Constipation refers to the condition characterized by infrequent bowel movements, often resulting in hard, dry stool. It typically involves passing stool fewer than three times a week. Various factors such as dietary habits, medication usage, pregnancy, or alterations in routine can contribute to its occurrence.

Constipation stands as a prevalent digestive issue within the United States, affecting approximately 16 out of 100 adults. This statistic notably increases for individuals aged 60 and above. To gain insight into the symptoms, causes, and treatment options for constipation, continue reading.

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Symptoms | Causes | Relief and treatment | Prevention | Diagnosis | Takeaway

Constipation Symptoms

Individual bowel habits vary; some individuals may have bowel movements three times a day, while others may have them three times a week. However, constipation may be indicated by the following symptoms:

  • Having fewer than three bowel movements a week
  • Passing lumpy, hard, or dry stools
  • Experiencing straining or pain during bowel movements
  • Feeling of fullness, even after having a bowel movement

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) advises seeking medical advice if symptoms persist or if you observe the following:

  • Bleeding from the rectum
  • Presence of blood in the stool
  • Persistent abdominal pain
  • Lower back pain
  • Sensation of trapped gas
  • Vomiting
  • Fever
  • Unexplained weight loss
  • Sudden change in bowel movements

Healthcare professionals may conduct tests to rule out more serious conditions like colorectal cancer or irritable bowel syndrome (IBS).

Constipation Causes

The colon’s primary function is to absorb water from food remnants as they traverse the digestive system, ultimately forming waste, or stool. Subsequently, the colon’s muscles propel this waste out through the rectum for elimination. However, if stool remains in the colon for an extended period, it can solidify, making it challenging to pass.

Constipation is frequently triggered by poor dietary habits. Adequate intake of dietary fiber and water is crucial to maintain soft stools.

Fiber-rich foods, typically of plant origin, are essential for promoting bowel regularity. Fiber exists in soluble and insoluble forms. Soluble fiber dissolves in water, forming a soft, gel-like substance as it traverses the digestive tract. On the other hand, insoluble fiber largely maintains its structure throughout digestion. Both types of fiber combine with stool, augmenting its bulk and softening it, facilitating easier passage through the rectum.

Additionally, factors such as stress, changes in routine, and conditions that impede muscle contractions in the colon or delay the urge to defecate can contribute to constipation.

Common causes of constipation encompass:

  • Low-fiber diets, particularly those high in meat, dairy, or cheese
  • Dehydration
  • Inadequate physical activity
  • Ignoring the urge to defecate
  • Travel or alterations in routine
  • Certain medications, including specific antacids, pain relievers, diuretics, and some treatments for Parkinson’s disease
  • Pregnancy
  • Advanced age (approximately one-third of individuals aged 60 and above experience constipation)

Underlying health conditions may also precipitate constipation, including:

  • Certain medical conditions such as stroke, Parkinson’s disease, and diabetes
  • Colon or rectal issues, such as intestinal obstruction, irritable bowel syndrome (IBS), or diverticulosis
  • Excessive or improper use of laxatives
  • Hormonal imbalances, such as an underactive thyroid gland

Relief and treatment

Implementing dietary changes and increasing physical activity levels represent the quickest and simplest approaches to address and prevent constipation. Consider the following techniques:

  • Ensure daily consumption of 1.5 to 2 quarts of unsweetened fluids, such as water, to maintain hydration.
  • Limit intake of alcohol and caffeinated beverages, as they can lead to dehydration.
  • Incorporate fiber-rich foods into your diet, including raw fruits and vegetables, whole grains, beans, prunes, or bran cereal. Aim for a daily fiber intake between 20 and 35 grams.
  • Reduce consumption of low-fiber foods like meat, dairy, cheese, and processed foods.
  • Strive for approximately 150 minutes of moderate exercise per week, with a goal of at least 30 minutes per day, five times a week. Activities such as walking, swimming, or biking are beneficial.
  • Respond promptly to the urge to have a bowel movement, as delaying can lead to harder stools.
  • Consult your doctor about bowel training, which involves establishing a routine for passing stool within 15 to 45 minutes after breakfast each day.
  • Elevate your knees by placing your feet on a footstool during bowel movements.
  • Allocate ample time for bathroom use and endeavor to relax your muscles while there.
  • Use laxatives sparingly, as excessive use can lead to dependence. If necessary, healthcare professionals may prescribe laxatives or enemas for a short duration to soften stools. Avoid prolonged laxative use without medical guidance.
  • Consult a healthcare professional regarding any medications that may contribute to constipation.

