe abdominal pain or vomiting with constipation
• Bleeding from your rectum or blood in your stool
• Constipation that started suddenly with no obvious cause
• You are unable to pass gas or stool at all

Book a routine appointment if:

• Constipation lasting more than three weeks despite self-care
• Constipation that is very painful or disrupts daily life
• You have a family history of colon cancer
• You notice a change in your normal bowel habits that lasts several weeks

Diagnosis

A healthcare provider will ask about your symptoms, diet, activity level, and medical history. They may perform a gentle physical exam, including checking your abdomen. In most cases, no tests are needed.

Tests that may be done

• Blood tests to check for thyroid problems or other conditions
• Imaging tests (like an X-ray) if there is concern about a blockage
• A colonoscopy (a camera test to look inside the bowel) if you have serious symptoms or are over 50 with new constipation

What to expect at your appointment

The provider will discuss possible causes and recommend lifestyle changes first. If needed, they may suggest over-the-counter treatments or prescribe medication. You will be given a plan and follow-up if symptoms do not improve.

Treatment

Treatment usually starts with simple self-care changes. If these do not help, a healthcare provider may recommend medications or other treatments. Most people get better with first-line approaches.

Self-care at home

• Drink more water (around 8 glasses a day unless your doctor says otherwise)
• Eat more fiber: choose whole grains, fruits, vegetables, beans, and nuts
• Get regular physical activity, like walking for 20–30 minutes a day
• Try to set a regular time each day to use the bathroom, such as after meals
• Do not ignore the urge to go to the toilet
• Consider a warm drink or a small glass of prune juice in the morning

Medical treatments

If self-care is not enough, a healthcare provider may suggest fiber supplements (like psyllium), stool softeners, or osmotic laxatives. These are available over the counter. For chronic or severe constipation, prescription medications may be used. Always follow your provider's advice on what to use and for how long.

When is surgery considered?

Surgery is very rarely needed for constipation. It may be considered if there is a structural problem, like a blockage or a condition called pelvic floor dysfunction that does not respond to other treatments.

Living with this condition

Most people manage constipation easily with diet and lifestyle changes. If it becomes a long-term issue, keep a diary of your bowel habits and what you eat. This can help you and your doctor find the best approach.

Lifestyle tips

• Stay active every day — even a short walk helps
• Drink plenty of fluids throughout the day
• Eat meals at regular times and include fiber-rich foods
• Manage stress with relaxation techniques like deep breathing or yoga

Diet and exercise

Eat plenty of fruits, vegetables, whole grains, and legumes. Drink water with meals and between meals. Avoid too many processed foods and reduce caffeine if it bothers you. Exercise, like walking, swimming, or cycling, helps stimulate bowel movements.

Mental health and emotional wellbeing

Constipation can be uncomfortable and frustrating. It may cause worry or embarrassment. If you feel anxious or stressed about it, talk to your doctor or a counsellor. Managing your emotional health can help improve bowel function too.

Prevention

In many cases, yes. Eating a balanced diet rich in fiber, drinking enough water, staying active, and not ignoring the urge to go to the toilet can help prevent constipation. If you have a medical condition, managing it well may also reduce your risk.

Complications

If left untreated

• Hemorrhoids (swollen veins in the rectum) from straining
• Anal fissures (small tears in the skin around the anus)
• Faecal impaction (hard stool stuck in the bowel, needing manual removal)
• Rectal prolapse (part of the rectum pushes out of the anus)

Long-term outlook

For the vast majority of people, constipation is temporary and clears up with simple measures. Even if it is chronic, treatments are available to help you have comfortable, regular bowel movements. Working with your healthcare provider can keep complications at bay and improve your quality of life.

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