Over-the-counter Medications

If home remedies prove ineffective, healthcare professionals may recommend over-the-counter laxatives, including:

  • Fiber supplements
  • Osmotic agents like Milk of Magnesia
  • Stool softeners
  • Lubricants such as mineral oil
  • Stimulants

Prescription Drugs

For persistent constipation, healthcare professionals may prescribe medications such as:

  • Lubiprostone, which increases fluid levels in the intestine
  • Linaclotide or plecanatide, beneficial for promoting regular bowel movements in individuals with long-term constipation or irritable bowel syndrome (IBS)
  • Prucalopride, which facilitates stool movement in the colon

Healthcare professionals may also suggest discontinuing certain medications known to cause constipation.

Other Options

Additional strategies that may provide relief include:

  • Biofeedback therapy to assist in muscle retraining
  • Enema administration
  • Manual fecal removal procedures for relief
  • Surgical intervention for blockage removal
  • Long-term management for chronic conditions like IBS

How to prevent constipation

While occasional constipation is common and usually not cause for concern, taking proactive steps to prevent it can help maintain regular bowel movements and promote overall digestive health. Here are some strategies to help prevent constipation:

  1. Maintain a High-Fiber Diet: Consuming an adequate amount of dietary fiber is crucial for preventing constipation. Aim to include plenty of fiber-rich foods in your diet, such as fruits, vegetables, whole grains, legumes, nuts, and seeds. Gradually increase your fiber intake to allow your digestive system to adjust.
  2. Stay Hydrated: Drinking plenty of fluids, particularly water, is essential for maintaining proper hydration and softening stool. Aim to drink at least eight glasses of water per day, and limit the intake of caffeinated and alcoholic beverages, which can contribute to dehydration and worsen constipation.
  3. Exercise Regularly: Engaging in regular physical activity helps stimulate bowel movements by promoting the natural contractions of the intestines. Aim for at least 30 minutes of moderate-intensity exercise most days of the week, such as walking, cycling, swimming, or yoga.
  4. Establish a Regular Bathroom Routine: Try to establish a consistent schedule for bowel movements by setting aside time each day for bathroom breaks. Pay attention to your body’s natural cues and avoid ignoring the urge to have a bowel movement.
  5. Practice Good Toilet Habits: When using the toilet, try to relax and allow enough time for a complete bowel movement. Avoid straining or holding your breath, as this can increase pressure in the abdomen and make constipation worse. Use a footstool or squatting position to help align the rectum for easier elimination.
  6. Limit Processed Foods and Refined Sugars: Foods high in refined sugars and processed carbohydrates can contribute to constipation by slowing down digestion and reducing stool bulk. Limit your intake of sugary snacks, sodas, white bread, and other processed foods.
  7. Manage Stress: Chronic stress can affect digestion and contribute to constipation. Practice stress-reduction techniques such as deep breathing, meditation, yoga, or mindfulness to promote relaxation and improve overall well-being.
  8. Don’t Ignore the Urge to Defecate: Pay attention to your body’s signals and respond promptly when you feel the urge to have a bowel movement. Ignoring the urge can disrupt the natural rhythm of bowel function and lead to constipation.
  9. Consider Probiotics: Probiotics are beneficial bacteria that can help regulate digestive function and promote gut health. Consider adding probiotic-rich foods such as yogurt, kefir, kimchi, or sauerkraut to your diet, or take a probiotic supplement as directed.
  10. Talk to Your Doctor: If you have recurring or persistent constipation despite making lifestyle changes, consult with your healthcare provider. They can help identify any underlying causes or medical conditions that may be contributing to your symptoms and recommend appropriate treatment options.

By incorporating these preventive measures into your daily routine, you can help reduce the risk of constipation and maintain optimal digestive health. Remember that consistency is key, and it may take time to see the full benefits of these lifestyle changes.

How is constipation diagnosed?

If constipation persists or raises concerns, seeking medical attention is advisable. A healthcare professional typically follows these steps for diagnosis:

  1. Medical History and Symptom Assessment: The healthcare professional will inquire about your symptoms, medical history, medications, and any underlying conditions contributing to your constipation.
  2. Physical Examination: A physical examination, including a rectal exam, may be conducted to assess for any abnormalities.
  3. Blood Tests: Blood tests may be ordered to evaluate your blood count, electrolyte levels, and thyroid function, which can provide insights into potential underlying causes of constipation.

Additional Tests:

Depending on the clinical evaluation, the healthcare professional may recommend further diagnostic tests to pinpoint the cause of your symptoms. These tests may include:

  1. Marker Study (Colorectal Transit Study): This test assesses the movement of food through your colon. You’ll ingest a pill containing tiny markers visible on X-rays. Abdominal X-rays will be taken over several days to monitor how well food moves through your colon and the function of intestinal muscles. Dietary modifications, such as a high-fiber diet, may be incorporated during the test.
  2. Anorectal Manometry: This test evaluates the function of the anal sphincter muscles. A thin tube with a balloon tip is inserted into the anus, and the balloon is inflated and gradually withdrawn to measure anal sphincter muscle strength and contraction.
  3. Barium Enema X-ray: In this test, a special liquid is ingested to cleanse the bowel. Then, a lubricated tube is used to introduce a dye (barium) into the rectum. Barium highlights the rectum and colon on X-rays, enabling visualization of any abnormalities.
  4. Colonoscopy: This procedure involves the examination of the colon using a colonoscope—a tube equipped with a camera and light source. Sedation and pain medication are often administered to ensure comfort during the procedure. Prior to the colonoscopy, you may be instructed to follow a liquid-only diet for 1 to 3 days and undergo bowel cleansing using laxatives or enemas.

These diagnostic tests help healthcare professionals identify the underlying causes of constipation and tailor appropriate treatment strategies accordingly.


Constipation is a common digestive issue that can affect people of all ages and lifestyles. Recognizing the symptoms, understanding the potential causes, and knowing how to prevent and manage constipation are essential for maintaining optimal digestive health. Here are some key takeaways:

  1. Know the Symptoms: Be aware of common symptoms of constipation, including infrequent bowel movements, difficulty passing stool, abdominal discomfort, and changes in bowel habits. Recognizing these symptoms early can help prompt appropriate action.
  2. Identify Causes: Understand the various factors that can contribute to constipation, such as a low-fiber diet, inadequate fluid intake, lack of physical activity, medications, changes in routine, and underlying medical conditions. Addressing underlying causes is essential for effective management.
  3. Seek Relief: Explore lifestyle modifications, dietary changes, and over-the-counter remedies to alleviate constipation symptoms. Increasing fiber intake, staying hydrated, exercising regularly, and establishing a regular bathroom routine can all help promote regular bowel movements.
  4. Consult a Healthcare Professional: If constipation persists or is accompanied by other concerning symptoms, consult with a healthcare provider for proper evaluation and treatment. They can help identify any underlying medical conditions, recommend appropriate therapies, and provide personalized guidance.
  5. Prevention is Key: Take proactive steps to prevent constipation by maintaining a high-fiber diet, staying hydrated, exercising regularly, managing stress, and practicing good toilet habits. Consistency in preventive measures can help reduce the risk of constipation and promote long-term digestive health.

By staying informed, proactive, and attentive to your body’s signals, you can effectively manage constipation and enjoy improved overall well-being. If you have any concerns or questions about constipation or digestive health, don’t hesitate to reach out to a healthcare professional for guidance and support.

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Symptoms | Causes | Relief and treatment | Prevention | Diagnosis | Takeaway

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